Doctors of chiropractic have always worked their fingers into injured soft tissue to increase blood flow and break up restrictions. Sometimes fingers alone cannot detect restrictions at deeper levels, nor can they match the ability of the right instruments to treat the full range of restrictions. Hand-held, stainless steel instruments with various angled surfaces can be utilized to perform what is known as instrument-assisted soft-tissue mobilization (sometimes referred to as Graston Technique or Gua Sha, among other names).
Soft-tissue injuries, such as strains and sprains, often affect the extremities – the legs or arms. A soft-tissue injury can occur anywhere that ligaments, tendons, muscles, or myofascia are found.
When the body is injured, it works to repair itself through a three-phase “healing cascade” process of inflammation, proliferation, and maturation. In the inflammatory (acute) phase, the body releases chemicals that start the healing process. During the second phase (the proliferative phase) the body migrates materials it needs to create scar tissue at the site of injury.
During the third phase of healing, the maturation phase, scar tissue forms at the soft-tissue injury site. In this phase, the injury becomes chronic. While healthy soft tissue fibers are laid out in the same direction and are flexible, the body lays out scar tissue in a haphazard fashion creating fairly rigid tissue to serve as a “patch” at the site of an open wound or internal injury. This new, rigid tissue is much less flexible than normal tissue and can restrict movement, leading to pain (for example, an athlete with a sprained ankle tries to return to running).
Most patients with soft-tissue injuries come to their doctor of chiropractic after injuries have become chronic (months post-injury). By that point, the body has completed most if not all of the healing tasks of the original healing cascade. A second healing cascade is needed to restart the healing process, bringing to the site, among other things, oxygen and nutrients.
To initiate a second healing cascade, your doctor of chiropractic can utilize instruments to manipulate damaged tissue and help release restrictions created by scar tissue to begin a chemical healing cascade. The goal is the normalization of the tissue. Normalization refers to the release of restrictions. Treatment, which includes stretching out muscles, helps patients build flexibility and strength in the area.
Instrument assisted soft tissue mobilization treatment breaks down scar tissue and encourages the body to remodel the underlying tissue. During treatment, smaller capillaries in the area are broken. Bruising is a normal response, signifying that a healing cascade is underway.
Treatments are typically short – often just three to five minutes but can cause minor discomfort. The level of discomfort typically is reduced with repeated treatments. Chronic soft-tissue injuries are not healed overnight, but performing home stretches and exercises as prescribed by your doctor of chiropractic will speed up the process.
Doctors of chiropractic are trained to effectively address your musculoskeletal complaints. If you have further questions about soft-tissue injuries, your doctor can help!