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

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Bending techniqueA therapeutic loading technique involving combined compression and tensionloading. One side of the tissue is compressed as the other side is elongated, oftenperformed cross fiber – intended to influence tissue length, tissue glide and fluidmovement and mechanical cleavage/disengagement of undue cross-links.
Best research evidenceThe best available clinical, client-centered research pertaining to accuracy, safetyand efficiency of diagnostic/assessment procedures, prognostic markers andtherapeutic interventions.
Page 2 and 3: Traumatic Scar Tissue ManagementMas
Page 4: Letter to NKS - from Camp Amigo cam
Page 7 and 8: Important noticeNeither the publish
Page 9 and 10: FOREWORDEveryone has scars: visible
Page 11 and 12: stories about how basic massage the
Page 13 and 14: to the events that resulted in the
Page 15 and 16: PREFACEMore people are surviving tr
Page 17 and 18: and
Page 19 and 20: ACKNOWLEDGEMENTSA thank you to the
Page 21 and 22: Lastly, thank you, the reader; the
Page 23 and 24: GLOSSARY AND KEY CONCEPTSAll the wo
Page 25 and 26: AdhesionsScar-like tissue that form
Page 27 and 28: Alphabet techniquesCs, Js, and Ss -
Page 29 and 30: AngiogenesisGrowth of new blood ves
Page 31 and 32: AponeurosesDense, sheet-like fascia
Page 33 and 34: Autonomic balanceHomeostatic and co
Page 35: BarrierIs defined as the point wher
Page 39 and 40: Body AwarenessConscious, attentiona
Page 41 and 42: BradykininInflammatory mediator - a
Page 43 and 44: Capsular contractureEnvelopment of
Page 45 and 46: ChemokinesSmall molecules released
Page 47 and 48: CicatrixAnother term for scar - the
Page 49 and 50: Collagen crimpThe wavy formation se
Page 51 and 52: Compassion fatigueThe profound emot
Page 53 and 54: Compression techniqueA therapeutic
Page 55 and 56: Consolidated edemaChronic stage ede
Page 57 and 58: CortisolHormone released in respons
Page 59 and 60: CreepA time-dependent response of v
Page 61 and 62: DebridementRemoval of foreign mater
Page 63 and 64: Degloving injuryA form of avulsion
Page 65 and 66: DermatomeAreas of skin supplied by
Page 67 and 68: Direct release techniqueCommonly us
Page 69 and 70: Dry needlingA procedure involving i
Page 71 and 72: Empathy strainA healthcare provider
Page 73 and 74: EndoneuriumFascia surrounding indiv
Page 75 and 76: Endothelial cellsSimple squamous ce
Page 77 and 78: EndoscopeAn instrument that is used
Page 79 and 80: EpidermisThe tough, outermost layer
Page 81 and 82: EpineuriumOutermost covering of fas
Page 83 and 84: Epithelial cellsCells that line the
Page 85 and 86: FasciaFibrocollagenous CT, its morp
Page 87 and 88:
FibrinFibrous protein involved bloo
Page 89 and 90:
FibroblastsSynthesize the component
Page 91 and 92:
FibrosisA process culminating in th
Page 93 and 94:
Fluid techniquesTechniques employed
Page 95 and 96:
Gentle circles techniqueCircular mo
Page 97 and 98:
Gross stretch techniqueCombination
Page 99 and 100:
HomeostasisState of physiological e
Page 101 and 102:
HyperalgesiaHeightened pain sensati
Page 103 and 104:
HyperexcitationNeurons firing too e
Page 105 and 106:
Hypertrophic scarA thickened, red a
Page 107 and 108:
HysteresisA property of systems (ti
Page 109 and 110:
Indirect release techniqueMechanica
Page 111 and 112:
Informed consentProcess involving t
Page 113 and 114:
Intense versus invasiveAn important
Page 115 and 116:
InteroceptionIncludes a wide range
Page 117 and 118:
KeratinA structural protein that pr
Page 119 and 120:
KininsPeptides (e.g. bradykinin) pr
Page 121 and 122:
Linking fasciaPlays a role in augme
Page 123 and 124:
Lymph nodesFilter and clean the lym
Page 125 and 126:
LymphangiogenesisFormation of new l
Page 127 and 128:
Lymphatic drainageThe movement of f
Page 129 and 130:
Lymphatic returnVolume of lymph ret
Page 131 and 132:
Lymphatic transportThe movement of
Page 133 and 134:
Lymphatic vesselsTri-laminar vessel
Page 135 and 136:
LymphocyteThe main cell type found
Page 137 and 138:
MacrophageA type of phagocytic whit
Page 139 and 140:
MastectomySurgical removal of all b
Page 141 and 142:
MechanotransductionThe mechanism by
Page 143 and 144:
MucopolysaccharidesSee GAGs.Myofasc
Page 145 and 146:
Nerve receptorsNerve terminations t
Page 147 and 148:
NeurofasciaTri-laminar, continuous
Page 149 and 150:
Neuropathic painPain due to damage
Page 151 and 152:
NeuropeptidesSignaling molecules th
Page 153 and 154:
NociceptionThreatening stimuli acti
Page 155 and 156:
Nociceptive painPain that arises fr
Page 157 and 158:
OxytocinHormone that plays role in
Page 159 and 160:
ParesthesiaAltered sensations; e.g.
