The Ins and Outs of Soft Tissue Treatment
This is something you need to know about.
Not just because it’s awesome on its own, but because it helps make everything else more awesome. Learning about this will have carry over to strength training, fat loss, conditioning and overall health and well-being.
Soft tissue work.
So what am I talking about? Soft tissue work is a term that can be difficult to break down—so I’ll do it for you. What can I say, I’m a nice guy.
Essentially, soft tissue is exactly what it sounds like—any tissue in your body that is soft. This includes muscles, fascia, ligaments, tendons and joint capsules.
The overarching term for any modality that is intended to treat and/or improve the quality of soft tissue. These modalities can include self-myofascial release (SMR), Active Release Therapy (ART), Graston Therapy and Massage Therapy.
The condition of the soft tissue to do what it do! That is, soft tissue quality basically means the ability of the tissue to perform optimally and without pain.
If you’re unfamiliar with soft tissue work, you may be wondering, “Why do I have to work on it at all?” That’s a fair question.
Let’s talk about how soft tissue damage occurs, and why it’s bad.
When you do any sort of challenging movement—whether it’s resistance training, intense cardio or even vigorous sex—it usually creates small tears in the muscle, called “microtrauma.”
This is not only part of training but it’s the entire point of training: The microtrauma results in the tissue healing, growing and getting stronger.
That’s the good. Now onto the bad.
Creating said microtrauma can, and eventually will lead to adhesions. This essentially occurs when tears don’t heal completely or properly, and muscle tissue begins to “stick” to other tissue, creating tension from those tissues pulling on each other. These types of soft tissue damages impede function and performance.
To give you a basic definition, knots can form and the soft tissue can’t perform as smoothly and efficiently as it would without these obstructions.
So when we talk about soft tissue work, we’re really talking about treatments that will work those knots out, restore blood flow (blood doesn’t flow too well through knots, as you can imagine) and reestablish proper function.
Soft tissue work, whether for chronic muscle strains or for tendon issues, is really a kind of stimulus. In effect, what the therapist is doing is irritating the tissue to produce a chemical response. The chemicals produced are what begin the healing process; which is why soft tissue work is often painful and can leave you feeling similar to a workout the next day.
Done regularly, this kind of work improves tissue quality and extensibility, which allows your tissue to properly lengthen.
Now, these adhesions are going to happen no matter what. That’s just part of training. However, they don’t have to cause injuries. In fact, if included as part of your regular regimen, you can drastically reduce your chance for injury.
Soft tissue quality is sort of like strength—there’s strong, and then there’s strong. Training will generally make you stronger, but if you pay special attention to your strength and make it a goal, you can really see it take off.
It works similarly with soft tissue quality: If you really pay attention to it, you’ll be able to maintain healthy tissue and prevent injury. Diligence pays off.
However, injuries often do occur, and various types of soft tissue work (which we’ll cover below) can be used to treat it. But what’s more important that, and something that nowhere near enough people focus on, is that doing soft tissue work as a regular part of your exercise regimen will improve your tissue quality and help prevent injury.
This is of particular importance to younger weightlifters, who almost invariably think of themselves as invincible (I should know, I was one of you).If you wait until pain or discomfort if felt you are facing that much more of a challenge. If you wait until you’re injured to start caring about your soft tissue, well… then you’re like most people who foam roll. It’s hard to impress the importance of injury prevention before someone’s ever been injured, but just believe me that you need to pay attention to this.
This is the type of soft tissue work you can do yourself, using various tools. This can be done with a roller (foam roller, PVC pipe or something like “The Stick”) or a ball, such as a lacrosse or tennis ball, which are handy for getting deeper into problem areas. The most popular of these tools (both in usage and discussion) is the foam roller—in fact, the foam roller is recommended so often that some consider it to be synonymous with SMR, which isn’t true.
A dense, cylindrical object on which you rest your body then set in slight motion. Basically, sit on the thing—sandwich the roller between the floor and the tissue being treated. Bear down with your body weight and roll slowly back and forth.
The guys over at Cressey Performance put together one of the best videos on foam rolling there is. Watch and learn:
The Foam Roller (my favorite, from Perform Better)
Another SMR tool worth mentioning is the Stick. The principle is the same to foam rolling, but because the tool is in your hand, you have a bit more control in terms of directionand pressure.
The Stick was recently featured on CBS’ The Doctors amid a surprising plethora of dick jokes. Check out this vid for more info.
To pick up the Stick, just head over to the site.
(Basically, stuff you don’t do yourself.)
I have to assume you know what this is, but in brief, it involves a therapist working through some of your hot spots, trigger points, painful areas and tightness with their fingers. Some massage is just for pleasure, some is for treatment. Pain is a good indicator of which you’re getting, since the therapist has to un-do the damage you have done to your tissues and that isn’t easy work.
Basically, if you are getting a massage and don’t at some point feel enough pain to hate the therapist, you are not getting “treated.”
If you are serious about improving your soft tissue quality, find a good massage therapist and try to go at least 1 massage per month; just keep in mind massage therapy for soft tissue treatment shouldn’t be a walk in the park.
Developed by Dr. Tim Leahy and now used all over the world in a variety of fields, Active Release is a manual therapy that works by putting tissue in a shortened state, applying pressure to the scar tissue/adhesion and then taking the tissue through a lengthening movement which serves to break up the scar tissue.
The differences between massage therapy and ART are many and varied, but the most practical distinction is that massage therapy performed on muscles in a stationary position, whereas ART is performed on a muscle moving through a range of motion.
It is very effective, painful, and not cheap. I have had it done on my shoulder and it worked quite well, but as with a lot of these therapies, don’t expect a day at the beach.
Charles Polquin has said that, “in 70% of patients, ART is 100% effective.”
Now, that sort of sounds like a commercial for Sex Panther—and everyone knows that 60% of the time, it works every time. (They’ve done studies.)
But in the case of ART, the take home is that while ART won’t work for everyone, it is extremely effective for most people. While I think that anyone who lifts heavy, is an athlete, or can afford it should go regularly—maybe once every 3 months for a check-up—ART really shines when it comes to injuries. And if you’ve neglected your regular soft tissue and SMR, you’re probably going to wind up at an Active Release Therapist.
Here is a video of me getting treatment on my shoulder by Dr. Christopher Anselmi—one of the best in NY and a guy who giggles when he hurts me.
Fore more information on Active Release Therapy, or to find a practicioner in your area, check out their site here. If you’re in the NYC area and looking for a great therapist, here’s a link to my Doc’s website.
Okay, so now you’ve completed Soft Tissue 101: What it is, why it’s important, and methods of treatment. Admittedly, I left a number of methods out (such as Graston Therapy), but this should give you the basics of all of the important points and treatments.