You may have heard about soft tissue mobilization that is used in the different forms of manual therapy. As a term soft tissue mobilization is very broad and very obscure – I feel to even to the therapists themselves. That’s why I came up with the idea to write about soft tissue mobilization. My objective is to explain what it can mean and what it holds in it and also to define what soft tissue mobilization means in naprapathy. Soft tissue mobilization is used in manual therapy to improve the function and the state of the soft tissues if they can be traced to be the contributors of musculoskeletal dysfunctions and symptoms. Quite often this is the case. For example in the presence of a joint dysfunction the soft tissues like muscles and connective tissue are most often affected as well. (Guanche et al 1995; Solomonov et al 1997) Soft tissue abnormalities may have an effect to the neuromuscular control and be the cause of pain which means that they may affect your movement patterns and coordination (Gerwin et al 1997).
What are soft tissues?
Basically all of the tissues in the musculoskeletal system are soft tissues except for bone and cartilage. The most obvious of soft tissues is probably muscle but also tendons, ligaments, joint capsules and other connective tissues such as fascia can be included in the group. Nerves and blood vessels crossing the joint can also be interpreted as soft tissues.
Soft tissue mobilization techniques
Now we come to the tricky part of defining what treatment techniques and procedures can be included in soft tissue mobilization. It probably depends on the viewpoint of the clinician. Of course it’s not possible to isolate a certain mobilization technique to affect a certain tissue. Soft tissue treatments can affect many structures, other than muscle and connective tissue, among these are joints, blood vessels and nerves (Kaltenborn 2011) Even mobilization and manipulation of the joints can be interpreted as soft tissue mobilization because these techniques are thought to affect the joint capsule and ligaments. In naprapathy the term soft tissue mobilization is more or less reserved for the tissues that surround the joint capsule like muscles and connective tissue. The soft tissue mobilization techniques can be distinguished from other techniques by the fact that the clinician re-examines the soft tissues after the treatment to find out if there is any change. In naprapathy the main aim is to affect the soft tissues while using soft tissue treatment techniques. The fact is there are probably countable ways and techniques to do soft tissue mobilization. In this post I’ll address the most important from the viewpoint of naprapathy.
Massage is the obvious and well known type of soft tissue mobilization. To make things even more complicated I’ll state here that there are various ways and types of massage. In naprapathy the aim is to find the possible abnormalities in the soft tissues – this can be called diagnostic or palpating massage. The goal is also to modify the soft tissues and affect them in therapeutic way and to improve and normalize the function of the area of complaint. The type of massage used in naprapathy is classical massage most often.
Digital ischemic pressure and muscle energy technique
Other types of soft tissue mobilization used in naprapathy include digital ischemic pressure, muscle stretching with a muscle energy technique, friction massage etc. Digital ischemic pressure is a technique in which the clinician applies direct pressure to a muscle to produce a temporary ischemic reaction. The intention is to reduce the muscle tone to provide a pain-relieving effect and to deactivate trigger points which are a very tender points or taut bands in a muscle (Hains 2002). The pressure is usually applied with the clinicians thumbs or elbow. Restricted motion in the spine and in the extremities is treated with a muscle energy technique (MET). Muscle energy technique is a gentle form of soft tissue mobilization where the patient voluntarily contracts their muscles for a few seconds while the clinician produces counterforce to the contraction. (Selkow et al 2009) After the contraction phase the muscle can be stretched. The contraction phase can be repeated several times for the treatment to be effective.
Soft tissue techniques are used in naprapathy quite a lot and often they are combined with other treatment techniques like mobilization or manipulation of the joints. Most often the soft tissue techniques are used prior treating the joints as a “warm up” and relaxation before heavier techniques. Many times joint mobilization and manipulation are more effective and easier to perform when soft tissue techniques have been applied first. Hopefully this post has clarified what is soft tissue mobilization and what it means in naprapathy. If any thoughts or questions rise please make sure to comment!
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Peace & love!