Page 161 and 162:
Peripheral sensitizationIncreased r
Page 163 and 164:
PerineuriumFascia surrounding/inves
Page 165 and 166:
Pitting edemaAn edematous region wh
Page 167 and 168:
Proprioceptive disinformationRecept
Page 169 and 170:
Provisional matrixDuring the early
Page 171 and 172:
Pumping techniqueA lymphatic techni
Page 173 and 174:
Referred painPain perceived at a lo
Page 175 and 176:
RetinaculaeDense fascial bands that
Page 177 and 178:
ScarMark left in various tissues or
Page 179 and 180:
Secondary lymphedemaOccurs as a res
Page 181 and 182:
Self careThose practices and activi
Page 183 and 184:
Selfcare managementResponse to sens
Page 185 and 186:
SensitizationChanges in the PNS or
Page 187 and 188:
SerotoninNeurotransmitter involved
Page 189 and 190:
Shear techniqueA therapeutic loadin
Page 191 and 192:
Skin graftMedical procedure where a
Page 193 and 194:
SomatizationA tendency to experienc
Page 195 and 196:
State anxietyThe experience of unpl
Page 197 and 198:
Stress response adaptationAny of th
Page 199 and 200:
Stress responseAny cognitive, physi
Page 201 and 202:
Substance PA neuropeptide acting as
Page 203 and 204:
Therapeutic environmentEncompasses
Page 205 and 206:
Therapeutic relationshipEncompasses
Page 207 and 208:
Trait anxietyA more intense degree
Page 209 and 210:
TraumaInsult or injury to the physi
Page 211 and 212:
Traumatic scarPathophysiological sc
Page 213 and 214:
ViscoelasticityThe ability of a med
Page 215 and 216:
Nowadays it is common to see massag
Page 217 and 218:
A Reasonable NexusPrecise etiologic
Page 219 and 220:
integration of art and science are
Page 221 and 222:
Diamond M (2012) Scars and adhesion
Page 223 and 224:
General HistologyExtracellular Matr
Page 225 and 226:
Clinical ConsiderationVitamin C has
Page 227 and 228:
Ground substanceGround substance (G
Page 229 and 230:
Pathophysiological ConsiderationIn
Page 231 and 232:
HyaluronanThis hydrophilic, viscous
Page 233 and 234:
Clinical ConsiderationHA and its fr
Page 236 and 237:
Figure 2.1Layers and components of
Page 238 and 239:
Skin HistologyThe skin comprises:
Page 241 and 242:
Figure 2.2The delicate, well-hydrat
Page 243 and 244:
DermisThe dermis is made up of laye
Page 245 and 246:
Fascia Structure and FunctionsIn th
Page 247 and 248:
fundamental characteristic is its c
Page 249 and 250:
tensional properties co-exist in bo
Page 251 and 252:
HistologyFascia comprises:• ECM (
Page 253 and 254:
Clinical ConsiderationManual therap
Page 255 and 256:
Clinical ConsiderationTransforming
Page 257 and 258:
CollagenCollagen is the most abunda
Page 259 and 260:
Clinical ConsiderationSignificant c
Page 261 and 262:
Fascia Layers and FunctionsFascia t
Page 263 and 264:
Clinical ConsiderationSuperficial a
Page 265:
Clinical ConsiderationWhen thickene
Page 268 and 269:
LinkingLinking fascia is sub-divide
Page 270 and 271:
FascicularFascicular fascia augment
Page 272 and 273:
Clinical ConsiderationMuscle spindl
Page 274 and 275:
SeparatingSeparating fascia provide
Page 276 and 277:
Clinical ConsiderationFascia suppor
Page 278 and 279:
Andrade C-K (2013) Outcome-based ma
Page 280 and 281:
Ingber D (2008) Tensegrity and mech
Page 282 and 283:
tendons: organisation in vivo and r
Page 284 and 285:
Zorn A, Hodeck K (2011) Walk with e
Page 286 and 287:
Discovery of the Lymphatic SystemTh
Page 288 and 289:
Hematic SystemThe heart, blood vess
Page 290 and 291:
Lymphatic System Structure and Func
Page 292 and 293:
Clinical ConsiderationNerves, blood
Page 295:
Figure 3.1Lymph tissue structure.In
Page 298 and 299:
Lymphoid OrgansThe lymphoid organs
Page 300 and 301:
ThymusThe thymus is a lymphoid glan
Page 302 and 303:
