Everything to Know About Soft Tissue Mobilization

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.

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:

• Frozen shoulder
• Carpal tunnel syndrome
• Shoulder impingement syndrome
• Medial epicondylitis
• De Quervain’s tenosynovitis
• Dupuytren's contracture

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:

• Calf pain
• Patellar tendinopathy
• Knee arthrofibrosis (joint disorder) after a patellar tendon repair surgery
• Achilles tendinopathy
• Plantar fasciitis
• Hamstring tendinopathy
• Ankle instability
• Limited hip or knee range of motion

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.

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:

• Lymphedema
• Osteoporosis
• Varicose veins
• People taking blood thinner medication
• Kidney dysfunction
• Diabetes
• Neuropathy or altered sensation
• Congestive heart disease or circulatory disorders
• Acute inflammatory conditions

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

• Acute injury or fracture
• Advanced osteoporosis
• Marfan’s syndrome or other connective tissue disorders
• High-risk pregnancy
• Unhealed surgical sites
• Peripheral vascular disease
• Unstable epilepsy

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.

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.