Soft tissue therapy covers a very wide umbrella of different techniques that are utilized to aid in the recovery of musculoskeletal injuries. The soft tissue consists of multiple structures including; muscles, tendons, and fascia to name a few. Many different types of injuries will cause dysfunction of these structures, giving way to a wide array of indications and applications. They’re many schools of thought on how to work through these dysfunctions, and the proper utilization of them depends on the type and acuity of injury. From a tight muscle to a muscle spasm, or recovery from surgery with scar tissue formation, massage for example can take many forms depending on circumstance.
The physiology of a tight muscle or soft tissue injury is mostly a chemical one. When an injury occurs to a muscle, certain chemicals are increased and released to help in the protection and prevention of that particular muscle from being overused creating more injury. While in the acute stage, this is very helpful, as the swelling and restriction of motion acts like a brace. The window of necessity is short lived, and after a week or so, it should start to dissipate. If however, the tissue continues to become injured, or chronic inflammation becomes present, the tissue can get stuck in a cycle. One of the main byproducts of this reaction is for the muscles to bind together, to help brace. This will cause the muscle to swell and consolidate, upon palpation it can feel like a lump, this is called a trigger point or knot. Certain structures in the body, like the shoulder, require the muscles to work properly from a stability aspect, due to the type of joint it is. So certain muscles, like the upper trapezius which helps in neck, back, and shoulder function can quickly become overworked. This is why almost everybody can find a knot in their neck, largely due to sitting.
Soft tissue therapy helps unlock these knots in the tight muscles, but also their connections into fascia and ultimately the tendons themselves. Fascia is the bridge from one structure to another, the IT band is mainly made up of this, which is as thick as a leather belt. The fascia can become restricted, but it does not move nor contract like a muscle, so it is not something you can stretch out. However they’re techniques which can help adhesions, or knot like structures that impair the fabric nature of the fascia. Think of a run in the middle of an old blanket, the more you pull the string, the deeper the knot becomes, which would eventually bring the edges closer together.
Common techniques of soft tissue therapy include; massage, trigger point release, myofascial release, and instrument assisted soft tissue mobilization. As previously discussed, all of these techniques can be indicated at one point or another, but proper utilization depends on the skill of the therapist to understand what phase or condition the tissue is under. While all techniques can be helpful, if not timed correctly, or the wrong technique is performed, it can prolong and worsen symptoms. It is always best for musculoskeletal injuries to seek the advice from an Orthopaedic Physical Therapist first.
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