William The Coroner’s Forensic Files

Friday, 7, May, 2010

In Which I Get E-mail

Filed under: Medicine,Oddness,WTF? — williamthecoroner @ 12:48

One thing about being a doctor is getting questions.  Sometimes they are interesting, sometimes they are intrusive.  Usually, people don’t press the issue when they learn that I’m a coroner, and my usual response if they don’t get it is that I’d be happy to do an autopsy on them and give them the report in three weeks.  Funny, but if you offer to eviscerate someone at a party they tend to go away.

My inherent smart-alec tendencies keeping most folks away, the questions I do get are interesting.  Someone asked me yesterday about the “Graston Technique” which a physical therapist recommended to treat her spinal canal stenosis and chronic migranes.  I had not heard of this technique, so I looked into it.

Evidently, it is some sort of massage technique where the someone rubs the patient with these stainless steel…things.  The things are supposed to “untangle muscle fibers”  and “break up scar tissue”.  Now.  I’ve looked at a lot of muscles.  I’ve never seen any of them tangle like they show in the slide show.  I’ve broken up scar tissue.  With a scalpel.

Now, rubbing contracted, sore muscles will make them feel better, and you can massage trigger points and make the muscle relax.  The fibers aren’t untwisting, however.  This looks like deep tissue massage with oddly shaped stainless steel things.  Chronic inflammation, though doesn’t get better if you rub it.  After all, your Mom told you that if you pick at it it won’t get better.  STEROIDS treat chronic inflammation.  I also noticed in their list of clinicians: “athletic trainers, chiropractors, physical therapists, occupational therapists” does not include doctors.

The Graston technique might make someone feel good.  Or it might hurt like the dickens.  Deep tissue massage tends to hurt, I’m not sure I want someone rubbing me hard with a steel thing when I hurt.  Hands would appear to be safer in my opinion.  The other part of the technique involves warm up, stretching, and strengthening the affected muscles.  I think the last two are what’s working in most of these cases.

EDITED TO ADD:  Science-Based Medicine has some information about it HERE.  It’s quackery.  The scientific basis arises from two mouse studies, one of which suggests it doesn’t work.  Also, the patient pays $500 for the treatments, the “instruments” cost $2700, and it is a way to get a placebo effect from paying someone to hurt you.



  1. I would think that pounding the muscle fibers with a tenderizing mallet would be just as effective, and more fun for the person wielding the mallet.

    Comment by CrankyProf — Friday, 7, May, 2010 @ 13:37 | Reply

    • Some people pay good money for that sort of thing.

      Comment by williamthecoroner — Friday, 7, May, 2010 @ 13:39

  2. So in the mouse studies, did they have to make little tiny Graston implements to use on them?

    Comment by Heather — Saturday, 8, May, 2010 @ 22:12 | Reply

  3. For your amusement: http://www.theexaminingroom.com/2010/05/caring-for-the-patient-who-is-a-zombie/

    Perhaps you can comment on proper pathology techniques for the undead. Though if they are undead, do they qualify for autopsy?

    This is a bit out of place, but I hope it will amuse the missing CLP.

    Comment by Glen — Tuesday, 11, May, 2010 @ 06:02 | Reply

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