Hand splinting

Shortening of the soft tissue occurs as a result of collagen cross-linking and adaptation to muscle fiber resting length coincident with the decreased demand for joint motion. For example, maintenance of metacarpal joints in full extension results in shortening of the true and accessory collateral ligaments. In patients with spasticity and diminished joint ROM, muscle tendon units shorten to produce fixed contractures.

Soft-tissue mobilization (STM) of tissue planes relative to one another is believed to promote joint ROM, reduce tissue stress, and stimulate lubrication and nutrition. However, additional research is required to determine whether STM improves therapeutic outcomes. STM techniques are believed to optimize these factors during the healing process, minimize adhesions between adjacent tissue planes, and decrease adaptive shortening.

The clinical effects of STM include decreased fluid stasis, increased extensibility of shortened tissues, improved blood flow, and proprioceptive awareness at the treatment site. The goals of STM are to improve ROM and soft tissue flexibility and to decrease pain. Gliding, that is, the movement of tendons within their sheaths or muscles within fascial compartments, is impeded by adhesions.