Dr. Spina,
There are many soft tissue release techniques utilizing various hold/relax intervals. What is the reasoning and background research for using 2 minutes during the relaxation phase? As always, I greatly appreciate your posts and willingness to share your wealth of knowledge.
The 2 minute mark comes out of an amalgamation of current literature that suggests that it takes approximately 2 minutes to induce plastic cellular changes. In other words, it would seem that connective tissues begin to respond in a lasting manner around this point in time after having sustained an applied load. There are several studies that lead to this theoretical application…the most recent of which was recently published in the Manual Therapy Journal:
This is by no means a hard-and-fast…most important to understand is that via cellular/histological research, more time is needed to induce plastic changes in soft tissue structure than is currently afforded by most practitioners/trainers. I personally hold treatment contacts until such time that a release occurs, as I do with flexibility training….thus I don’t use a stop watch to take an exact time…but you will notice that ‘releases’ begin to occur around this mark
Thanks for your quick response and reference, Dr. Spina. Most would view this plastic deformation of a tissue as “stretching” but could the reason for greater strength obtained at this end range be due to a proliferation of fibroblasts therefore strengthening of the tissue? I guess I’m asking if isometric load for a specific time at end range will induce a stronger ligament at the cellular level? Are we stretching AND strengthening the capsule ligamentous structures (not asking about muscle sarcomeres) at the same time?
When looking at the research as a whole, we have every reason to work with the premise that any induced load/force on tissues of all types (especially on the collective ‘connective tissues’ which all originate from the same pre-genitor cell) will induce changes such that the tissues will be better able to handle, or ‘accept’ the imposed loads. This concept is of course subject to certain ‘rules’ of load application…for example: 1. Load imparted must be at a level that does not exceed the particular tissues load bearing capacity so as not to induce injury – 2. Loads imparted (which I like to think of as communicated ‘messages’) must be received over prolonged periods in both the frequency, as well as time-span of individual ‘messages.’ – 3. The directionality of the load/force must be such that they ‘blastic cells’ are able to create load bearing alterations to accommodate for the line of force application. To answer your question directly, we can conclude, using sensical extrapolation from a variety of research streams, that angle specific load application will effectively induce changes at the cellular level (which themselves are the result of action at the sub-cellular level – including alterations of RNA activity and protein production) that will produce stronger tissues which are more capable of dealing with angle/direction specific loads. It would seem that force/load/messages need not be contractile in nature, and that passive force application can also induce favourable changes. An example of this is ‘Stretch Induced Hypertrophy’ in muscle tissue as a result of passive stretching alone.
The ‘magic’ rule seems to be that a force (which I deem the ‘language of cells’) alone provides the necessary stimulus for plastic tissue changes. However, the resultant changes themselves depend on alteration of the parameters of said force application (ie. amount, direction, frequency, angle, speed, etc.)
This gets even more interesting when we look at the force generated by ‘active,’ contractile tissue (for example isometric loads) and how they influence the tissues that are commonly, yet incorrectly, considered to be ‘passive’ tissues such as ligaments, capsules, etc., in light of work by authors such as Van der wal, who redefine articular anatomy by describing a continuity of tissue rather than distinct separation. In this view, all tissues, including those traditionally thought of as ‘active’ and those thought of as ‘passive,’ are subject to changes under imposed forces simultaneously….but this is another topic altogether.
Dr. Spina, the 2 minutes mark must be achieved in that particular “set” or can someone split the 2 minutes for example in 30” holds? (making the total volume represent 2 or + minutes in the position)
Dr. Spina, the 2 minutes mark must be reached in one “set” or can someone split the 2 minutes between for example 30” holds? (Making the total volume correspond to 2 or + minutes in the position)
Thanks for your question. First off…don’t take the “2 minute” mark as a hard and fast rule….it is an approximation. To answer your question, no…it is not a cumulative thing. You want to stay in the range for that time period. That is what seems to be required to get cellular/fibroblastic activation
Great video. I use this as a posterior capsule mob as well..kind of like a PNF stretch for the posterior cuff to bias the capsule.
