Massage/Soft Tissue Mobilization

Question 1

What are the mechanical effects of soft tissue mobilization?

Answer 1

-Increases warmth
-Used in the treatment of scar tissue/adhesions
-Promotes and retains mobility of new skin tissues
-Frees adherent mucus from bronchial tubes (over lungs)
-Encourages hyperaemia (brings more blood to the area)

Question 2

What are the physiological effects of soft tissue mobilization?

Answer 2

-Increased circulation
-Effect on BP, HR, skin temp.
-Increased release of histamine & platelets from blood
-Spinal motor neuron excitability reduced
-Releases endorphins
-Affects muscle fatigue & tone
-Increased levels of immunoglobulin A

Question 3

What are the absolute contraindications to massage/soft tissue mobilization?

Answer 3

-Tissue inflammation/malignancy
-Circulatory disorders
-Abnormal sensations
-Skin disorders
-Open wounds or unhealed scars
-Recent fracture
-Acute inflammation
-Burns
-DVT
-Advanced osteoporosis

Question 4

What are relative contraindications to massage/soft tissue mobilization?

Answer 4

-Older people
-Fragile skin
-Early stage osteoporosis
-Children
-Adults w/ learning or physical disabilities
-People recovering from infections or bone diseases

Question 5

What basic types of STM techniques will we perform?

Answer 5

-Effleurage
-Stroking
-Petrissage
-Cross friction massage
-Strumming
-Skin rolling

Question 6

What is soft tissue mobilization (STM)? What is it used for?

Answer 6

-A form of manual therapy
-Decrease muscle tension
-Improve skin mobility/reduce scar tissue adhesions
-General relaxation
-Move fluid trapped in tissue
-Stretching or lengthening of fascia

Question 7

What is effleurage? What is its goal?

Answer 7

-Very light, gentle brushing technique applied to muscle and soft tissue from distal to proximal
-Pressure is applied using the palm of the hand in a continuous stroke
-Goal: relaxation, increased venous and lymphatic drainage

Question 8

What is stroking? What is its goal?

Answer 8

-A long, superficial stroke applied along the length of the tissue
-Typically deeper pressure than effleurage
-Goal: muscle relaxation

Question 9

What is petrissage? What is its goal?

Answer 9

-Groups of techniques that involve compression of the soft tissue
-Kneading, wringing, or rolling
-Goal: release areas of muscle fibrosis and to “milk” the muscle of waste product

Question 10

What is strumming? What is its goal?

Answer 10

-Application of repeated rhythmic deformations of a muscle belly in a strumming fashion
-Similar to playing a stringed instrument
-Goal: decrease muscle tension, get knots out, etc.

Question 11

What is cross friction massage? What is its goal?

Answer 11

-Repeated cross-grain massage applied to muscle, tendon, tendon sheaths, ligaments
-Tendons and ligaments should be put on gentle stretch during treatment
-2-3/sec for 3-5 minutes or until desensitization
-Goal: increase mobility and extensibility of musculoskeletal tissues; prevent and treat inflammatory scar tissue

Question 12

What are contraindications for cross friction massage?

Answer 12

-Hematomas
-Debilitated or open skin
-Peripheral nerve of diminished sensation

Question 13

What are the therapeutic effects of cross friction massage according to Cyriax?

Answer 13

-Increase blood flow and lymph
-Removal of chemical irritant
-Reduces venous congestion
-Stimulates mechanoreceptors
-Reduce scar tissue and improve scar tissue mobility

Question 14

What is skin rolling? What is its goal?

Answer 14

-Gather up the tissue between the thumb and index & middle fingers and continue a rolling pattern over the tissue
-Goal: to assist w/ movement of superficial layers and superficial fascia

Question 15

What are more advanced types of STM?

Answer 15

-Graston or IASTM
-Strain/counterstrain
-Manual lymphatic drainage
-Trigger point therapy or myofascial release
-Cupping

Question 16

What is Graston/IASTM?

Answer 16

-Uses a specially designed tool to treat scar tissue
-Graston is a type of IASTM (instrument assisted soft tissue mobilization)
-Allows for faster rehabilitation
-Requires additional training

Question 17

What is strain/counterstrain?

Answer 17

-Uses passive positioning to relieve muscle, joint, and tissue tightness
-The PT will identify specific pain points and hold the position for 90 seconds-3 minutes to relax the soft tissue
-Requires additional training

Question 18

What is manual lymphatic drainage?

Answer 18

-Uses specific manual hand movements that follow anatomical lymph pathways, helping to move fluid and improve circulation
-Manual lymphatic drainage for headaches, migraines, swollen legs, and more

Question 19

What is trigger point/myofascial release?

Answer 19

-Myofascial release if a STM for the treatment of chronic muscular pain and immobility
-Myofascial release focuses on reducing pain by easing the tension and tightness in the specified areas of pain
-NOT trigger point injections
-Developed by Janet Travell

Question 20

What is cupping?

Answer 20

-Placing cups on the skin and creating suction
-Can be placed on any muscle group
-Suction creates a negative pressure environment allowing for myofascial decompression as the skin is drawn into the cups, which lifts the muscle fibers and draws blood to the area