Graston Technique in Williamsville, NY

What Instrument Assisted Soft Tissue Mobilization Is

Graston Technique is a form of instrument assisted soft tissue mobilization, often shortened to IASTM. Instead of working only with the hands, the clinician holds a shaped stainless steel instrument and glides it across the skin over a muscle, tendon, ligament or sheet of fascia. A light emollient reduces friction so the tool moves smoothly rather than dragging. The instrument does two jobs at once. It transmits pressure into the tissue in a controlled, repeatable way, and it reads texture, feeding small vibrations back through the steel when the edge passes over an area that is thickened, ropey or restricted. Dr. Niccole Jefferlone is a Certified Graston Technique Provider and uses it as one tool inside a larger plan, not as a treatment that stands on its own.

It helps to know what Graston is not. It is not a spinal adjustment, and it is not a massage. An adjustment is a specific, quick input to a joint, and our chiropractic adjustment page covers those mechanics in detail. Massage is broader, rhythmic work across a whole region, and our massage therapy page explains that service, including the fact that massage appointments at this office do not begin until October 5, 2026. Graston sits between the two. It is targeted, usually a few minutes per area, and aimed at the one strip of tissue the examination flagged. Most of the time we pair it with hands on work, stretching and loading exercise, because the instrument alone rarely finishes the job.

Patients usually arrive at Graston by one of two routes. Some have a stubborn tendon problem that has been grumbling for months, an Achilles, an elbow, a shoulder, a plantar fascia, and the familiar rest and ice cycle has stopped helping. Others have a scar or a healed injury, from surgery, a deep laceration or a badly strained muscle, and the area now feels tight and does not move the way the other side does. In both cases the tissue has changed its texture and its tolerance for load. Graston is one way to introduce a controlled mechanical stimulus to that tissue so it can begin remodeling, and then to rebuild capacity with exercise. Whether it helps you is something we judge by measurement, not by assumption.

The Instruments, and What Happens in the Tissue

The instruments are solid pieces of stainless steel with beveled edges, each shaped for a different part of the body. A large curved tool fits the sweep of a hamstring or a calf. A small one with a narrow scanning edge fits the forearm, the shin or the bottom of the foot. The edges are beveled, not sharp, so the tool presses and shears rather than cuts. Steel is used because it is rigid, easy to disinfect between patients, and it carries vibration well. That last point matters more than it sounds. As the edge passes over normal tissue it feels smooth. Over an area of thickened or disorganized tissue it grates slightly, and that feedback helps guide where the doctor spends time and how much pressure is reasonable.

What the instrument does inside the tissue is more interesting than the old explanation suggests. Pressure and shear load the fibroblasts, the cells that build and maintain collagen. Research suggests mechanical loading of this kind can change how those cells behave, nudging them to lay down and align collagen more like healthy tendon and less like a disorganized patch. The treatment also produces a local circulatory and inflammatory response, which is part of why the skin reddens. A large share of the short term change is probably neurological as well. Stimulating skin and fascial receptors may turn down protective muscle guarding and briefly raise pain tolerance, which is one reason range of motion often improves inside the same visit and why that gain needs exercise to hold.

You will hear Graston described as breaking up scar tissue. That is a useful picture and a poor description of the physics. Mature collagen is strong. A hand held instrument moved by a clinician does not generate the force required to tear it, and if it did, the result would be an injury rather than a treatment. What is more likely happening is a combination of cellular signaling, fluid movement, a temporary change in tissue stiffness and a nervous system response. Honest answer, nobody can tell you with certainty which of those is doing the most work. We say so plainly, because a treatment described honestly is easier to judge. If it is helping you, that should show up in what you can do, not only in what you were told.

Conditions We Treat With Graston Technique in Williamsville

The clearest use is tendinopathy, the modern name for what people still call tendinitis. Tennis elbow and golfer's elbow, Achilles pain, patellar tendon pain under the kneecap, rotator cuff and gluteal tendon problems, and plantar heel pain all belong to this group. These are not simple inflammation. A long standing tendon problem shows disorganized collagen, extra ground substance, and new blood vessels and nerve endings growing into the tendon, which helps explain the pain. Because the problem is one of tissue quality and load tolerance, the work has two halves. Graston supplies a mechanical stimulus, and progressive loading exercise supplies the reason for the tendon to rebuild. Skipping the second half is the most common reason people stall out after a promising start.

The second group is scar tissue and adhesion. After surgery, a deep bruise, a torn muscle or a long stretch in a cast or boot, tissue heals, but it often heals stuck to its neighbors. Layers that should slide on each other stop sliding. The result is a stiff area, a pulling sensation at end range, and sometimes pain some distance away because something else is moving more to compensate. Graston applied along and across the plane of restriction, then followed immediately by movement in that direction, is a reasonable way to work on glide. We wait until a surgical site is fully healed and cleared by the surgeon before working on it, and we start far lighter than most people expect.