Thanks for sharing
Dr. Spina,
There are many soft tissue release techniques utilizing various hold/relax intervals. What is the reasoning and background research for using 2 minutes during the relaxation phase? As always, I greatly appreciate your posts and willingness to share your wealth of knowledge.
Hi Joe…thanks for the question
The 2 minute mark comes out of an amalgamation of current literature that suggests that it takes approximately 2 minutes to induce plastic cellular changes. In other words, it would seem that connective tissues begin to respond in a lasting manner around this point in time after having sustained an applied load. There are several studies that lead to this theoretical application…the most recent of which was recently published in the Manual Therapy Journal:
http://www.manualtherapyjournal.com/article/S1356-689X(12)00202-0/abstract
This is by no means a hard-and-fast…most important to understand is that via cellular/histological research, more time is needed to induce plastic changes in soft tissue structure than is currently afforded by most practitioners/trainers. I personally hold treatment contacts until such time that a release occurs, as I do with flexibility training….thus I don’t use a stop watch to take an exact time…but you will notice that ‘releases’ begin to occur around this mark
regards
Thanks for your quick response and reference, Dr. Spina. Most would view this plastic deformation of a tissue as “stretching” but could the reason for greater strength obtained at this end range be due to a proliferation of fibroblasts therefore strengthening of the tissue? I guess I’m asking if isometric load for a specific time at end range will induce a stronger ligament at the cellular level? Are we stretching AND strengthening the capsule ligamentous structures (not asking about muscle sarcomeres) at the same time?
When looking at the research as a whole, we have every reason to work with the premise that any induced load/force on tissues of all types (especially on the collective ‘connective tissues’ which all originate from the same pre-genitor cell) will induce changes such that the tissues will be better able to handle, or ‘accept’ the imposed loads. This concept is of course subject to certain ‘rules’ of load application…for example: 1. Load imparted must be at a level that does not exceed the particular tissues load bearing capacity so as not to induce injury – 2. Loads imparted (which I like to think of as communicated ‘messages’) must be received over prolonged periods in both the frequency, as well as time-span of individual ‘messages.’ – 3. The directionality of the load/force must be such that they ‘blastic cells’ are able to create load bearing alterations to accommodate for the line of force application. To answer your question directly, we can conclude, using sensical extrapolation from a variety of research streams, that angle specific load application will effectively induce changes at the cellular level (which themselves are the result of action at the sub-cellular level – including alterations of RNA activity and protein production) that will produce stronger tissues which are more capable of dealing with angle/direction specific loads. It would seem that force/load/messages need not be contractile in nature, and that passive force application can also induce favourable changes. An example of this is ‘Stretch Induced Hypertrophy’ in muscle tissue as a result of passive stretching alone.
The ‘magic’ rule seems to be that a force (which I deem the ‘language of cells’) alone provides the necessary stimulus for plastic tissue changes. However, the resultant changes themselves depend on alteration of the parameters of said force application (ie. amount, direction, frequency, angle, speed, etc.)
This gets even more interesting when we look at the force generated by ‘active,’ contractile tissue (for example isometric loads) and how they influence the tissues that are commonly, yet incorrectly, considered to be ‘passive’ tissues such as ligaments, capsules, etc., in light of work by authors such as Van der wal, who redefine articular anatomy by describing a continuity of tissue rather than distinct separation. In this view, all tissues, including those traditionally thought of as ‘active’ and those thought of as ‘passive,’ are subject to changes under imposed forces simultaneously….but this is another topic altogether.
Dr. Spina, the 2 minutes mark must be achieved in that particular “set” or can someone split the 2 minutes for example in 30” holds? (making the total volume represent 2 or + minutes in the position)
Thanks in advance.
Dr. Spina, the 2 minutes mark must be reached in one “set” or can someone split the 2 minutes between for example 30” holds? (Making the total volume correspond to 2 or + minutes in the position)
Thanks in advance
Hi Diiaz
Thanks for your question. First off…don’t take the “2 minute” mark as a hard and fast rule….it is an approximation. To answer your question, no…it is not a cumulative thing. You want to stay in the range for that time period. That is what seems to be required to get cellular/fibroblastic activation