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Soft Tissue Release Treatment - Coggle Diagram
Soft Tissue Release Treatment
Muscle Spindles
found in intrafusal muscle fibres (skeletal)
Sensory receptors, informs the CNS about changes in length of muscles & speed of stretching which regulates the contraction of muscles, by activating motor neurons via the stretch reflex to resist muscle stretch
Muscle spindles are the most important proprioceptors and
Golgi Tendon Organ
Proprioceptors located in the tendon adjacent to the myotendinous junction
Tree like sensory ending enclosed in connective tissue
GTOs lie in series with the extrafusal fibres and receive no motor innervation.
send force information to the spinal cord, where interneurons receive input from the brain that specifies the amount of force that a muscle should produce.
If that muscle's force level exceeds this set point, the GTO inputs inhibit the alpha motor neurons innervating that muscle, which lowers the force produced unless some other mechanism cancels that signal.
A reflex action mediated by the Golgi tendon organs that is called the inverse stretch reflex.
Autogenic Inhibition
The GTO senses increased tension when the muscle contracts or stretches. When the muscle contracts, the GTO is activated and responds by inhibiting this contraction (reflex inhibition) and contracting the opposing (antagonist) muscle group.
Post isometric relaxation PIR & Post fascilitation stretch PFS
Reciprocal Inhibition
The muscle spindle is located within the muscle belly and stretches along with the muscle itself. When this occurs, the muscle spindle is activated and causes a reflexive contraction in the agonist muscle (known as the stretch reflex) and relaxation in the antagonist muscle.
TPs
Areas of contracted sarcomeres within a ‘relaxed muscle.'
hyperirritable spot in a muscle that results in reduced range of motion and muscle weakness
When the muscle experiences overuse or injury, tight bands of fibres form within the muscle to create a temporary stabilising effect to protect the
TP’s are a protective response to injury ,many outlive their usefulness and remain when not needed causing altered movement patterns of the muscle
Benefits
Increased flexibility and contractibility of the affected muscle
Improved ROM
Reduced local pain
Reduced referred pain
Improved circulation
Increased local and general relaxation
How does TP therapy work?
TP’s are created by the muscle in a chemical cycle, to treat the TP the chemical cycle needs to be altered.
Find most active TP, ask patient VAS score, don't exceed 6, hold pressure until pain subsides, remove pressure allow bloodflow, repeat 3 times until pain is gone
The therapist will apply direct pressure on the TP and in doing so starves it of oxygen so the muscles fibres no longer have the ability to continue to contract.
This leads to a release of tension within the fibers which reduces or releases the taut bands (spasm) that they have created. The spasm is released quickly and often permanently which in turn removes local pain, referred pain and dysfunction.
Soft tissue release
targets specific areas of tension within an individual muscle with the aim of removing scar tissue and adhesion
applying and maintaining a pressure, or locking into the relevant tissues whilst simultaneously stretching away aligning fibres
How does STR work?
Therapist will either get you to actively contract the muscle, or will passively contract the muscle for you, to a make it ‘shortened before applying the lock
Active- patient moves into length
Passive- therapist moves into length
Resisted- patient trys to stretch but resisted by therapist -isometric contraction of antagonist produces enhanced relaxation in treated muscle (Reciprocal Inhibition)
Weight bearing STR late-stage
The therapist will the put some pressure on the muscle, called a lock
While maintaining pressure on the restricted tissues the therapist will either move the nearest joint in order to create a stretch between the lock and the joint (passive STR), or they can ask you, the client to move the joint for them (active STR).
Benefits STR
Releases and lengthens tight tissues
Releases and separates adhesions in soft tissues
Breaks down/mobilise scar tissue
Encourages correct alignment of collagen fibres during injury healing
Alleviates pain caused by increased muscle tension
Maintain or increase joint ROM
Post isometric relaxation PIR
decrease in muscle tone after a brief period of submaximal isometric contraction of the same muscle
PIR works on the concept of
autogenic inhibition
Contraindications
Acute injury/inflammation (apply 10 second test if in doubt)
The usual massage contraindications – if you wouldn’t use massage, don’t use STR
Joint problems where movement is compromised e.g. arthritis, hip replacement
Hypermobility syndromes (further stretch is inappropriate)
How does PIR work ?
The hypertonic muscle is taken to a length just short of pain, or to the point where resistance to movement is first noted
A submaximal (10-20%) contraction of the hypertonic muscle is performed for between 5-10 seconds and the therapist applies resistance in the opposite direction. The patient should inhale during this effort
After the isometric contraction, the patient is asked to relax and exhale while doing so. Following this, a gentle stretch is applied to take up the slack till the new barrier
Starting from this new barrier, the procedure is repeated two or three times
Post facilitative stretch
more aggressive than PIR works off autogenic inhibition
How does PFS work?
The hypertonic and shortened muscle is placed between a fully stretched and a fully relaxed state.
The patient is asked to contract the agonist using a maximum degree of effort for 5–10 seconds