Lymphatic Drainage and TransportIn
Page 304 and 305:
SuperficialThe superficial layer is
Page 306:
Primary upper lymphatic structuresT
Page 309 and 310:
Primary lower lymphatic structuresT
Page 311 and 312:
Left side lymphatic drainageThe lef
Page 313 and 314:
Lymphatic System FunctionsA brief o
Page 316 and 317:
Fig 3.5Brain lymphatic vessels.Give
Page 318:
ImmunityLymph nodes play an importa
Page 321 and 322:
Wound HealingAs with the blood vasc
Page 323 and 324:
Clinical ConsiderationFour continuo
Page 325 and 326:
Lymphatic InadequacyInadequacy in t
Page 327 and 328:
EdemaEdema - the medical term for s
Page 329 and 330:
Lymphatic treatment protocols will
Page 331 and 332:
CHAPTER 4NeurologyEach human nervou
Page 333:
NS StructureThe human NS comprises
Page 337 and 338:
Figure 4.1B Functional composition
Page 339 and 340:
Pathophysiological ConsiderationWhe
Page 341 and 342:
Figure 4.2Dorsal and ventral compon
Page 344 and 345:
Figure 4.3Neuron anatomy: most neur
Page 346 and 347:
Figure 4.4Classic axon to dendrite
Page 349:
Figure 4.6PNS efferent (motor) and
Page 352 and 353:
Clinical ConsiderationPSNS afferent
Page 354 and 355:
Clinical ConsiderationSNS activatio
Page 357 and 358:
Figure 4.8Anterior and posterior di
Page 360 and 361:
Figure 4.9Neurofascial envelopes.
Page 362 and 363:
Pathophysiological ConsiderationA n
Page 364 and 365:
Clinical ConsiderationThere is an e
Page 366 and 367:
Clinical ConsiderationDiane Jacobs
Page 368 and 369:
Clinical ConsiderationIt appears th
Page 370 and 371:
Clinical ConsiderationAlthough musc
Page 372 and 373:
Clinical ConsiderationThe form of s
Page 374 and 375:
Example 2Ruffini stimulation result
Page 376 and 377:
Table 4.1Summary of receptor typolo
Page 378 and 379:
• Therapeutic outcome include enh
Page 380 and 381:
NS FunctionThe primary functions of
Page 382 and 383:
Clinical ConsiderationMechanorecept
Page 384 and 385:
Clinical ConsiderationIn addition t
Page 386 and 387:
Clinical ConsiderationManual techni
Page 388 and 389:
large enough, a voltage spike is pr
Page 390 and 391:
PathophysiologicalconsiderationUnde
Page 392 and 393:
Table 4.2Important pain terms. Vari
Page 394 and 395:
Clinical ConsiderationAccording to
Page 396 and 397:
disorders (diabetes mellitus), drug
Page 398 and 399:
forms of negative plasticity includ
Page 400 and 401:
Central and peripheral sensitizatio
Page 402 and 403:
Clinical ConsiderationFollowing per
Page 404 and 405:
ExampleHypersensitive nerves (assoc
Page 406 and 407:
Example 1Hypersensitized nerve fibe
Page 408 and 409:
Clinical ConsiderationIt is suggest
Page 410 and 411:
Clinical ConsiderationNeuropathic p
Page 412 and 413:
Wound HealingThe NS plays an import
Page 414 and 415:
Clinical ConsiderationNeural and ci
Page 416 and 417:
Compression SyndromesAlthough perip
Page 418 and 419:
Pathophysiological ConsiderationIf
Page 420 and 421:
Pathophysiological ConsiderationUni
Page 422 and 423:
Clinical ConsiderationAs is the cas
Page 424 and 425:
Pathophysiological ConsiderationFas
Page 426 and 427:
Damasio AR, Grabowski TJ, Bechara A
Page 428 and 429:
Magee DJ (2008) Orthopedic physical
Page 430 and 431:
Stecco C, Porzionato A, Macchi V et
Page 432 and 433:
CHAPTER 5Wound healing and scarsNev
Page 434 and 435:
Wound HealingWound healing, a compl
Page 436 and 437:
Table 5.1Stages of wound healing
Page 438:
Clinical ConsiderationBecause thera
Page 441 and 442:
fibroblast growth factor (FGF), epi
Page 443 and 444:
Clinical ConsiderationDuring wound
Page 445 and 446:
Clinical ConsiderationAlthough the
Page 447 and 448:
Pathophysiological ScarsPathophysio
Page 450 and 451:
Figure 5.3Adapted from Huang et al.
