Soft Tissue Work
Soft tissue work can mean a lot of things. It could simply mean massage or assisted stretch or something less recognizable like gua-sha or graston technique. The world of soft tissue treatment options is quite astoundingly huge. Here at the clinic I use several techniques and I have a strong affinity for those who produce the best outcomes. Hundreds of techniques have came into existence over the millenia that humans have been performing soft tissue work on one another. In the modern age, a few techniques have solidified their place as highly effective treatments for the type of musculoskeletal (MSK) problems I see in practice as a chiropractor.
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Massage Therapy
The oldest and possibly the most universally understood is massage therapy. While massage therapy could certainly encompass several of the techniques that will follow in this discussion, what I am talking about here is classic massage therapy where two schools dominate. First and most popular is Swedish massage which is light pressure and flowey with a specific emphasis of direction of massage strokes generally leading towards the heart. Swedish massage is the gold standard of massage therapy and hugely effective for patients. Honestly, it's often overlooked by people in pain who feel like deep pressure is needed to help. That leads us to the second school of massage therapy which is deep tissue massage. Deep tissue focuses on deep pressure to create changes in the structures of the myofascial system to effectively treat all sorts of MSK ailments. I really don't need to harp on about the benefits of massage therapy, I think it is ubiquitous enough as is.
Myofascial Release
Myofascial release constitutes a highly specialized form of soft tissue work that is similar to deep pressure but with a different goal in mind. The goal of myofascial release is ,as the name suggest, to release the fascia from the muscles and surrounding tissues. The role of fascia in MSK disease and injuries has become a major topic in recent years with the importance of fascia being amplified many times over. There are two main types of myofascial release. Passive myofascial release is more traditional and involved a specific contact while the muscles and fascia are pulled under that contact by the practitioner creating what has been dubbed the scoop effect. Active myofascial release on the other hand involves the same type of contact with the patient contracting the muscles of interest while the practitioner maintains that contact. Between the two, both have their place but active release techniques get results faster but produce more side effects like soreness.
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Trigger Point Therapy
This is an offshoot of deep tissue massage therapy with one notable exception: sustained pressure. The pressure with trigger point needs to be high and steady enough to cause the muscles physiology the react. Pressure is often held for 30-120s over a specific point. The points of interest in trigger point therapy are of course trigger points. People often call them 'knots' but trigger points specifically cause radiating pain that is often distant from the trigger point itself. If you have ever had someone press on your shoulder blade and felt an ache behind your ear, you know what I am talking about. Trigger point therapy is effective although time consuming and generally leaves patients sore. However, the results speak for themselves which is why this is a frequently utilized tool in my tool box.
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Stretch
Humans have been stretching since the beginning. Next time you see a dog get up from a nap watch how they instinctively stretch their hips out before they get moving. Stretching is essential to a healthy musculoskeletal system. Some of us have a stiffer collagen makeup and need it more and some of us have very a very lax collagen which doesn't require much stretching, but if you are like the majority (and statistically speaking you probably are) the frequency of stretching should match the frequency of moderate to vigorous activity. Now, when MSK conditions arise, muscles often spasm or become hypertonic or tight. A bid part of treating those conditions is assisted stretch to help break the pain spasm cycle or to reduce muscle tension as it may be hindering the healing process.
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Instrument Assisted Soft Tissue
The goal of instrument assisted soft tissue work is very similar to myofascial release and somewhat similar to swedish massage. The instrument is, instead of a hand, something rigid usually made of steel or bone. This technique spares the practitioners hands but ignores one of the best parts of hands-on therapy which is feel. It may be very easy to asses tension and trigger points by hand but through an instrument it takes a lot of experience and the information obtained is usually of a lower quality. Techniques like graston or gua-sha are well established and the benefits known. A good practitioner can use instruments to deliver soft tissue therapy effectively and comfortably. There is generally a little less soreness but more reddening, petechia, and bruising than techniques that involve a hand contact. I don't favor instrument techniques over any of the above because as a chiropractor, how the tissues feel is of great importance to me. In practice, I use instruments to work stubborn areas or to create a desired response in the tissues.
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Wrap it up already will ya?
In conclusion, there are hundreds of techniques and there is frequently not one type or another that will work best for a given condition but a combination of therapies expertly applied that yields the best results. I have been doing soft tissue work since 2014 and its an essential part of my practice and has been a life changer for 1000s of folks. Come see what soft tissue work can do for you.
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See ya soon, ~Dr Malone