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What is Soft Tissue Therapy

If you are uncertain of the type of injuries a Soft Tissue Therapist treats we have listed some common injuries we see daily in the clinic. Very common are sprained ankles, strained hamstrings, plantar fasciitis (heel pain) and runner’s knee pain.

Soft Tissue Therapy aims to treat clients who are struggling with Injury recovery, restricted mobility & any musculoskeletal pain or dysfunction that is caused from a previous soft tissue injury. This may be from sport & exercise to life’s everyday stresses. Soft Tissues, refers to tendons and ligaments with a direct focus on muscles & fascia (connective tissue).

Soft Tissue Therapy aims to provide remedial treatment through the following techniques:

  • Myofascial release
  • Neuromuscular technique
  • Positional Release
  • Muscle Energy Techniques (PIR & RI)
  • Soft Tissue Release
  • Sports Massage

How Soft Tissue Therapy helps minor and chronic musculoskeletal issues

Regular appointments may be beneficial for the client, depending on their injury/recovery status and whether they are suffering from a chronic or minor musculoskeletal condition. This will help to recognise any weaknesses or areas that need attention, which may otherwise progressively worsen. This may be recognised by a soft tissue therapist through injury assessments.

If issues are addressed early enough, then further injury prevention can also be achieved. Assessing muscle/tendon function can be effective when comparing its functional movement to the opposing muscle. If this is also restricted or impaired, it is important for us to consider an average normal range for that client.

A runner suffering with Runner's Knee - Patella Femoral pain
Runner’s Knee – a common ailgment treated with Soft Tissue Therapy

When a client concentrically contracts (shortens) a muscle, strength, function and range of motion can be assessed. An overuse strain for example may be presented if the client has experienced a combination of discomfort and a restricted range of motion. Whereas an overuse microtrauma, may be shown if there is a limit to its range but pain or discomfort is not felt.

Repetitive strain injury can develop slowly whilst microtrauma gradually builds up in that area of muscle. Very few muscle fibres are usually damaged at a time during overuse strains. As this persists, and rest and recovery are not provided then the trauma to the muscle fibres can worsen. Micro-trauma within the muscles, refers to the damage of the muscle fibres that are bound together by endomysium (connective tissue) to form one fascicle.

If a muscle or tendon is only slightly damaged, then resistive movements can be a better way to identify this. The therapist will be able to determine the level of strength and quality of the movement when a resistance is applied against the contracting muscle.

Assuming that an acute injury is not present, passive movements can be utilised to stretch the soft tissues in order to test its flexibility/elasticity.  Furthermore, if a client experiences pain when doing active movements but not when performing passive functional movements, then it is assumed that there is a soft tissue issue present. However, if pain is experienced when performing both active and passive movements, there may be a more structural problem present, potentially due to the moving joint itself.

How it works

Techniques such as soft tissue release, will also help to restore any lost flexibility of the muscle. Along with providing exercises to work on at home. Muscle energy techniques (MET) such as reciprocal inhibition may be useful as it is safer than other techniques because the client would contract the opposing muscle, not the one needing attention. If a client is coming on a regular basis, then assessing the muscle/tendon function may be useful. This will help to identify any improvements at joints and flexibility even for chronic conditions. Furthermore, neuromuscular technique (NMT) may help relieve trigger and reflex points that may be causing referred chronic pain.

Although this NMT would usually be used in conjunction with others for more chronic tension. Factors such as: Active movements, resistive movements, passive movements, muscle control and importantly palpation, can all be used to keep track of progress and help to assess where the issues may lie, if yet unidentified. If conditions such as carpel tunnel syndrome have been diagnosed and permission has been granted to work on the client, then massage techniques and gentle Soft Tissue Release (STR) may be beneficial.

This may help to lengthen the muscles and fascia and reduce unwanted tension at the area, which may also help with pain and inflammation reduction. This may be the case for other joint inflammatory issues too. If an individual is suffering from a musculoskeletal condition, they may also be quite stressed and tense, so basic massage techniques such as gentle effleurage, petrissage, friction may also ease symptoms for the client depending on their condition.

Examples of acute injury

Exercises may also be given to the client for them to perform at home, which may help long term, depending on the issue. Direct injuries such as Achilles’ tendinitis, can be treated with light friction techniques to avoid further aggravation. Notwithstanding, it is advised for the client to apply ice after friction techniques to avoid inflammation. It may also be important to address any joint alignment issues to prevent reoccurrence and help reduce injury long term. Positional release is an effective way of dealing with muscle restrictions for example a whiplash injury.

This is because it is a pain free technique that works with muscles that may have been locked into a protective holding pattern, such as piriformis syndrome that may be compressing the sciatic nerve. If someone has suffered from a direct Injury, such as a strain or sprain then they will be advised to Rest, Ice, Compress and Elevate. If this method does not help after 24-48 hours, they may need to see a medical professional. Mobility can be incorporated to the procedure if improvements are seen. After discolouration swelling and heat is no more, the therapist can aid with rehabilitation.

A strain is identified when a tear in a muscle occurs, due to overstretching or overloading the muscle. This can also be caused by overuse, known as an overuse or chronic strain, or by improper technique when weightlifting. This overstretching action may result to either a complete, or partial tear of the muscle or tendon fibres, as the tensile strength of the muscle fibres have been exceeded.

Regarding overloading, a strain will occur if the muscle fibres cannot cope with the demands of the excessive loads, during the extensive mechanical stress. This results in the muscle fibre tears. A strain can also commonly occur when forcefully stretched and contracting simultaneously; this is due to the contraction force being incapable of overcoming the force from the stretch. This may be more traumatic causing a full rupture. An example of a STRAIN treated by a Soft Tissue Therapist would be a pulled Hamstring muscle

Treating a hamstring strain with soft tissue therapy

A sprain is commonly caused when a joint has gone beyond its usual comfortable range of motion. A common sprain would be a sprained ankle, often connected with running on uneven ground. This results to a complete or partial tear of the supporting ligaments of the joint. The ligaments help to prevent excessive movement. However, regardless of their tough fibrous tissue, predominantly composed of collagen fibres, which provide great tensile strength, an injury can still take place. This can result to these partial or complete tears of the fibres. An example of a SPRAIN treated by a Soft Tissue Therapist would be a sprained ankle

Image showing a therapist manipulating a sprained ankle

Sprains can be categorised as a first-, second- or third-degree sprain, depending on their severity. A first-degree sprain is where the ligament’s fibres have experienced a minor partial tear or have just been overstretched. The joint should also retain most of its stability with little swelling around the injured joint.

A second-degree sprain would mean that the ligament has more severely partially teared, swelling bruising and moderate pain would also be present. In addition, heat and redness would be present, due to excessive blood in the injured area.

Third-degree sprains are the most severe as the ligament (s) would be completely torn or ruptured and would most likely require surgical repair. The swelling of a third-degree sprain would be severe and if it were to occur at the ankle joint (talocrural joint) it would not be able to bear any weight and would be incredibly painful.

Disclaimer information

*This should not be taken as medical advice and you should still contact your GP/hospital if you suspect a serious injury. *