Page 452 and 453:
Pathophysiological considerationFib
Page 454 and 455:
Table 5.2Important pathophysiologic
Page 456 and 457:
According to Klingler (2012):… pa
Page 458 and 459:
Table 5.3Scar types and related ter
Page 460 and 461:
unyielding or pliable and mobile. R
Page 462 and 463:
Prolonged InflammationInflammation
Page 464 and 465:
ImmobilizationThe impact of immobil
Page 467 and 468:
Figure 5.4The fall-out associated w
Page 469 and 470:
Clinical ConsiderationHere we see t
Page 471 and 472:
Pathophysiological ConsiderationAcc
Page 473 and 474:
Pathophysiological ConsiderationNeu
Page 475 and 476:
The diverse biological effects of N
Page 477 and 478:
Clinical ConsiderationCareful appli
Page 479 and 480:
Clinical ConsiderationSome patholog
Page 481 and 482:
Pathophysiological ConsiderationSom
Page 483 and 484:
compressive effect in the keloidal
Page 485 and 486:
alterations in the mechanical envir
Page 487 and 488:
Clinical ConsiderationMechanical fo
Page 489 and 490:
Table 5.4Role of neuropeptides (NP)
Page 491 and 492:
Fitch P (2005) Scars of life. Journ
Page 493 and 494:
Langevin HM (2006) Connective tissu
Page 495 and 496:
active scars. Journal of Bodywork a
Page 497 and 498:
trauma.
Page 499 and 500:
Clinical ConsiderationPostsurgical
Page 501 and 502:
following burn injury,bacterial col
Page 503 and 504:
Table 6.1Comparison of scars (Ogawa
Page 505 and 506:
Page 507 and 508:
BurnsA burn injury to the skin or o
Page 510 and 511:
Figure 6.1Depth of burn trauma and
Page 512 and 513:
• Stimulate ECM formation• Regu
Page 514 and 515:
Clinical ConsiderationIt has been i
Page 516 and 517:
Clinical ConsiderationMT may be a v
Page 518 and 519:
ThermoregulationThermoregulation (t
Page 520 and 521:
from the tissues and taken up by th
Page 522 and 523:
treatment strategies are difficult
Page 524 and 525:
Clinical ConsiderationSkin rolling
Page 526 and 527:
Sequelae and ComplicationsAdvances
Page 528 and 529:
• Paresthesia - 47%• Arm/should
Page 530 and 531:
breast or around the edge of the ar
Page 532 and 533:
Radiation scarringScar tissue as a
Page 534 and 535:
Implants and painPain of fluctuatin
Page 536 and 537:
LymphedemaBreast cancer treatment o
Page 538 and 539:
volume of fluid that accumulates or
Page 540 and 541:
OneTwoThreeCommonly referred to as
Page 542 and 543:
myokinetic chain/myofascial meridia
Page 544:
• Loss of touch sensation• Clum
Page 548 and 549:
Figure 6.3Distribution of nerves in
Page 550 and 551:
include preservation of as much of
Page 552 and 553:
complication is present there is de
Page 554 and 555:
Clinical ConsiderationScar complica
Page 556 and 557:
BreastCancer.org (2015c) Side Effec
Page 558 and 559:
323-9.Kania A (2012) Scars. In: Dry
Page 560 and 561:
Slemp AE, Kirschner RE (2006) Keloi
Page 562 and 563:
scar tissue, while being mindful of
Page 564 and 565:
Physiological ResponseAs discussed
Page 566 and 567:
• The realization that one is abo
Page 568 and 569:
Stress Response and Stress Hormones
Page 570 and 571:
dissociation and inner shakiness) (
Page 572:
Figure 7.1(A) Summary of the HPA me
Page 575 and 576:
Chronic Stress ResponseChronic stre
Page 577 and 578:
Pathophysiological ConsiderationChr
Page 579 and 580:
Clinical ConsiderationProlonged str
Page 581 and 582:
Psychological Stress and Wound Heal
