Dr. Manison is proud to be an Advanced Certified Practitioner for the Graston Instrument Soft Tissue Mobilization Technique, or the Graston Technique (GT). He is one of only a few advanced certified providers for the Graston Technique in the Baltimore and Howard County (Columbia / Ellicott City), Maryland region. He has been advanced certified since 2003, making him one of the first certified doctors in the area. His expertise and experience with the technique is extensive.


raston Technique is an innovative, advanced, and highly successful instrument soft tissue mobilization assessment and treatment technique that is used for all sorts of soft tissue conditions.  Numerous professional and amateur sports teams have practitioners who are certified Graston Technique providers due to its high rate of success for such a large array of soft tissue injuries.

The Graston Technique was originally created for athletes to help with stubborn injuries. It was found that following soft tissue injuries, either from a trauma or from repetitive use injury, adhesions (scar tissue) would form in the surrounding tissues. This scar tissue can be microscopic in nature and/or be evident with palpation of the involved area of dysfunction. Scar tissue results from the body’s attempt to quickly heal an injured area by laying down tissue that is more fibrotic and less elastic than it should be. The body does this so as to avoid additional injury even though the resultant tissue is less healthy and certainly less functional.

Each layer of muscle (and most other soft tissues, including organs) has a thin layer of tissue surrounding it call fascia. Picture the thin layer of tissue that you can pull off of a chicken breast that lies beneath the skin.this is fascia. Fascia surrounds so much of your body’s tissues that if you looked at just the fascia of the body (and took out all the muscles, ligaments, bones, etc.), your body would still have the same form.

Scar tissue (adhesions) develops not only in damaged muscles and ligaments, but also in fascia. It is through this mechanism that a lot of restriction occurs in your musculoskeletal system. This restriction leads to pain and dysfunction. When you have adhesions in fascia, this leads to limitations in the function of the muscle(s) the fascia surrounds as well as the movement of the involved muscle(s) ‘gliding’ across other muscle(s) that are adjacent to it. When this occurs, your body has to exert more energy to move the involved area of your body and the uneven pulling and tugging to get the muscles moving and functioning properly leads to further injury and dysfunction. This becomes a vicious cycle of continual injury.

The Graston instruments are specially weighted and designed to help the licensed practitioner identify and break up, or eliminate, the scar tissue (adhesions) found in injured / damaged muscles and fascia. By doing so, there is a reduction in pain and normal function can be restored. The instruments allow for a deep, focused, and successful approach to help eliminate scar tissue (adhesions).  There are some Graston copycats on the market now but none have the amount of specially crafted instruments to treat all areas and none offer the high level education that Graston does.

The Graston Technique is patented and very highly respected in manual therapy fields. It is used to treat problems such as neck pain, rotator cuff injuries, headaches, tendinitis/tendinosis issues such as ‘tennis elbow’ and ‘golfer’s elbow’, carpal tunnel syndrome (CTS) and other hand/wrist/elbow problems, rib dysfunction, thigh pain, leg pain, knee tracking disorders and other forms of knee pain, ankle sprains/strains, plantar fasciitis, foot/toe pain, and more.

As mentioned above, Dr. Manison is an Advanced Level Certified Graston Technique Practitioner. He is one of the only Graston Technique providers in the Baltimore / Ellicott City / Columbia (Howard County) area. He uses Graston Technique along with his other skill sets to maximize patient progress and help condition the patient for rehabilitative/stabilization exercises.

Please visit our Techniques Page to learn more about all the techniques we utilize to help our patients get better.