“I wish I could just have your hands on me all the time.”
–Overheard in my clinic
I’ve had more indecent proposals.
Soft Tissue Mobilization
In the world of manual physical therapy, many different “massage” techniques are used. The more technical term for this is Soft Tissue Mobilization, coined by Gregory Johnson, PT, FFFMT, which describes the overall mobility of the muscle unit and surrounding fascia. Afterall, muscles shouldn’t just contract and relax, they should have sufficient mobility to passively shorten, lengthen, and otherwise “get out of the way” when the body is moving.
Ever see Michael Phelps on the starting block before a race? He shakes out his limbs, does his pteradactyl wing-flaps, and you can see all of his muscles gliding and sliding in a relaxed state. Michael Phelps doesn’t have “old granny arms”: loose skin and triceps with no tone. He has incredibly efficient muscle mobility. As a manual physical therapist, it’s a beautiful sight, and it’s what I work towards with all of my patients. Muscles should be able to glide and slide on each other.
Get Some Balls
Such mobility of the soft tissue helps to relieve pain, improve muscle contraction and recruitment, and increase mobility. It’s a wonderful feeling, and patients often want to know what they can do to maintain this at home, on their own. The answer? Get some balls. Tennis balls, for example. Using a ball for soft tissue mobilization is an easy way to work on tight spots, tender “trigger points”, and improve fascial mobility. Just know what tool you’re reaching for before you get started.
Tennis balls are a great way to get started. They’re very accessible, cheap (a canister of 3 is usually under $3), have a soft surface (which prevents slipping), and they hollow center allows for some give. With a few spares, you can take one to work, leave one at home, and put one in your gym bag. For your upper traps, try this: put the ball right on those bricks of upper traps of yours and then lean into a doorway or corner. Let your arms just hang down and breathe into it. Stay there for 30-90 seconds, and then work on the other side.
For the more masochist person, try a Lacrosse ball. They’re about the same size as a tennis ball, have some weight to them, a “grippier” outer texture, and are VERY firm. To get into your glutes and piriforms (the deep external rotator beneath the glutes), try this: Cross your right ankle over your left knee and lean about 45° to the right side. Place the ball in the dimple of your butt cheek, adjusting to find that “sweet spot”. Hint: don’t hang out here too long, as the sciatic nerve passes right under the piriformis. Numbness or tingling in your leg or foot tells you you’ve stayed a bit too long. It should resolve quickly, though.
For smaller, more precise places, like your plantar fascia (the sole of your foot), a golf ball is a great choice. Use some caution, especially given the very slick surface of the ball. Roll your foot over it about 30 times to get some good mobility in your foot. You may even notice some other benefits, like improved hamstring mobility. This gets into the work of Thomas Meyer’s Anatomy Trains – and it’s a magic moment when you put in the work here!
Tip: When you’re using a ball against a wall to work on your shoulders, scapulae, and mid-back, try putting the ball in an old dress sock, tube sock, or knee-high stocking. You can hold onto the top of the sock, swing the ball around back and more easily place it where you want it. Plus, it keeps it from popping out and rolling away. You’ll spend less time chasing the ball around and looking like a contortionist act.
Some Other Tools
Your imagination is the limit with self soft tissue mobilization. There’s many products available on the market for this very purpose: foam rollers, stick massagers, thera-canes, balls, mini rollers. So feel free to try them out. Just exercise some caution and don’t over-do it.
Finally, the best way to maintain that newly found mobility of yours is to use it. If you’re currently working with a PT on an injury, do the “homework” assignments you’ve been given. Soft tissue mobilization isn’t the “cure all” for your injury – it’s a tool in the toolbox. It’s best when used with exercise, according to recent research. As a reminder, see our earlier blog post about Your Un-sexy Home Exercise Program.
So – grab some balls and get mobilizing!
Mark M Lusk, DPT, OCS, CFMT