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Soft Tissue Injury

By Dr. Patrick J. McBrearty

Did you know that the most common injury people experience from exercise and daily recreational activities is a soft tissue injury? That’s right, a soft tissue injury! So what is a soft tissue injury? By definition, the “soft tissue” in the body refers to the muscles, tendons, ligaments, nerves, and even fascia (for example the Plantar Fascia in your foot). These are the tissues that actually move your body or lengthen and shorten when your body is moving. There are many types of injuries that can occur to these tissues.

Some can be obvious, such as a sprained ankle. Others can sneak up on us, like that time you bent forward and felt that twinge in your low back without any sign that you were starting to become injured. When a person experiences a soft tissue injury, many people consult their primary care physician, an Urgent Care facility, or an orthopedist hoping to get “fixed” and resume their weekly exercise regimen or weekend warrior activities. The reality is that health care providers at these facilities are very limited in what tools they have available to fix the true cause of pain and/or dysfunction. A typical method of care from any of the above-mentioned medical professionals is a prescription of muscle relaxants, anti-inflammatories, and pain medication and then be on your way. While all of these can be valuable given the circumstances, none of them specifically address the true root cause of the pain and/or dysfunction. This is why when a person experiences a soft tissue injury, they need to look for a provider certified in Active Release Techniques as their FIRST choice for treatment.

Active Release Techniques (ART) is a method of diagnosing and treating soft tissue injuries. During the examination and treatment an ART provider evaluates the soft tissue for “hard tissue.” This “hard tissue” is scar tissue that has developed as the body repairs itself. As you exercise your soft tissue becomes fatigued. This causes the soft tissue to become weak and tight. The body interprets this weakness and tightness as damage in the soft tissue. Any time there is an injury to the body, your body goes through a natural response to heal the damaged tissue.

This process consists of three phases of healing. The first phase is the inflammation phase. During this phase the tissue will become red, swollen, and very sensitive. Once this phase is complete, the body will go into the second phase of healing which is the repair phase. During this phase, the body lays down scar tissue to repair the tissue that has been damaged. The third and final phase of healing is the remodeling phase. It is during this phase that the scar tissue reshapes itself depending on the forces that are being applied to it.

Scar tissue has two effects on the body. The first effect is that scar tissue is not elastic. When viewed under a microscope, scar tissue looks like overlapping spider webs. As you can imagine, this is not very elastic which limits the tissue’s ability to stretch and restricts range of motion. The second and most important effect is that the scar tissue limits blood flow to the soft tissue. If blood flow to a soft tissue becomes restricted, it will cause the soft tissue to fatigue faster and heal slower which will effect performance, recovery and repair.

ART is a movement-based technique that focuses on restoring the natural function of the soft tissue. With ART, a provider can quickly and effectively break up the scar tissue that is effecting circulation to the soft tissue and function of the soft tissue. Soft tissue should be by definition, soft and supple. The tissues should be able to move freely without irritating any surrounding structures. When scar tissue is present, it acts as an adhesive between tissues. Two tissues that have scar tissue between them will cause an “Indian Rug Burn” effect that causes the soft tissues to become irritated and inflamed causing the phases of healing to occur. During treatment, there is usually a slight burning sensation at the area of scar tissue due to the sensitivity of the scar tissue. Scar tissue is very sensitive to treat because there are 10 times more free nerve endings in scar tissue than in healthy tissue. This increased sensitivity allows the body to have a heightened awareness of the damaged tissue so that you do not do any further damage.
With Active Release Techniques, performing the treatment is very simple. The ART provider finds the area of scar tissue and evaluates what tissues are being affected. This evaluation requires an expert knowledge of the anatomy through pinpoint accuracy with their touch. Once the effected tissue has been identified, the provider shortens the tissue, establishes tension, and lengthens the tissue. At the end of the range of motion, the ART provider holds until the scar tissue releases. It is this release that allows the “hard” scar tissue to resume its natural healthy state as soft tissue. With this method of treatment, the ART provider is able to treat the root cause of pain and/or dysfunction. Typically, patients feel the effect immediately! If you could find a treatment that treated the cause of your pain immediately, wouldn’t you want to go there first before trying any other method of treatment? Patients get results fast, which is why most teams in the NFL, MLB, NBA, and NHL utilize ART providers to get athletes back playing quickly after being injured.

Dr. Patrick McBrearty is an ART instructor and his team of ART providers is Full Body Certified with over 15 years of experience. If you would like to learn more about ART, you can email Dr. McBrearty at or visit his website at

Soft Tissue Injury

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