Soft tissue and skin injuries account for more than 14 million outpatient visits each year in the United States. But what are soft tissues, and how does mobilization therapy help relieve pain and injury to them?
Soft tissues are the different kinds of cells that surround and support your organs and skeletal system. They include muscles, nerves, tendons, ligaments, joints, cartilage, and spinal discs.
Soft tissue injury (STI) is an umbrella term for any type of injury to connective tissue. Common types of injury are:
- stress injuries
These injuries usually affect your muscles, tendons, and fascia. Fascia are the connective tissues that surround, connect, or support your muscles, organs, bones, blood vessels, and nerves.
STIs occur when your muscles are abnormally tense. Your muscles work by tensing up and contracting, then relaxing. They get shorter when they contract. This causes movement in the part of the skeletal system they’re attached to.
Pain, muscle weakness, a restricted range of motion, and a misalignment of the skeletal system can result if the muscle doesn’t relax completely. Other soft tissue injuries can happen acutely. For example, when you twist your ankle or pull a tendon in your groin.
Mobilization therapy can relax tense muscles, break up scar tissue, and reduce fluid build up in the tissue. Soft-tissue mobilization is a manual therapy that is said to relax tense muscles, reduce scar tissue, and stretch or lengthen your fascia. It does this via a number of techniques, including applying gentle pressure and stretching the affected tissue. Sometimes doctors use ergonomically designed tools. This is called instrument-assisted soft tissue mobilization.
STI treatment begins with a physical examination to assess your overall condition. This can identify hot spots and determine the range of motion in your affected joints. From there, you’ll be advised on a course of action. This may include a number of therapy sessions.
Mobilization therapy treats problems affecting the upper and lower extremities, as well as neck and back pain. Problems in the upper extremities include:
- tennis elbow
- golf elbow
- carpal tunnel syndrome
- tendinitis of the biceps and rotator cuff
Problems in the lower extremities include:
- tendinitis of the heel and knee
- sprained ankle and knee
- hip replacement
- quadriceps tendon strain or tear
- shin splints
- plantar fasciitis
- Morton’s neuroma
Mobilization therapy is provided by a number of health professionals. These include occupational therapists, physical therapists, osteopathic physicians, chiropractors, and massage therapists.
How mobilization therapy works is not fully understood. Most clinical studies have either been too small or involved only animals.
“Soft-tissue mobilization has been suggested to have an array of benefits, however most of the claims are in fact not supported by the research,” says physical therapist Shane Hayes, BAppSc (Physio), PostGrad (SportsPhty), who works with Olympic athletes.
“Evidence shows us that you can't break down tissues, release muscles, or change muscle structure.”
In fact, the effect may actually be neurological, not physical. “The benefits instead may lie in psychological and neurological mechanisms. The sensation of touch that occurs is the key actually,” says Hayes.
“The sensation or pressure provides a neural input to the brain which subsequently may result in a decrease in … neural activity to the muscle.”
The first step in treating a sprain or strain is to follow RICE. That stands for rest, ice, compression, and elevation. Mobilization therapy may provide relief for some people with strains and other connective tissue damage.