Agents - Soft Tissue Mobilization

What is soft tissue mobilization?

Mechanical manipulation of soft tissue by the hands; manual therapy

What does the term “soft tissue” include?

Muscle, fascia, tendons, ligaments

What are the effects of STM?

Breaks down adhesions, relaxes muscle tension, reduces edema, decreases pain, restores function

What are some indications for STM?

Decreased extensibility and pliability, intermittent MSK pain, pain that is altered by postural changes or motions, muscle spasm, edema, tightness, scars, trigger points, myofascial issues, tendonitis, tension headaches, etc

What are the three purposes of STM?

Mechanical, physiological, and psychological

What are some contraindications of STM?

Acute inflammation, infection, open/irritated skin, malignancy, DVT, recent fracture, osteomyelitis, acute circulatory condition, skin hypersensitivity

List the guidelines for STM preparation

1 Clear the patient. 2 Drape and position. 3 Clean the area. 4 Assess sensation and capillary refill. 5 Assess via skin rolling. 6 Put on lotion. 7 Effleurage. 8 Petrissage. 9 Effleurage. 10 Wipe off lotion, assess skin rolling/sensation/cap refill

What is effleurage?

Rhythmic long strokes with constant contact; completed first and last, along direction of muscle fibers and toward heart. Stimulates sensory nerves, preps for deeper work, identifies restriction

What is petrissage?

Kneading/lifting of skin and tissues. Done 3-4 times in an area, with or against fibers. Frees adhesions, assists venous and lymph return and removal of waste

What is friction massage?

Transverse or parallel massage for collagen alignment; indicated with adhesions, muscle spasms, and trigger points. Fairly aggressive.

What is myofascial release?

Long duration low load, gentle sustained pressure to fascia at end range

What is ischemic compression?

Pressure applied to trigger points to create local ischemia (leads to later hyperemia). Relieves muscle tension and pain, increases the pressure pain threshold (PPT)

What are the steps of ischemic compression?

Press until painful point, hold until that subsides, then increase pressure again. Do this three times, less than 3 minutes total

What motion specifically should therapists avoid while administering STM?

Hyperextension of joints

What are some key points of patient education for STM?

It is not comfortable, not done solo. Shouldn’t be painful, follow it up with stretching