The third group is chronic overuse. Forearm and wrist complaints from keyboards, tools and hair shears. Shin and calf pain in runners. Neck and shoulder tightness in people who lift overhead or hold one position for hours. Dr. Jefferlone treats the entire musculoskeletal system, including shoulders, feet and joints, and she is known here for sports injuries, strained and torn muscles, and stubborn migraines and headaches. Our conditions page gives the broader picture on each of those problems, and our symptoms page sorts things by where it hurts. This page stays deliberately narrow. It is about the instrument work itself, who it suits, what happens while you are on the table, and how we decide whether to keep going.

• Tennis elbow, golfer's elbow and other forearm tendon pain
• Achilles and patellar tendon problems
• Plantar heel pain and stubborn foot complaints
• Rotator cuff and other shoulder tendon pain
• Post surgical or post injury scar tissue, once healing is complete
• Repetitive strain from work, tools, keyboards or training
• Muscle strains that healed stiff and never regained full range

What a Graston Session Actually Feels Like

In our Williamsville office a treated area gets a warm up first, usually a few minutes of easy movement or a hot pack, because warm tissue tolerates the work better. The doctor applies a light emollient so the steel can glide. The first pass is a scan, slow and light, mapping where the texture changes. Then pressure increases and the strokes get more specific, angled along the fibers and across them, over the spot the scan found. Each area gets a short bout, often two to five minutes. Longer is not better, and grinding away at a sore tendon for fifteen minutes does more harm than good. Right afterward we move the area, stretch it or load it, so the nervous system has a reason to keep the new range.

Most patients describe the sensation as a firm scrape with a gritty quality over the rough spots, uncomfortable but tolerable, similar to deep massage on a tender area. You should be able to breathe normally and hold a conversation. Sharp pain, burning, or the urge to brace and pull away means the pressure is too high, and saying so is not a complaint, it is useful information. Pressure is adjustable in real time and we use the least that produces a change. Some people feel looser as they get off the table. Others feel a dull ache for a day, then better. Both are common, and neither one predicts how the plan will go over the following several weeks.

A typical course is one or two sessions a week for a few weeks, not an open ended arrangement. We measure progress with things you can check yourself. How far the joint moves before it catches. How many stairs, steps or repetitions before the pain starts. How the area feels the next morning, which for tendons is often the most honest signal there is. If two or three weeks pass with no movement in those numbers, we change the plan rather than repeating it louder. That might mean more emphasis on loading, imaging, a different technique, or a referral out to another provider. Results vary from person to person, and careful measurement is how we tell real progress from wishful thinking.

• A warm up, then a light scanning pass to map the tissue
• Emollient so the instrument glides instead of dragging on skin
• Short treatment bouts, often two to five minutes per area
• Movement, stretching or loading immediately after the instrument work
• Home exercise between visits, which is where most of the change happens
• Progress judged by range, function and next morning soreness
• Usually one or two visits a week for a few weeks, then reassess

Bruising, Redness and Who Should Not Have It

Redness is expected. The treated strip often turns pink or red within a minute or two, and that flush usually fades over a few hours. Small pinpoint bruising, called petechiae, can also appear, and larger bruises are possible in people who bruise easily or who take blood thinning medication. Bruising is not the goal and it is not a measure of a good session. For years it was treated as proof the treatment was working. It is better understood as a side effect of pressure, and a clinician who leaves patients purple is simply pressing too hard. Tell us about medications, bleeding disorders and skin conditions before we start, and tell us if you bruised more than you expected after the last visit.

Aftercare is simple. Move the area through comfortable range the same day, drink normally, and do the exercises you were given. Heat usually feels better than ice the day after treatment, though either is fine if it helps you move. Expect some tenderness for a day or two, similar to the day after a hard workout. Hard training on a freshly treated tendon that same afternoon is a bad idea, so we will tell you what to skip and for how long. If you had a strong reaction, we lighten the pressure next visit rather than pushing on. SpiderTech kinesiology taping is sometimes applied afterward for comfort and feedback between appointments, though the evidence for taping is mixed and we treat it as a small support, not a fix.

Graston is not appropriate for everyone. We avoid treating over open wounds, active infections, unhealed fractures, acute or unexplained swelling, an area with a known blood clot, uncontrolled bleeding disorders, and skin that is fragile, burned or in a flare of a condition like eczema or psoriasis. Cancer in the region under consideration, an active rheumatoid flare and any recent surgical site all need clearance first. Some symptoms mean you need a medical evaluation before any soft tissue treatment at all. Calf pain with swelling, warmth and redness, a limb that is cold, pale or numb, chest pain, fever with severe back pain, loss of bowel or bladder control, or sudden and worsening weakness all belong in an emergency department.

