Graston technique is uncomfortable for most people, but it shouldn’t be outright painful. The sensation is often described as a deep, scraping pressure that ranges from mildly irritating to moderately intense, depending on the area being treated and how much tissue damage exists underneath. Some soreness after a session is normal and expected, similar to what you might feel after a deep tissue massage.
What the Treatment Feels Like
During a Graston session, a clinician uses stainless steel instruments to apply firm, repeated strokes across your skin over areas of injured or scarred soft tissue. The instruments have curved edges designed to detect and treat areas where scar tissue, adhesions, or chronic tension have built up. When the tool passes over healthy tissue, you’ll feel pressure but little discomfort. When it hits a problem area, the sensation sharpens noticeably, sometimes described as a gritty or crunchy feeling under the skin.
The actual treatment strokes on a given area typically last only 30 to 60 seconds before the clinician moves on or changes technique. That short duration matters. Even if a particular spot feels intense, it doesn’t last long. Your clinician should be checking in with you throughout the session, and the pressure can be adjusted. If the pain becomes sharp or feels like something is wrong rather than just uncomfortable, that’s a signal to speak up immediately.
Why It Causes Discomfort
The discomfort isn’t a side effect. It’s part of how the treatment works. Graston introduces controlled microtrauma to dysfunctional tissue, which triggers the body’s natural healing response. This increases blood flow to the area, stimulates the cells responsible for building new connective tissue (fibroblasts), and helps remodel disorganized collagen back into a more functional structure. That controlled irritation is what creates the sensation you feel during treatment.
Areas with more scar tissue or chronic tightness tend to be more sensitive. A relatively healthy muscle might barely register the treatment, while a spot with long-standing tendon problems or dense adhesions can feel quite tender. This is also why early sessions often feel more intense than later ones. As the tissue quality improves over multiple treatments, the discomfort typically decreases.
What to Expect After a Session
Post-treatment soreness is common and can last one to two days. The treated area may also show redness or minor bruising, which is a normal response to the increased blood flow and microtrauma. Think of it like the soreness after a hard workout: it’s a sign that something happened in the tissue, not that something went wrong.
Applying ice for about 15 minutes after treatment can help manage the soreness. Your clinician will also likely prescribe specific stretches or exercises to do in the days following treatment. These aren’t optional extras. They help guide the healing tissue into proper alignment and improve the long-term results of the session.
How Many Sessions It Takes
A typical course of Graston treatment runs about eight weeks, with sessions happening one to three times per week for a total of eight or more visits. Some conditions resolve faster, and some take longer. The pattern most people notice is that the first few sessions feel the most uncomfortable, both during and after treatment, while later sessions become progressively easier as the tissue responds.
Clinical studies tracking pain scores over the course of treatment show meaningful reductions. In one study of patients with musculoskeletal pain, average pain scores dropped by roughly half after a course of treatment, from about 51 out of 100 on a standard pain scale down to around 26. Several other studies showed similar patterns, with pain reductions that persisted at three-month and even twelve-month follow-ups.
When Graston May Be More Painful
Certain conditions make Graston treatment riskier or more uncomfortable than it should be. If you’re taking blood-thinning medications, you bruise more easily and the treatment may cause excessive bruising. People with varicose veins, burn scars, acute inflammatory conditions, or rheumatoid arthritis should be treated with extra caution or may need to avoid the technique entirely.
Graston is not appropriate at all for people with open wounds, unhealed fractures, blood clotting disorders like hemophilia, blood clots in the veins, or bone infections. These aren’t just situations where the treatment would hurt more. They’re conditions where the technique could cause real harm.
How Practitioner Skill Affects Pain
The difference between a skilled Graston session and a poorly performed one often comes down to pressure, angle, and knowing when to ease off. Graston Technique certification requires completion of an essential training course before a clinician can even purchase the instruments, and advanced training builds on that with more complex applications. Only licensed professionals like physical therapists, chiropractors, athletic trainers, and occupational therapists are eligible for certification.
That said, “instrument-assisted soft tissue mobilization” is a broader category, and not every practitioner using metal scraping tools has gone through Graston-specific training. If minimizing unnecessary pain matters to you, asking whether your provider is specifically Graston-certified, or what IASTM training they’ve completed, is reasonable. A well-trained clinician will use the least aggressive pressure needed to get a therapeutic response and will adjust based on your feedback throughout the session.