Soft Tissue Release - Brisbane MSK Clinic

What is Soft Tissue Release?

For over a decade, Terry at TotalMSK in Brisbane has specialised in soft tissue therapy techniques and a specific form of myofascial release, Soft Tissue Release (STR). Unlike other types of massage, myofascial release, and other soft tissue therapy techniques, soft tissue release is hugely versatile yet highly effective. Although it is possible to apply Soft Tissue Release directly to the skin and with lotion, the technique works just as well through clothing and without lotion.

Soft tissues such as muscles, tendons, fascia and ligaments can become dysfunctional for many reasons, often resulting in a combination of myofascial trigger points, pain and restricted mobility. Soft Tissue Release helps release dysfunctional tissue and can produce fast, better lasting and easily noticeable improvements in mobility and pain relief. There are a wide variety of factors that can play a part in how and why functional soft tissue problems can occur.

In essence, there are four main reasons:-

• Abuse (activity likely to cause injury)
• Misuse (activity performed incorrectly)
• Overuse (too much activity and lack of recovery)
• Lack of Use (poor conditioning of tissues)

The article on lower back pain has a more detailed description of the main injury mechanisms listed above. Generally speaking, soft tissues will adapt "as is tolerable" to how we use them, good or bad. Though, hydration, nutrition and some diseases can also negatively impact function. Damage to soft tissues can often prove very painful, due to sensory receptors within and around tissues. Such receptors detect soft tissue damage, which is often felt as pain. However, the body's healing response involves inflammation, which can put further pressure on the areas of injury and add to the pain sensation. The soft tissue healing process involves stages which effectively repair the damage caused by injuries to soft tissues. The quality of the repair can depend on many factors, and even with optimal healing, the repair is never as good as the original.

Soft Tissue Release (STR) can effectively treat both acute and chronic myofascial pain and related injuries. The articles on Adaptation, Healing and Biotensegrity explain everything in far more detail. Also, the article on sports injury prevention has relevance too (see the related articles section later). Provided there are no treatment contraindications a well-trained practitioner can apply the Soft Tissue Release (STR) technique to virtually any muscle they can access.

What are the benefits of soft tissue release?

Soft Tissue Release (STR) is very different to soft tissue massage and does not involve massage strokes. It is also possible to perform soft tissue treatments with or without lotion/oil. Only a minimal amount is required when applying the technique with oil or lotion. Equally, direct skin contact is not always necessary, and one can treat soft tissues directly through clothing. Hence, one does not feel oily after treatment or even undress. There are variations in applying the technique; the patient can actively move the area under treatment, or the therapist can passively treat the area. Treatment areas can also be treated in weight-bearing or non-weight-bearing positions and actively or passively. STR is a form of Fascial Release, though the addition of the "lock” is quite distinctly different to other such methods. It is possible to apply the "lock" in various ways depending on the desired treatment outcome.

There is a huge amount of versatility in how one can use the method, including in similar ways to Active Release Technique (ART) ®. The general public needs to understand that just because a soft tissue therapy technique is patented or has a registered trademark does not mean it is better. In many respects, ART ® is essentially movement-based method of releasing myofascial tissues. However, owning a patent or trademark enables the owner to commercialise the treatment method. The fact that ART ® had a patented protocol does not mean much in the scheme of things and relates more to gaining a patent. Using the ART ® trademark as a therapist means training in the technique and completing annual top-up training in the method. Generally, professional therapists are only required to complete yearly training when using commercialised soft tissue therapy technique names. In many respects, advances in soft tissue therapy techniques are relatively limited across the field and even more limited within any specific technique. Professional associations have yearly continual professional development or education rather than technique-specific requirements. Only therapists who meet the yearly requirements of the trademark use are legally allowed to say that they perform ART ®. However, many professional therapists claim to use the technique and do not meet the requirements of using the trademark. Our principal therapist did complete training in the method over a decade ago out of interest, but he does not meet the use of trademark use requirements. The general public will be familiar with other commercialised soft tissue therapy techniques due to their highly effective marketing, such as Graston Technique ®.