• Redness for a few hours is normal, deep bruising is not the goal
• Tell us about blood thinners, bleeding disorders and skin conditions
• Expect mild soreness for a day or two, like the day after a workout
• We do not treat over open wounds, infections, fractures or known clots
• Recent surgical sites need clearance from your surgeon first
• Swollen, hot, red calf pain or sudden numbness needs urgent medical care

What the Research Actually Shows

Here is the honest version. Instrument assisted soft tissue work has been studied for roughly two decades, and the picture is mixed. A number of small trials and several reviews report short term gains in range of motion and reductions in pain, particularly at the ankle, the hamstrings and the thoracic spine. Other trials show no meaningful difference between the instrument and skilled hands, or between instrument work and a sham treatment. Sample sizes are frequently small, protocols vary from study to study, and blinding a patient to a steel tool scraping their leg is close to impossible. That combination makes firm conclusions difficult, and it should make anyone cautious about strong claims, including claims made by a chiropractic office.

What does that mean for you, sitting in the chair? It means Graston is reasonable to try, not something to build an entire plan around. The strongest evidence in tendon problems is for progressive loading exercise, and that stays the backbone of what we do here. Instrument work earns its place when it makes the loading possible, by improving tolerance and range enough that you can actually perform the exercise well. It also means a fair trial has a limit. If a few weeks of consistent treatment and homework produce no measurable change, the answer is not more sessions of the same thing. We would rather tell you that early than keep booking visits out of habit.

We keep Graston in the toolbox because in practice many patients find they move more comfortably within the same visit, and that window is useful. Chronic tendon and scar problems are stubborn, and a treatment that is low risk, short and adjustable is worth including so long as nobody oversells it. There are no guarantees here, and we do not offer any. Dr. Jefferlone's certification means she trained in the protocols and the safety limits, not that the technique works for everyone. Results vary. Some people respond quickly, some respond slowly, and some do not respond at all, which is true of every treatment in musculoskeletal care. We will tell you which group you appear to be in as the information comes in.

Getting Started at Our Williamsville Office

A first visit starts with history and examination, not with an instrument. We want to know when the problem started, what makes it worse, what you do for work and for sport, what you have already tried, and what you need to get back to. Then we examine. Range of motion, strength testing, palpation, orthopedic tests for the joint involved, and a look at how you move the whole chain, because a painful Achilles often has a hip or an ankle story behind it. Digital x-ray is available on site when the history warrants it, and our spinal x-rays page explains when imaging helps and when it does not. Then we tell you what we found and what we recommend, including when Graston is not the right choice.

Munroe Chiropractic has served Williamsville since 1987 from the office at 6035 Main Street, and the practice has helped more than 40,000 patients. Experience. Quality. Compassion. is the standard we hold ourselves to. In 2026 the practice became part of the Complete Care Chiropractic family, with the same team in the same building. Four doctors treat patients here. Dr. Niccole Jefferlone, the owner and our Certified Graston Technique Provider, Dr. Safeya Muhammad, Dr. Megan Berndt, and Dr. Matt Millanti. Three of the four doctors are women, and if you have a preference about who treats you, say so and we will do our best. We are open Monday to Friday from 8:00am to 7:00pm, closed 1:00pm to 2:00pm for lunch, and Saturday from 8:00am to 2:00pm.

On the payment side we are straightforward. We accept Workers' Compensation, No-Fault for auto accidents, and Medicare. By choice we are out of network for private health insurance, which keeps the treatment plan a clinical decision rather than a coverage decision, and we provide itemized receipts, sometimes called superbills, that you can submit to your own plan. Cash and self pay are welcome, including major credit cards, checks, FSA and HSA. We have deep experience documenting no-fault, workers' compensation and personal injury cases, which matters a great deal when a claim depends on clear records. Call or text and our staff will walk you through what applies to your situation before you commit to anything.

To get started, call or text (716) 632-4476. Tell us where it hurts and how long it has been going on, and we will find you a time that fits your schedule. New patient forms are on our Paperwork page, and filling them out ahead of your visit saves you time in the waiting room. Bring any imaging reports you already have, bring the shoes you train or work in if the problem sits below the knee, and wear clothing that lets us reach the area. We see patients from Williamsville and the neighboring parts of Amherst, Clarence and Buffalo, and plenty of people drive in from across Western New York for this kind of work.

• Call or text (716) 632-4476 to get on the schedule
• New patient forms are available on our Paperwork page
• Monday to Friday 8:00am to 7:00pm, closed 1:00pm to 2:00pm for lunch
• Saturday 8:00am to 2:00pm, six days a week
• 6035 Main Street, Williamsville, NY 14221
• Workers' Compensation, No-Fault and Medicare accepted, plus cash and self pay
• Itemized receipts provided if you carry out of network private insurance