[libribook.com] Traumatic Scar Tissue Management 1st Edition

Clinical Consideration
It appears that manual therapies employ mechanosensory afferents (group
I–IV). Manual technique effectiveness is – in part – due to evocation of
neuronal activity of particular magnitude and in a pattern not seen during
‘normal’ activity (Pickar et al. 2007). Mechanical (manual) stimulation of
intrafascial mechanoreceptors evokes cellular ‘downstream’ effects linked
to fascial tonus changes and healing (Langevin et al. 2002), as illustrated in
Figure 4.10.
There are several types of mechanoreceptors and proprioceptive
mechanoreceptors (e.g. muscle spindles, Ruffini, Golgi, Pacini, paciniform and
interstitial receptors (IRs); see Table 4.1).
Proprioceptive mechanoreceptors are found throughout skin and fascia, showing
that these tissues play an important proprioceptive role (Yahia et al. 1993).
Proprioceptors are more concentrated in transitional zones occurring near the
myotendinous junctions (MTJ), tenoperiosteal junctions, in fascial connections
between muscle/ligaments and joint capsules, retinaculum and in aponeuroses
functioning as a ‘coupling unit’.