Unlike some other myofascial releasing techniques, Soft Tissue Release (STR) does not directly identify and treat Myofascial Trigger Point's. However, a therapist can use the method very effectively with other such techniques. A therapist with the right training, knowledge, and experience can precisely and effectively use this technique to treat various sports injuries, conditions and pain. As with other Myofascial Releasing Techniques, good results rely heavily on the individual practitioner's skill, knowledge and experience. Palpation skills and the application of techniques play a large part, as does detailed knowledge about anatomy, biomechanics, musculoskeletal medicine and diagnostics.

The TotalMSK Myotherapist Terry first learnt Advanced Soft Tissue Release in the UK in 2008. He was lucky enough to train under Mary Sanderson, one of the technique's pioneers and his biomechanics lecturer. The initial course was a two-day course completed as CPD/CPE while studying at the McTimoney College of Chiropractic, and he has used the method ever since. Terry later completed further training in 2012 during his BTEC level 5 in clinical sports and remedial massage therapy course. His final exams took place under the watchful eye of Mel Cash, the founder of the famous London School of Sports Massage.

How is Soft Tissue Release performed?

Soft Tissue Release (STR) works by changing a muscles origin and insertion points before stretching (see the STR - Muscle anatomy attachment section later). The practitioner alters the muscles' origin and insertion points by applying a "soft tissue lock" to the area under treatment. The therapist then stretches the area once the "lock" is in place. The stretch can often have a brief and intense sensation, followed by a melting or softening feel. In some countries, the method is called "Pin and Stretch", which explains the technique in basic terms.

All muscles within the body have start and end anchor points. Such anchor points are how muscles attach from one bone to another via a tendon. The medical terminology for these points are origin and insertion, and the simplest of muscles only have (1) origin and (1) insertion point. Muscle contractions apply a force pulling the origin and insertion points closer together. Bundles of fibres (fascicles) within muscles do not all have to run in the same direction. Contractions of muscle fibres will be along the length of them. However, actual bodily movement will depend on the muscle anchor points and direction of the muscle fibres. Other factors, such as the joint type, fascial network, stabilising muscles, other layers of muscles, and the kinetic chain, will also play a part. For example, the Trapezius muscle covers a large portion of the mid to upper back, neck, and shoulders. Different sections of this muscle can create various movements. In simple terms, movement involves alternate muscles contracting and relaxing. However, movement is far more complicated than this. Hence, it is not always possible to effectively stretch or even self-treat all relevant muscles in the body.

The following images relate to the Rectus Femoris and are an anterior (front) view of the Left upper leg. The image on the Left shows the Rectus Femoris muscle. The image on the Right shows the Origin (Red coloured x 2) and insertion point (Blue coloured x 1) for the muscle.

Images produced with kind permission of 3d4medical.com - Rectus Femoris image from Essential Anatomy 5

(Copyright © 2018 - 2023 3D4Medical. All rights reserved.)

The following images relate to the Latissimus Dorsi, which has multiple origins (12) and a single insertion point (1). The image on the left is a posterior (rear) view of the Latissimus Dorsi muscle. The image in the middle is also a posterior (rear) view and highlights the twelve Origin (Red coloured) Latissimus Dorsi attachment points. The image on the right is an anterior (front) view of the Latissimus Dorsi and the one insertion point (Blue coloured). Other muscles may have multiple origins and insertion points.

Images produced with kind permission of 3d4medical.com - Latissimus Dorsi image from Essential Anatomy 5

(Copyright © 2018 - 2023 3D4Medical. All rights reserved.)

Other Myofascial Releasing Techniques

Besides Soft Tissue Release, many other methods exist for releasing soft tissues. Sometimes a particular treatment method might prove contraindicated (not advisable or safe) to use in certain circumstances. However, another technique might be perfectly safe in the same case. For example, a patient might be on heart medications to thin blood, so Dry Needling, Gua Sha or IASTM is not advisable, though other methods would be appropriate. Some people may not like specific techniques, yet other ways exist to achieve the same end treatment goals.

• Dry Needling - DN
• IASTM - Instrument Assisted Soft Tissue Mobilisation
• Gua Sha Therapy
• Muscle Energy Technique - MET
• Neuromuscular Therapy - NMT
• Positional Release Technique - PRT