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  • Rob

What is manual therapy, Part 2

Welcome back! This week I am going to talk about a soft tissue techniques that I picked up and 'developed' myself with influences from many different physiotherapists along the way. Let's start by talking about what STM is.

Soft tissue mobilization (STM) is another type of manual therapy. It can include massage but there are other techniques included as well. Other techniques could be, for example, skin rolling, simply picking up a fold of skin and ‘rolling’ it up the spine or away from the spine.

Skin rolling, taken from:

One technique, I developed along the way, is simply feeling around the tender area and feeling for ‘pebbles’ in the muscle. They feel like tight bulges in the muscles and they are quite tender. They can also go by the name of trigger points. The technique involves rubbing the trigger point with my fingertips, generally perpendicular to the direction of the muscle fibers. I think about prying those tiny muscle fibers apart. The ‘pebble’ in my fingertips slowly get smaller and smaller. The pebble simply vanishes. Another way I explain it to clients, is to think of a sugar cube and you have a eye dropper filled with hot water. You slowly drop the hot water on the sugar cube and you can slowly see it melt away. That is what the muscle knot/ trigger point in my fingers feels like it is doing. While performing this technique, I have noticed something else changes for the client.

When the muscle is initially grabbed, the client’s say that the pain is quite intense, almost sharp. Rubbing the tight spot, unfortunately does not make the pain any easier to take. However, within 30-60 seconds, the trigger point seems to shrink, much like the sugar cube getting drops of hot water. Once the change in muscle tone is detected, my clients say something like ‘it just let go’ or ‘the pain is much more of an ache now, not as intense’. That change signals to me that the muscle has initiated a reflex to decrease the tension on itself. A lot of my client’s get this technique on a regular basis. The client’s that do their exercises typically get this technique less. Why? Possible, they are starting to recruit their muscles while the trigger point is not present or minimally present. This muscle recruitment will bring more nerve impulses and blood flood to the muscle as well as contracting and relaxing of the muscle. I do not know which part of it helps the most but it seems to work really, really well.

The above two techniques (see Part 1) are generally used on soft tissue, i.e. muscles, ligaments… In the next couple of blog posts we will look at two techniques are done on joints of the human body, where two bones meet. They are mobilizations and manipulations. Stay tuned!

Do you have sore muscles and think this technique could help? Conact us and we will be pleased to work with you to assess and treat your pain.

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