Soft Tissue and Chiropractic

Many chiropractors fall into the one trick pony model of adjusting only, and ignore the soft tissue component of people's dysfunction. Or the nutritional needs, exercises, ergonomics or other things, but the title of this post dictates that I get back to the soft tissue...

Here's the deal--there are really four main pain generators when it comes to back or neck pain: joint, muscle, nerve, and disc. They all have their signature pain description (although there is some overlap), and they often cause pain in combination. Muscle, for instance, almost always gets involved.

Chiropractors are known for joint manipulation (the adjustment), which is often the treatment of choice for back and neck pain. Patients tend to self-select for that particular treatment, too. But when the soft tissues are involved they should be addressed. The most oft overlooked soft tissue component is something you may have never heard of called fascia.

Fascia is the connective tissue that surrounds your muscles and allows your muscles and skin to slide over each other smoothly. Injuries to the soft tissue can produce adhesions in the fascia which will cause movement restrictions which can eventually lead one down the path of dysfunction. Another problem with the fascia is the fact that it's relatively  avascular, that is, it doesn't have much blood supply. Tissues without much blood supply don't heal as quickly. What that means is after an injury muscles heal, but fascia can be deformed and cause lasting problems.

Enter Instrument Assisted Soft Tissue Mobilization (IASTM). I'm not the only Houston chiropractor to use it, but you can probably count on one hand how many do, and this is a big city. IASTM involves using a special set of tools to identify the adhesions in the fascia and then break them down. The tools purposely cause an inflammatory reaction which can bring blood flow to an area that doesn't usually get much blood. It also helps break down scar tissue which causes movement restriction.

What is it good for? I'm glad you asked. Just today I've seen two shoulder complaints, both of which are bordering on being fairly chronic. I also have a chronic tennis elbow (lateral epicondylitis if you want to be technical) patient who is responding nicely, and another with the same condition who is now pain free. Ankle sprains respond well, too. And that's just the extremity stuff. Fascia is often involved with chronic neck pain as well.

I love treating back pain and neck pain. When I get ten seconds to tell people what I do, I stick to those two bread and butter conditions. But give me 45 seconds and I'll get through headaches and move straight into extremity conditions that are usually driven by soft tissue dysfunction.