Fitness & Health, Sports Medicine

Active assisted soft tissue release for the upper back

Active assisted soft tissue release for the upper back

The Upper Trapezius, Levator Scapulae and Erector Spinae are often tight in athletes (and non-athletes). This post adapted from Soft Tissue and Trigger Point Release, 2nd Edition helps you understand and perform active- assisted soft tissue release for the upper back.

Introduction to Active-Assisted Soft Tissue Release

Unlike passive soft tissue release (STR) where tissues are shortened and locked by the therapist or active STR, where the client performs the technique, active-assisted STR combines the efforts of both client and therapist.

It’s useful for working with clients who find it difficult to relax during treatment and also for those who like to be engaged with their treatment. It also enables the practitioner to apply more pressure when locking tissues, as might occur when treating clients who do not feel the stretch of passive STR.

Active-assisted STR enables the therapist to use both hands if necessary to apply a firmer lock, which is helpful when treating large, bulky muscles such as hamstrings and quadriceps. Ability to reinforce a lock also enables you to safeguard your wrists, fingers and thumbs.

Active Assisted Soft Tissue Release for Rehab

Active-assisted STR is particularly useful as part of the rehabilitation process after joint immobilisation. Not only does it facilitate an increased range of motion in the joint, but it also contributes to improving strength in the associated muscles. This strengthening occurs because the client is actively engaged in using the muscle being treated or the opposing muscle. It is a valuable rehabilitation technique and may be a safer post-surgery application than passive STR because clients are encouraged to work within their pain-free range.

With permission from medical personnel, it may be used early in the rehabilitation process to help keep joints lubricated and active movement may encourage better alignment of collagen fibres that might otherwise occur if the joint were left immobile.

Active Assisted or Passive Soft Tissue Release

The biggest difference between active-assisted and passive STR is that in passive STR, the therapist is stretching a relaxed muscle. In active-assisted STR, the muscle being stretched might be contracting eccentrically as the client uses it to move the associated joint.

Active assisted soft tissue release for the upper back

Upper Trapezius

With your client sitting, lock the upper fibres of the trapezius. Whilst maintaining your lock, ask your client to flex his or her neck laterally until he or she feels a comfortable stretch. Repeat the action three times, then repeat on the opposite side of the body. Notice how your lock gets dragged towards the ear slightly as your client laterally flexes the neck. To counter this movement, you need to direct your pressure gently away from the ear, toward the top of the shoulder, without pressing into the acromion, which would be uncomfortable for the client.

Active assisted soft tissue release for the upper back/trapezius

Another option is to use your thumbs, a massage tool or a tennis ball to lock into the upper fibres of the trapezius whilst your client is in the supine position. Once locked, ask your client to laterally flex the head and neck. For example, when locking the right trapezius you might ask the client to take the left ear to the left shoulder.

Scalenes

With your client sitting, gently lock the scalenes using your fingers. Ask your client to rotate his or her head away from you until he or she feels a comfortable stretch in the tissues. Perform the action three times on both the left and right sides. Notice how your fingers are drawn away from the clavicle as your client turns the head away from you. Counter this movement with very gentle pressure, taking care not to press too deeply.

Active assisted soft tissue release for the upper back scalenes
Scalenes are a group of three pairs of muscles in the lateral neck: scalenus anterior, scalenus medius and scalenus posterior. Sometimes a fourth muscle, the scalenus minimus is present behind the lower portion of the scalenus anterior.
Active assisted soft tissue release for the upper back scalenes_2
This technique is also effective when treating a client in the supine position.

Levator Scapulae

Locate and lock the levator scapulae. Whilst maintaining your lock, ask your client to rotate the head to about 45 degrees and then lower the chin to look to the floor. Ask your client to repeat this stretch three times; then use the same stretch on the opposite side of the body. Notice how your elbow is drawn up towards the head as the client stretches. Counter this movement with gentle pressure in the opposite direction, towards the top of the scapula.

Active assisted soft tissue release for the upper back levator scapulae
Active assisted soft tissue release for the upper back/levator scapulae

Erector Spinae (Spinalis)

With your client sitting, lock the tissues just below the neck. Whilst maintaining your lock, ask your client to flex the neck. Release and repeat, placing your lock slightly superior to the first one. To counter the drag of soft tissues into the neck, direct your lock into the tissues and to the floor at the same time. One of the challenges of applying active-assisted STR to erector spinae with a client seated is that there is a tendency to push the client forwards as you press into the tissues in an attempt to create a lock. One way to counter this movement is to have the client straddle the chair, with a pillow between his or her chest and the back of the chair.

Active assisted soft tissue release for the upper back erector spinae
Active assisted soft tissue release for the upper back erector spinae

Who can benefit from active assisted soft tissue release for the upper back?

As many athletes and non athletes suffer with back pain. Active assisted soft tissue release for the upper back is often carried out on:

  • Office workers who spend long periods of the day sitting
  • Long distance drivers
  • Clients who suffer headaches due to muscle tension
  • Athletes needing treatment after immobilization of the scapula or as part of the rehabilitation process after injury to the shoulder
  • Athletes who perform repeated shoulder or prolonged movements of the shoulder, such as weightlifters swimmers, tennis players or cricket bowlers.
  • Professional artists, painters and models who hold static postures for prolonged periods of time

Why active assisted soft tissue release?

These are a few of the reasons you or your clinet may want to perform active assisted soft tissue release:

  • Increase the range of motion in the neck
  • For treatment after immobilisation of the neck
  • Release tension from the back

To find out more about active assisted soft tissue release you can buy
Soft Tissue and Trigger Point Release, 2nd Edition now.

The book also goes into depth about passive STR and active STR for every part of the body. Author Jane Johnson also helps you create an STR programme.

Free webinars on back and neck pain

If you’d like to learn more about neck pain, do not miss out on our free upcoming webinar the author of Soft Tissue and Trigger Point Release, 2nd Edition, Jane Johnson. The webinar is titled Treating neck pain it will be presented on Wednesday 27th March at 15.00GMT.

Last year Jane delivered a free webinar on back pain. At the end of 2018 we wrote about our year in review. Jane’s back pain presentation was our most popular webinar, not only last year but of all time.

More from Jane

Jane Johnson is a bestselling author for Human Kinetics, not only an expert in treating neck pain and muscle injuries. She has authored Postural Assessment, Postural Correction, Soft Tissue ReleaseDeep Tissue MassageTherapeutic Stretching and of course the new for 2019 Soft Tissue and Trigger Point Release for Human Kinetics.

Some of our most popular blog articles have also been written by Jane, such as:

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Hi, I'm Ryan, one of the bloggers here at Human Kinetics Europe Ltd. (If you want my official title, it's Marketing Executive.) I've always had a passion for health and fitness, having previously worked in gyms and played a variety of sports all my life. Now (as a somewhat of a washed-up athlete) I find myself working at the world’s biggest independent publisher of sport, health, dance and fitness resources. Which is amazing! Why? Because I get unrestricted access to all the best, most interesting, scientifically-proven writing on sports science. And what's more, I get to share it all with you!