Soft Tissue Mobilization PDF

Soft Tissue Mobilization Adam Squires PT, DPT, Cert SMT, Cert DN Board Certified Specialist in Orthopedic Physical Therapy  Objectives Understand indications and contraindications for soft tissue mobilization. Understand and demonstrate ability to perform common so...

Soft Tissue Mobilization Adam Squires PT, DPT, Cert SMT, Cert DN Board Certified Specialist in Orthopedic Physical Therapy  Objectives Understand indications and contraindications for soft tissue mobilization. Understand and demonstrate ability to perform common soft tissue mobilization techniques. Mechanisms, Indications, Contraindications  Soft Tissue Mobilization Manual therapy techniques directed at soft tissues Does it work? YES! Short-term improvements in pain, ROM, and resulting function How does it work? No high quality evidence to support more than transient changes in tissue characteristics Neurophysiological effects “You are talking to the patient’s nervous system through your hands.” – Modern Pain Podcast  Indications Pain Muscle guarding/spasm ROM limitations Scar Mobilization Fluid Mobilization Muscle Stimulation  Contraindications Skin conditions (open wounds, rash, burns, etc.) Infection Fever Suspicion of DVT/Clotting disorder Phlebitis Active Bruising Congestive Heart Failure  Precautions Altered skin sensation Immune system disorders Around fracture or joint instability Soft Tissue Mobilization Techniques  Overview Effleurage Petrissage Trigger Point Pin and stretch Cross-friction  Effleurage Gentle, broad strokes Relaxation Circulation Warm-up tissues  Petrissage Deeper pressure Kneading Slow, rhymical Decrease tension/spasm Pain modulation  Trigger Point Therapy AKA Trigger Point “Release” Trigger Point “hyperirritable spot, associated with a taut band of a skeletal muscle that is painful on compression or stretch, and that can give rise to a typical referred pain pattern” Poor inter-rater reliability and validity for palpation Tenderness and pain reproduction most reliable  Trigger Point Therapy Find painful band of tissue Apply pressure at a tolerable level Not usually more than 5-6/10 Hold until discomfort eases 30-60 seconds Increase pressure to 5-6/10 Repeat 2-4 cycles https://massagetherapypaloalto.com/modalities/trigger-point-therapy/  Pin and Stretch Trigger point pressure with stretch opposite muscle line of force Hold 5-10 seconds, relax 2-5 seconds Repeat 5-10 repetitions https://learnmuscles.com/blog/2024/10/06/pin-stretch-technique/  Cross Friction Massage Hypersensitive connective tissues Stacked fingers Force applied perpendicular to fiber orientation “Strumming” back and forth https://www.youtube.com/watch?app=desktop&v=E0tD-srDYOQ Instrument Assisted Soft Tissue Mobilization (IASTM)  IASTM Graston®, ASTYM®, Gua Sha, “Scraping” Utilizes an instrument made of metal, plastic, or stone May more directly stimulate fascia and fibroblasts Instrument increases vibratory perception Changes in tissue texture easier to distinguish  Mechanisms Claims made related to breaking fascial restrictions and scar tissue No evidence to support Some evidence for increased fibroblast activity Neurophysiological effects  Techniques Brushing Sweeping Fanning Strumming Add movement to enhance effects  Objectives Understand indications and contraindications for soft tissue mobilization. Understand and demonstrate ability to perform common soft tissue mobilization techniques. Questions