Targeted manual therapy techniques that release muscle tension, break down scar tissue, restore circulation, and complement your chiropractic care for lasting, durable results.
Manual Therapy
Chiropractic adjustments restore spinal alignment — but the muscles, tendons, ligaments, and fascia surrounding your spine and joints need targeted care too. When only one piece is addressed, the other works against it.
Chronic muscle spasm, scar tissue from old injuries, and myofascial trigger points create a constant pulling force on your skeletal system. Without releasing these tissue restrictions, adjusted vertebrae are continuously pulled back toward dysfunction — which is why some patients plateau despite regular chiropractic care. The connective tissue needs to be addressed alongside the joints.
Dr. Etemadi integrates soft tissue therapy directly into your chiropractic visit, treating the muscles before adjusting the joint. When tight tissue is released first, the joint moves more freely during the adjustment and holds the correction longer afterward. Research published in the Journal of Chiropractic Medicine confirms that combined approaches — manual therapy plus spinal manipulation — produce superior outcomes to either treatment in isolation.
Sustained pressure releases restrictions in the fascia — the connective tissue web surrounding every muscle and organ in your body
Targeted ischemic compression on active muscle knots that refer pain to distant areas, directly breaking the pain-spasm cycle
Slow, firm cross-fiber strokes reach deeper muscle layers to release chronic tension and long-standing adhesions
Specialized stainless steel tools break down scar tissue and fibrotic adhesions with more precision and depth than hands alone
A widespread condition in which trigger points in muscle tissue generate local and referred pain throughout the body
Old injuries leave behind disorganized collagen fibers that restrict motion and cause chronic pulling sensations
Shoulder impingement and rotator cuff issues often have a significant myofascial component that responds well to manual therapy
Chronic tightness in the iliotibial band, piriformis, and hip flexors contributes to lower back pain and knee dysfunction
Clinical Evidence
Myofascial trigger points are recognized as one of the most common — and commonly overlooked — sources of musculoskeletal pain. Studies estimate they are the primary contributing factor in 30–85% of chronic pain presentations.
A 2024 meta-analysis reviewed 13 randomized controlled trials and found that trigger point therapy produced significantly greater reductions in pain intensity compared to other non-pharmacological treatments (Visual Analog Scale reduction of 1.32 points on average, p<0.0001). For patients with neck pain, a 2024 randomized clinical trial in the Hong Kong Physiotherapy Journal found that instrument-assisted soft tissue mobilization (IASTM) produced comparable results to manual myofascial release, with both groups achieving meaningful improvements in pain, range of motion, and function.
The research consistently supports what Dr. Etemadi sees clinically: when soft tissue therapy is combined with spinal manipulation, outcomes improve across every measure — pain levels, range of motion, and how long results last.
Conditions We Address
Soft tissue therapy is appropriate for a wide range of acute and chronic conditions — both as standalone care and as an essential complement to chiropractic and SoftWave treatment.
Treatment Protocol
Dr. Etemadi's treatment protocol sequences each modality in the order that produces the best physiological response — soft tissue first, then structural correction, then regenerative therapy, then rehabilitation.
Myofascial release, trigger point work, and deep tissue massage relax the surrounding musculature, reduce spasm, and restore circulation to the target area before any joint work is performed.
With the surrounding muscles no longer in protective spasm, the vertebra or joint moves more freely and with less force required — producing a more precise correction that holds position longer.
Electrohydraulic shockwave energy stimulates cellular repair, reduces residual inflammation, and reactivates the tissue's natural healing response at the biological level — complementing the manual work just performed.
Strengthening the muscles that support your corrected spinal position ensures results are maintained between visits and become progressively more durable over time.
Technique Spotlight
IASTM uses precisely shaped stainless steel instruments to detect and treat fascial restrictions, scar tissue, and chronic adhesions with a level of specificity that hands alone cannot achieve.
The instruments are designed to transmit tactile feedback to the clinician's hands, allowing Dr. Etemadi to feel subtle tissue texture changes, fibrotic nodules, and restriction patterns as he works. The tools glide across the skin with a specialized emollient, and the beveled edges create a controlled micro-inflammatory response at the treatment site — signaling the body to remodel the disorganized scar tissue into properly aligned collagen fibers.
IASTM is particularly effective for chronic conditions where scar tissue has been present for months or years: old ankle sprains that never quite healed, shoulder injuries with restricted internal rotation, hamstring adhesions from repeated micro-tears, and post-surgical tissue that has lost normal mobility. Patients often report significant changes in tissue mobility within 3–5 sessions.
Technique Spotlight
A trigger point is a hyperirritable spot in a taut band of skeletal muscle that produces a characteristic pattern of referred pain when compressed — often in a location far from the actual muscle involved.
The upper trapezius trigger point, for example, commonly generates pain at the side of the head and temple — mimicking tension headaches. The piriformis trigger point refers pain down the back of the leg — mimicking sciatica. Correctly identifying and deactivating the trigger point source resolves the referred symptom.
Dr. Etemadi uses sustained ischemic compression (direct sustained pressure) to deactivate active trigger points. This reduces localized blood flow temporarily, causing a buildup of metabolic waste that signals the central nervous system to relax the muscle fiber. When the pressure is released, fresh oxygenated blood floods the area, restoring normal muscle chemistry. A 2023 systematic review confirmed that manual trigger point therapies achieve measurable improvements in pain intensity and pressure pain threshold in upper trapezius trigger points — one of the most common presentations seen in chiropractic practice.
FAQ
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Your new patient visit includes a full consultation, exam, X-rays, and your first treatment session — giving Dr. Etemadi the full picture before designing your care plan.