As a person experiencing post-polio syndrome (PPS), your experience of occupational therapy (OT) is probably of a person in a hospital. If you use adaptive equipment such as a shower chair or walker, an OT may have helped you to choose it. OTs often help people with PPS to stay independent or conserve energy and reduce fatigue.
OTs do many other kinds of work- all help people to stay strong and independent. One of these areas, soft tissue therapy, involves hands-on treatment. Soft tissue OTs work on the body’s ‘soft tissues’- your muscles, ligaments, tendons and connective tissue (fascia). This can help people who have PPS stay healthy, strong and functional. This can be a huge help for people who are feeling the muscle pain and fatigue that PPS brings.

When you have muscle pain, it can be one of three problems:¹
· Pain due to polio-affected muscles – When you originally had polio, these are the muscles that were weakened or paralysed
· Pain due to overuse – These muscles have been used more because they are compensating for other weaker, easily-tiring or unusable muscles. They have been doing way more work than they were designed for!
· Pain due to poor posture and movement patterns – Your body has an amazing ability to adapt! If your muscles aren’t strong enough to walk, you may use other muscles and walk very differently. This puts pressure in places your body isn’t able to deal with. If you are still able to walk independently, the problems are usually in your lower body. If you are using a cane or other walking assistance, the problems are usually in your upper body.

Soft tissue therapy uses a variety of techniques to help to solve all three of these problems. Two of the most common techniques are stretching and trigger point. A trigger point is a particularly painful nodule, inside a tight band of muscle. ²  By releasing those trigger points, your muscle is able to work better and recover better. If more of the muscle is working, you may find that you are even stronger. Soft tissue OTs want to help your muscles work smarter, not harder.

In the same way that we wouldn’t ask a just one person to lift a very heavy box, we shouldn’t ask just one weak muscle to do all the work. By helping weaker or overused muscles to recover, you can then recruit more muscles and share the load. If your posture or movement patterns are preventing that, then a soft tissue OT may help you begin to change these. Sometimes by compensating and changing your posture or movement patterns, your muscles end up working far harder than they need to. You could be wasting valuable energy that could be spent doing something that is important to you!

Just as your pain and movement/posture problems have developed over many years, treatment does not work overnight. Soft tissue therapy requires a consistent approach. Muscles need to recover and be retrained to stay in lengthened and strong positions. It is usual to feel pain begin to decrease after one session- but it could take up to four treatments before you feel this happen. This is because therapy may need to be slow and steady so as not to fatigue your body.

A good OT will always be aware of what you want to achieve, and will work on areas that are causing problems for you. That way, you can work towards regaining function in areas that you see as important. OT is always about helping you to do the things in your life that you really want to do- soft tissue therapy is just a more hands-on approach!

References:

1. Gawne AC, ‘Pain in Post-Polio Syndrome’ Polio Network News, 13 (1) 1997

2. Simons DG et al, Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual, Volume 1
(2nd ed) Williams & Wilkins, Philadelphia  1999.