Soft Tissue PDF

# Soft Tissue ## Key Concepts Soft tissue techniques are directly applied to the muscular and fascial structures of the body, and affect the associated neural and vascular elements. Soft tissue preparation facilitates improvement of articular motion. This basic tenet of manipulative intervention...

# Soft Tissue ## Key Concepts Soft tissue techniques are directly applied to the muscular and fascial structures of the body, and affect the associated neural and vascular elements. Soft tissue preparation facilitates improvement of articular motion. This basic tenet of manipulative intervention has been consistent throughout the history of osteopathic medicine. ## Definition Soft tissue is a direct technique that usually involves: - Lateral stretching - Linear stretching - Deep pressure - Traction and/or separation of muscle origin and insertion while monitoring tissue response and motion changes by palpation. This technique is a form of myofascial treatment (1). ## History Soft tissue techniques are among the oldest techniques in osteopathic medical profession, having been among those taught by Dr. Still, D.O.. Based on descriptions by his students, it is believed that Dr. Still made extensive use of the style-direct inhibitory pressure. Soft tissue techniques and deep directed massage therapies have been known to exist for millennia. ## Proposed Mechanism of Action - Relaxes hypertonic muscles and reduces spasm by decreasing motor neuron activity and Hoffman reflexes - Stretches and increases the elasticity of shortened fascial structures. - Improves circulation to local myofascial structures - Improves local tissue nutrition, oxygenation, and removal of metabolic wastes. - Identifies areas of restricted motion, tissue texture changes, and sensitivity. - Improves local and systemic immune response - Provides a general state of relaxation - Provides a general state of tonic stimulation by stimulating the stretch reflex in hypotonic muscles. ## Indications - Somatic dysfunction of the body's soft tissues, as characterized by TART (2, pp. 115-116): - Tissue tenderness - Asymmetry - Restriction of motion - Tissue texture changes ## Clinical conditions that would benefit from soft tissue techniques: - Hypertonic muscles - Excessive tension in fascial structures - Abnormal somato-somatic and somato-visceral reflexes ## Soft tissue techniques are used as an adjunct to additional manipulative treatment in order to: - Identify other areas of somatic dysfunction - Observe tissue response to the application of manipulative technique - Provide a general state of relaxation - Provide a general state of tonic stimulation - Prepare tissues for other types of manipulation ## Contraindications ### Absolute contraindications (2, pp. 116-117) - Lack of patient consent and/or cooperation (Ed. note: this is true for any medical procedure; when the skin and/or soft tissues are not intact, traumatized from blunt or sharp objects, altered, or there is friable tissue that can be easily disrupted by pressure or strain, it is reasonable to assume that these situations are considered contraindications to soft tissue manipulative procedures) ### Cautions and relative contraindications - **Skin (disorders that would preclude skin contact)** - Contagious skin diseases - Acute burns - Painful rashes - Abscesses or cellulitis - Skin cancers - **Fascia** - Acute fasciitis (infectious or autoimmune) - Acute fascial tears - **Muscle** - Acute muscular strains - Acute myositis - Muscle neoplasms - **Ligament** - Acute ligamentous sprain - Acute ligamentous inflammatory disorders - Septic arthritis - Primary or secondary joint neoplasms ## Soft tissue techniques employ a wide range of force application. It is this characteristic that makes it one of the most versatile technique forms.