I have been steadily transitioning the way I use IASTM and Soft Tissue
Techniques over the past decade. As a result, not only have my outcomes
improved, but my patients have little to no soreness between treatments. That is
a big change. Ten years ago, I used to teach being "appropriately aggressive."
Myths of Soft Tissue Mobilization
Soft Tissue Mobilization Myths
Looking back at it, I don't know what I was thinking being so aggressive in the past.. This article by Chaudry, et albasically shows it takes extremely large forces (more than 1000 lbs) to even produce 1% deformation. This is hardly the amount of deformation that would be required to see the rapid changes in ROM we often see when doing manual tissue work.
Soft Tissue Mobilization Myths
Even early research from 1992 showed that much longer duration was needed for fascial deformation. Longer than what we would be able to treat, or that a patient would be willing to endure. So how do we explain these changes that we can feel through our hands or our tools?
Soft Tissue Mobilization Myths
They communicate pressure to the CNS which in turn reduces tone in the area (and adjacent areas) you are working on. These concepts are covered much further here. If you stop and think about it, do you really want to cause trauma to something like an ITB just to have a patient's knee or hip feel "better?"
Soft Tissue Mobilization Myths
This also explains how when we work on patterns or what others call lines, we are able to make global changes. These articles are from researchers that are very well known in the Body Worker and Massage circles, but not the Peer Reviewed Manual PT or PT circles.
Soft Tissue Mobilization Myths
I am glad I was exposed to them, and I'm sure all of my patients are as well. In the end, you can still make rapid changes with either STM or IASTM and there are still advantages to using tools over your hands.
Think about it... surgeons have difficulty breaking up scar tissue with a scalpel! It is a lengthy, INVASIVE surgery.
Think About It!
Is your hand or whatever tool you're using this sharp?
From Increasing Muscle Extensibility:A Matter of Increasing Length or Modifying Sensation?
In the above mentioned article, the researcher goes over various myths of muscle extensibility. The conclusion: increases in muscle extensibility in the short term (less than 3-8 weeks) is due to alterations in the perception of stretch, not actual physical changes in the muscle
So What?
Too many clinicians using soft tissue techniques think they are breaking up fascial adhesions, scar tissue or lengthening muscle. Getting results does not need excessive force and in most cases should not even cause discomfort.
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