What Is Soft Tissue Mobilization?
The primary focus of treatment at this facility is the soft tissue component of the injury. Simply noted, soft tissue is everything other than bone. Soft tissue does include the organs, but our interest is: muscle, tendon, ligament, bursa, fascia and nerve. The treatment of these structures is known as soft tissue mobilization.
The basis for this method of treatment is several fold. When trauma occurs, whether it be major trauma, or repeated microtrauma, inflammation occurs. The inflammation leads to fibrous tissue formation (scar tissue) in the muscle, between the muscles and between the layers of connective tissue. This fibrous tissue formation causes a decreased ability of the muscle to lengthen and contract as it normally does which in turn leads to a decreased range of motion. This effect can be very local within a muscle or can affect the muscle groups very broadly. The fibrous tissue can also cause pain and a predisposition to re-injury in the same injury. Additionally, pain can lead to muscle guarding, or splinting. the guarding protects the injured area. If the contraction of the muscle guarding is prolonged, the muscle can lose its normal length by the process of adaptive shortening.
There are other factors that have not been researched thoroughly. These factors include a chemical effect from treatment such as a release of histamines and endorphins to name a few. Also, the proprioceptive mechanism is not understood but clearly exists. There are sensory feedback loops that are not yet understood. An example of this is often seen when injuries receive proper taping treatment and significant improvement occurs. This was first seen with the patella (knee cap). Specific taping of the patella could markedly improve the patient’s pain. This may be the same reason we can provide light manual pressure treatment in some cases and produce significant results.
Soft tissue mobilization addresses the previously described complication of soft tissue injuries. There are really two components to soft tissue mobilization. By definition, manipulation implies high velocity, high amplitude thrust or motion. Mobilization implies low velocity, low amplitude thrust or motion. The soft tissue is mobilized by the doctor’s hands as his/her hands/fingers move through the muscle. The patient has the involved joint moving as well. This motion is joint mobilization, which occurs simultaneously during the soft tissue mobilization. This motion may occur with the patient performing all the motion (active), or with help from the doctor (active-assisted), or entirely by the doctor (passive). All of the muscles surrounding the injured joint/region are treated (mobilized) and the joint is moved (mobilized) in all planes of motion. This comprehensive approach makes the treatment time consuming but highly effective. The treatment can be modified to be sport specific or task specific if needed or required. Joint manipulation is used as indicated.
Exercises to strengthen an area of the body, improve it’s range of motion, or improve balance and function may be prescribed, instructed and implemented. The staff at the Soft Tissue Center is strongly suited for this. Many of the doctors are Certified Strength and Conditioning Specialists (CSCS) staff. Several of the doctors are USA Weightlifting Level 1 certified coaches (Club Coach). Dr. Horrigan also served on the USA Weightlifting Sports Medicine Committee from 1997- 2005 and served as the Head Speed-Strength and Conditioning Coach for the Los Angeles Kings (NHL) from 1999 – 2002 and Long Beach Ice Dogs from 1996 – 2002.