Everything to Know About Soft Tissue Mobilization

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Soft tissue mobilization (STM) is a type of hands-on treatment that is commonly used in physical therapy (PT) sessions. Chiropractors may also use STM in their practice.

This technique, which can be performed with a therapist’s bare hands or using a metallic tool (also known as instrument-assisted soft tissue mobilization—or IASTM—and the Gaston Technique), aims to reduce pain, improve range of motion, and decrease disability by working on the body’s myofascial (soft tissue) system.

This article will provide more information on soft tissue mobilization and its potential benefits.

Doctor doing deep tissue IASTM massage for man with back pain

Svitlana Hulko / Getty Images

If you have reduced sensation, significantly diminished bone density, or a connective tissue disorder, you shouldn't undergo soft tissue mobilization without speaking to your healthcare provider.

Uses

The myofascial system includes all of the body’s muscles and the connective tissue (or fascia) that surrounds them. Soft tissue mobilization primarily targets the weblike fascia layer, which helps to:

  • Reduce friction
  • Improve a muscle’s ability to generate force
  • Provide input on different body movements or sensations to the brain

Occasionally, the myofascial system can become restricted and its ability to function properly is diminished. When this occurs, STM may help remedy this problem. This is because the treatment is thought to:

  • Break down scar tissue
  • Release fascial adhesions
  • Stimulate new connective tissue formation

It is important to note that these potential mechanisms of action are still somewhat theoretical, however.

Upper-Extremity Soft Tissue Injuries

Because of the potential benefits noted above, soft tissue mobilization is frequently used to address several upper body injuries or conditions. Some of the more common diagnoses treated with STM include:

Lower-Extremity Soft Tissue Injuries

Like in the upper body, many different lower-body injuries and musculoskeletal diagnoses may also benefit from soft tissue mobilization. While not an inclusive list, here are some of the more frequently treated conditions:

Benefits

While soft tissue mobilization is a widely used treatment technique, the evidence supporting its benefits is still somewhat mixed.

Several studies have shown improvements in joint range of motion and reductions in functional limitations following IASTM treatments. This is thought to be because of the treatment’s ability to increase blood flow and improve tissue mobility in an area.  The research does note, however, that most of these benefits are relatively, short-lived with many lasting less than three months.

Increasing Muscle Strength

Current research does not definitively support the use of IASTM as a means of increasing muscle strength in an injured or weak area.

Overall, the most beneficial and evidence-based use of this treatment technique seems to be in reducing pain and increasing the function of people who are injured, particularly with tendinopathy issues.

Risks

While soft tissue mobilization is a relatively safe treatment, it is not without risks. Because of this, some caution should be used by people with the following conditions:

In addition, there are certain diagnoses that are considered contraindications and people with these conditions should generally not receive STM. These include:

Each person’s medication history is unique. Because of this, it is recommended that you speak to your healthcare provider about your individual circumstances before beginning any new treatments.

What to Expect

When therapists perform soft tissue mobilization on an area, they typically utilize a friction-reducing lubricant or cream to help make the treatment more comfortable and effective. Once this substance has been applied, the PT will use their hands or a metallic tool to administer focused stroking movements along the targeted area of the body.

The pressure, duration, and pattern of these strokes can vary depending on the type of mobilization being performed. Some variations involve a held or sustained pressure over a restricted area while others are more rhythmic and oscillating. Regardless of the technique that is utilized, however,
the mobilization treatments should not be painful.

It should also be noted that occasionally after IASTM, red or purple spots (known as petechiae) may appear in the treatment area. This is because the pressure of the mobilization may rupture the superficial capillaries in the skin.

Red or Purple Spots From Treatment

While red or purple spots (petechiae) are a known potential side effect of STM, it should not be a goal of treatment and could also be a sign that excessive pressure is being used by your therapist.

Summary

Soft tissue mobilization is a hands-on treatment that can be utilized to treat several conditions in physical therapy. Typically, the therapist uses their hands or a metallic tool to apply pressure to the targeted area. This technique is thought to improve the mobility of the body's fascial layer and break up scar formation, though this is still being researched. STM may be indicated for a variety of upper body and lower body diagnoses, particularly tendinopathy issues.

A Word From Verywell

If you are dealing with pain, stiffness, or functional limitations, soft tissue mobilization may be a beneficial treatment. This hands-on technique can help improve your range of motion and restore your ability to go about your daily tasks. If you are suffering from one of the conditions listed above or just have questions about STM in general, be sure to speak to a physical therapist about your situation.

Following a review of your medical history and a comprehensive evaluation, your therapist can help you decide whether soft tissue mobilization is appropriate for you.  

Frequently Asked Questions

  • What are soft tissues and where are they located?

    Soft tissue refers to any of the muscles, tendons, ligaments, organs, or connective tissues located throughout the body. When it comes to soft tissue mobilization, however, the muscles and surrounding connective tissue (fascia) are specifically targeted.

  • How long does it take to see improvement from soft tissue mobilization?

    Improvements in range of motion and reductions in pain may be seen almost immediately after a soft tissue mobilization session. Several weeks of STM may be required, however, to fully achieve the benefits of this treatment. In addition, it is important to remember that any benefits that occur may be short-lived. Because of this, STM is frequently performed along with other PT treatments with more lasting effects.

  • Is soft tissue mobilization treatment safe?

    Soft tissue mobilization is generally considered safe. That said, because it involves sustained pressure, certain individuals should use increased caution. In particular, people on blood thinners, with sensory or circulatory issues, or who are at a higher risk of bone fractures should speak to their healthcare provider before receiving STM.

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3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Cheatham SW, Baker R, Kreiswirth E. Instrument assisted soft-tissue mobilization: a commentary on clinical practice guidelines forrehabilitation professionals. Int J Sports Phys Ther.2019;14(4):670-682.

  3. Lambert M, Hitchcock R, Lavallee K, et al. The effects of instrument-assisted soft tissue mobilization compared to other interventions on pain and function: a systematic review. PhysicalTherapy Reviews. 2017;22(1-2):76-85. doi:10.1080/10833196.2017.1304184