Injured Again? The Scoop on Dry Needling and Graston Technique

Dry Needling Acupuncture
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We’ve all been desperate to shake an injury. But would you subject yourself to “dry needling,” during which tiny needles are threaded in and out of your muscles, for relief? Or the “Graston Technique,” which involves having your kinks worked out — with potentially bruise-inducing metal instruments?

It used to be that if you got injured, there wasn’t much you could do to speed the healing process other than rest. In the last decade or so, however, an increasing number of alternative therapies have gained popularity, and deep tissue massage is just the tip of the iceberg. An estimated 40 percent of Americans have sought out alternative therapies, with treatments such as dry needling, Graston and Active Release Therapy (ART) becoming more and more mainstream. In fact, many athletes are turning to these modalities not just for injury treatment, but for prevention as well.

But just how legit are these less-traditional approaches, and are they worth the time and money? Insurance companies consider most to be “alternative,” meaning payment usually comes out of pocket in the range of $60 to $90 per treatment. In most cases, therapy isn’t going to be limited to one visit, either. And while popular, there isn’t much research-based evidence to support any of these emerging techniques — at least not yet.

If you’re at the end of your injury rope and are considering all your options, make sure you’re an informed consumer first. The last thing you want is to prolong your time on the sidelines due to improper treatment. Read on for the need-to-know on these emerging methods, their efficacy, and their pros and cons.

The Truth About Dry Needling, Graston Technique & ART

1. Dry needling

The treatment is very low risk, Lyon says, and most discomfort will be fleeting.

Also known as Western acupuncture, dry needling involves the insertion of small acupuncture needles into specific trigger points to relieve muscle pain. It can trace its origins back 2,000 years to China and somewhat corresponds with traditional Chinese acupuncture points. Therapists either leave the needles in for up to 15 minutes or “thread” them in and out of the trigger point. The treatment protocol is usually in the range of four to six visits over the course of two to three weeks.

Physical therapist Tracy Lyon, DPT, of Momentum Physical Therapy in Fort Collins, Colorado, uses dry needling to help relieve tight muscles, and encourage the body’s natural healing response by disrupting the tissue and bringing more blood flow to the injured area. “Symptoms might feel worse for a day or two after treatment [before they feel better],” she says, “but some patients can feel almost immediate relief.”

Pros: Dry needling is a relatively non-invasive procedure that is readily available in a growing number of practitioner offices. The treatment is very low risk, Lyon says, and most discomfort will be fleeting. “It also doesn’t require much time, so patients can find relief quickly.”

Cons: For some individuals, the treatment itself can be painful, and the efficacy of dry needling is still a question mark, according to an article published in the Journal of the American Board of Family Medicine. While some studies on the technique have shown promise, others suggest dry needling won’t offer much more than a placebo effect. The other drawback is that costs for the multiple treatments can add up.

2. Active Release Therapy (ART)

ART is a soft tissue movement-based technique developed and patented by chiropractor Michael Leahy. The theory behind ART, according to certified athletic trainer Jason D’Amelio, MS, ATC-L, ART-C, of Total Athletic Performance Training is that injured muscle is in a high-tension state and the tissue doesn’t glide as it should. The fix? “We apply external tension to put muscles into a shortened position, and then lengthen the tissue to break up the dysfunctional fibers and restore range of motion,” D’Amelio says.

As with dry needling, ART will typically require more than one visit in order to see improvements. Treatments usually require about 15 to 20 minutes per session and often involve the patient assisting with the movement patterns while the practitioner applies the proper tension. Translation: This is not a passive day at the spa.

Pros: ART is a non-invasive, readily available treatment. Patients can hope to see improvement within about two to three visits and total relief after about three weeks, says D’Amelio. While studies on ART are limited, some have shown promising results.

Cons: A trained practitioner is essential, especially in the case of a muscle tear, which must be treated differently than a chronic condition to prevent further harm, says D’Amelio. Treatment may also get expensive if it requires the often-recommended two to three sessions per week for several weeks.

3. Graston Technique

“The goal should be to fix the functional problem that got you there in the first place.”

Fear not: the small metal instruments used in Graston technique are not torture devices (though, treatment isn’t a walk in the park, either). Originally created by athletes, Graston is designed to break up muscle adhesions and allow muscles to reach their full range of motion. Using a range of tools, therapists apply friction to the muscle site to “work out the wrinkles” that have built up over time, according to Virginia-based chiropractor Waleed Hawa, DC, of Riverside Chiropractic. Like other Graston practitioners, Hawa has undergone specific training in order to properly administer treatment. “I use the right sized tool for the area I am treating, like a sculptor, and ‘carve out’ the adhesions,” he explains.

Pros: Like ART, Graston is non-invasive and finding a local practitioner is generally easy to do. Treatments are also quick and have patients out the door within about 20 minutes.

Cons: While the official Graston site lists several case studies on the method, few research-based studies exist. Treatment can sometimes be painful and lead to bruising, so if you’re not up for being poked and prodded, this one’s not for you. Treatment protocols might require several visits per week over a four- to five-week period, adding up on cost level.

While these methods can provide alternative paths toward injury relief, the bottom line is that athletes need to focus on system upkeep — in addition to treatment, says Dr. Hawa. Those prone to overuse injuries have even more work to do. “Runners, in particular, must put in the strength and conditioning work necessary for injury prevention,” he explains. “I can assist in working on pain, but the goal should be to fix the functional problem that got you there in the first place.”

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