Therapeutic effects of heat, cold, and stretch on connective tissue

The anatomic architecture of connective tissue is dependent on the stresses associated with motion. Immobilization results in stress deprivation, causing structural changes in the tissue matrix. The structural changes that occur are due to the remodeling of tissue to its new resting length while being held immobile. The goal of remodeling stiffened, shortened tissues is to regain tissue length and promote unrestricted tissue gliding. The article reviews studies that examine the viscoelastic response of connective tissue to heat, cold, and stretch. An understanding of connective tissue response to these therapeutic interventions will enable clinicians to choose the appropriate modality and apply stretching techniques in a safe, efficient manner to enable patients to regain mobility.