Question 1

Soft Tissue Techniques to Support & Manage Injury +

Accepted Answer

Soft tissue techniques can be used after general massage has warmed up your muscles. These techniques are used to improve your range of movement, increase flexibility and reduce your ongoing pain and discomfort levels. These techniques can be used for neuromuscular problems and help to calm irritated and reactive nerve/ muscle interactions. Treatments include Trigger Point Therapy and Muscle Energy Techniques (METs).
 Additionally, soft tissue mobilisation techniques can be employed to break down knots in muscles (also called sticky adhesions), which can develop after injuries or very inactive times in our lives. These techniques include: Transverse Frictions, Soft Tissue Release and Connective Tissue Massage.

Question 2

Neuromuscular Techniques +

Accepted Answer

Trigger Point Therapy ( TPT)
What is a trigger point?
After injury, a hyperirritable area, or trigger point, may stay within a muscle, so that it is effectively in spasm all the time. This can be felt as local or transferred pain. Trigger points can also be caused by overuse, postural imbalances, strains, stresses and shortenings.
What to expect.
Your therapist will apply direct pressure to the trigger point for a few seconds. You will be asked to report when you feel that you have reached about 7/10 in pain levels. Your therapist will then work with you until the trigger point has subsided.
In some cases, it may be necessary to use techniques whereby your therapist will either alternate pressure and release, or keep bringing the pressure point back to 7/10, for up to two minutes, for particularly stubborn areas.
What are the benefits?
This can be a permanent and immediate solution, reducing local and any referred pain, increasing range of movement and flexibility. Circulation will improve and general relaxation is increased.
Risks/ contraindications.
This treatment can cause soreness and/ or bruising for up to two days post treatment. Your therapist cannot use this technique over an inflamed area. Also, trigger point therapy cannot be used too early in the injury cycle because instability could be induced in the joint, due to the trigger point’s protective role.

Question 3

Muscle Energy Techniques (METs) +

Accepted Answer

What are METs?
This is a form of assisted stretching which works by lengthening a muscle that is restricted by neuromuscular issues. There are two types: Post-isometric relaxation or PIR and Reciprocal inhibition or RI.
What to expect.
In PIR, your therapist will work with your affected or target muscle. Your muscle will be comfortably stretched to its normal limit or point of bind and you will relax. You will then be directed to contract your targeted muscle for a given percentage of effort (5% to 50% dependent on injury), for 10 seconds. After this, your therapist will further stretch your muscle to a comfortable point. This can be repeated up to three times. The last stretch is held for 30 seconds.
 When there is a lot of discomfort in a muscle, your therapist may choose RI, which uses the opposite muscle group. The aim is that by contracting the opposite muscle, your target muscle will be able to relax. Exactly the same procedure is followed as with PIR.
What are the benefits?
RI is safe to use from the early subacute phase of injury. Both methods increase the range of stretch for the target muscle, enabling increased mobility and flexibility. These methods can be learnt and then used independently at home.
 Risks/ contraindications.
PIR should not be used to invasively stretch a muscle in the early sub-acute stage of injury. Work with your therapist to communicate any discomfort through the stretching phase and follow instructions carefully.

Question 4

Soft Tissue Techniques +

Accepted Answer

Deep Friction Massage, also known as Transverse Frictions (DFM)
What are Transverse Frictions?
These are a more intense version of simple kneading frictions. Transverse frictions break down and can also restructure sticky adhesions in muscles, tendons and ligaments.
What to expect.
Your therapist will do a press test to ensure that the area is not a trigger point. If the target area is muscular, it will be placed in a position of ease, whereas if the area is a ligament, it should be taut. Short frictions are applied at right angles to the muscle alignment in the affected area. Every 10 to 20 seconds, your therapist will re-palpate the area to check progress. During these breaks, the therapist will effleurage massage to the nearest lymph nodes. Ice may be used afterwards.
What are the benefits?
Deep frictions can increase the mobility of a muscle by removing physical restrictions. Scar tissue can be realigned and optimised during repair. Collagen fibres are realigned, and excessive scar tissue is removed, along with adhesions. Local circulation is improved.
Risks/ contraindications.
Deep frictions can cause bruising and discomfort for two days after treatment. The actual treatment can be painful, however this can be managed by careful communication with your therapist and also using cryotherapy post treatment.

Question 5

Soft Tissue Release (STR) active and passive +

Accepted Answer

What is soft tissue release?
It involves mobilising joints to stretch a muscle or specific parts of a muscle. This leads to increased mobility by removing physical adhesions.
What to expect.
The muscle is shortened either by the therapist (passive) or client (active). Your therapist will then place a ‘lock’ on the tissues, using their hands. The joint is then moved to produce a stretch. The lock begins near to the joint but gradually moves away, shearing the tissues and separating adhesions. The therapist will begin this movement passively until you are confident to apply your own active  joint movement. This can be continued for up to two minutes.
What are the benefits?
STR increases the mobility of soft tissues and improves the range of movement. It helps to break down fibrous adhesions, whilst promoting optimal scar formation in injuries and aiding soft tissue repair.
Risks/ contraindications.
It is important to communicate honestly with your therapist as too much pressure may lead to excessive damage to the muscle which may lead to muscle spasm. Pain levels should not exceed 6/10.

Question 6

Connective Tissue Massage ( CTM) +

Accepted Answer

What is connective tissue massage?
Just beneath the skin, lies the superficial fascia or sheet of connective tissue. If there are restrictions in this, the whole body could be affected, placing stresses at places on the body far removed from the problem area. Connective tissue massage allows this fascia to remodel.
What to expect.
Your therapist will work from superficial to deeper layers. They will remove some of the oil from the target area, and using flat hands will push tissue apart slowly. If a restriction is felt, the stretch is held for up to 30 seconds. The therapist will then work gradually deeper, firstly rolling the tissues into a crescent shape and then in a wave across the whole area.
What are the benefits?
Restrictions in the connective tissue are freed, aiding circulation and mobility. You can learn to do this at home with a foam roller.
Risks/ contraindications.
Keep hydrated post treatment.

THE FIRM

Below we've described treatments, their benefits and whats involved. We don't expect you to read these at length, but may be useful if you're curious as to what benefits can be obtained by massage therapy.