Introduction to Soft tissue

Question 1

Name some signs and symptoms of soft tissue involvement

Answer 1

• pain
• swelling
• increased muscle tone/protective spasm
• tightness/restricted ROM (afraid to move)
• laxity/increased ROM
• trigger points - tight bands in muscle
• muscle inhibition, weakness, atrophy (post injury)
• muscle hypertrophy
• Mal-alignment issues
• muscle imbalances
• instabilities

Question 2

Name some abnormalities in soft tissues that can be noticed

Answer 2

• temperature changes
• sensation changes
• color/pigmentation, hair, rash, blemishes, irregular moles
• trophic changes related to disease
• lesions/breakdown

Question 3

Myofascial pain syndrome signs and symptoms

Answer 3

• regional: pain, tenderness, limited ROM
• trigger points: painful/palpable taut bands in muscles with distinct referral patterns
• may result in muscle tightness and limited ROM
  weakness

Question 4

What is myofascial pain syndrome often related to or caused by

Answer 4

• poor posture/muscle imbalances
• poor body mechanics, overuse, overload of deconditioned muscles
• previous injury, protective immobilization
• if spine involved: adjacent spine musculature is commonly involved
• painful guarding/protective spasms
• tightness, decreased ROM, weakness

Question 5

Lower cross syndrome

Answer 5

• LQ trunk, LS, pelvis
• hyperlordic LS
• anterior tilt of pelvis
• tight erector spinea
• tight hip flexors
• weak abs
• weak glutes
• anterior tilt places hams under tension

Question 6

Soft tissue mechanical/mobility perspective

steps to determine the mobility of Soft tissue

Answer 6

• observe posture
• mobility testing superficial to deep
• STM: multiplaner, assess longitudinal, transverse
• palpation for trigger points
• use reactions as objective measures

Question 7

Palpation for trigger points

Answer 7

• taut bands/knots in muscle, spasms, tissue swelling
• pressure - banche thumbnail consistency
• response: won’t allow, says it hurts, wince, and withdraw can be objective

Question 8

Indication for soft tissue mobilizations

Answer 8

• increase circulation and nutrition to tissue
• decreased muscle spasm, relaxation of tissue
• increase extensibility of tissue allows restoration of ROM
• deactivate trigger points
• mobilize scar tissue
• prevent break up and adhesions
• prevent contractures
• assist in resolution of edema/fluid accumulation

Question 9

effects of STM

Answer 9

• histamine released and mast cells which act as a vasodilator
• increase circulation, local temperature and tissue extensibility
• decrease spasms and pain
• increase tissue metabolism (lactic acid can build up)
• decrease waste products, increase nutrition

Question 10

STM contraindications and precautions

Answer 10

• Severe injury - acute inflammation and pain
• infection = don’t want to spread
• hematoma - bleeding
• shortened tissue providing stability
• shortened tissue providing function (posterior pelvic tilt with hamstring tightness can be helpful with spinal stenosis)

Question 11

STM techniques with stages of healing

Answer 11

• acute/inflammatory stage: gentle techniques
• fibroblastic stage: controlled mobility for fiber alignment of scars
• remodeling: more aggressive, increase scar tissue extensibility
  12 week window: can make improvements after this but its harder