Page 583 and 584:
Pathophysiological ConsiderationNor
Page 585 and 586:
Pathophysiological ConsiderationStr
Page 587 and 588:
Page 589 and 590:
Clinical ConsiderationEvidence sugg
Page 591 and 592:
Page 593 and 594:
Clinical ConsiderationThe effects o
Page 595 and 596:
Stress DisordersFollowing a traumat
Page 597 and 598:
Clinical ConsiderationThe Task Forc
Page 599 and 600:
Clinical ConsiderationCertainly it
Page 601 and 602:
ASD symptoms include (DSM-V 2013):
Page 603 and 604:
Box 7.1Why do medical events potent
Page 605 and 606:
Rehabilitation and reintegrationThi
Page 607 and 608:
Page 609 and 610:
Page 611 and 612:
DissociationDissociation is describ
Page 613 and 614:
Page 615 and 616:
not only does the brain carry memor
Page 617 and 618:
Page 619 and 620:
Somatoemotional ResponseDuring trea
Page 621 and 622:
• If the client asks what happene
Page 623 and 624:
Clinical ConsiderationWorking with
Page 625 and 626:
Given the impact of trauma on the b
Page 627 and 628:
Page 629 and 630:
The Massage Therapist and TraumaThe
Page 631 and 632:
Bordoni B, Zanier E (2014) Skin, fa
Page 633 and 634:
Foex (2013) Surgical Tutor UK Avail
Page 635 and 636:
Kutner JS, Smith MC, Corbin L et al
Page 637 and 638:
Schmidt NB, Richey JA, Zvolensky MJ
Page 639 and 640:
CHAPTER 8Communication and the ther
Page 641 and 642:
The Therapeutic RelationshipThe the
Page 643 and 644:
Needs assessment, treatment plannin
Page 645 and 646:
Clinical ConsiderationIt is importa
Page 647 and 648:
Therapeutic Closeness and Vulnerabi
Page 649 and 650:
BoundariesOver the course of our li
Page 651 and 652:
Box 8.1Aside from obvious sexually
Page 653 and 654:
Box 8.2Eight principles that guide
Page 655 and 656:
Effective Listening and Empathetic
Page 657 and 658:
Clinical ConsiderationNever underst
Page 659 and 660:
Clinical ConsiderationAs manual the
Page 661 and 662:
Interview exampleMary is a client w
Page 663 and 664:
SummarySeveral pieces of informatio
Page 665 and 666:
with traumatic scar tissue clients.
Page 667 and 668:
‘Physicians’ perspective of mas
Page 669 and 670:
Referral exampleTonya, a 21-year-ol
Page 671 and 672:
Referral exampleJane experienced me
Page 673 and 674:
CHAPTER 9Assessment and treatmentHe
Page 675 and 676:
MT. Additionally, sometimes people
Page 677 and 678:
Traumatic Scars and Associated Impa
Page 679 and 680:
Clinical ConsiderationReduction of
Page 681 and 682:
Clinical ConsiderationMT has been f
Page 683 and 684:
Clinical ConsiderationMassage can h
Page 685 and 686:
Health History and InterviewA stand
Page 687 and 688:
surrounding muscle structures that
Page 689 and 690:
we are gathering information about
Page 691 and 692:
Keep in mind that the therapist’s
Page 693 and 694:
Continuous evaluation during the se
Page 695 and 696:
Pre-treatment assessment/evaluation
Page 697 and 698:
Scar scalesScar scales can be used
Page 699 and 700:
response to negative pressure. It h
Page 701 and 702:
• Client self-management strategi
Page 703 and 704:
BindOnce barrier is reached or surp
Page 705 and 706:
Table 9.1Comparative of normal and
Page 707 and 708:
2-3 times a year effectively addres
Page 709 and 710:
Myofascial meridian exampleSuperfic
Page 711:
Clinical ConsiderationKnee and back
Page 715 and 716:
Clinical ConsiderationApplication t
Page 717 and 718:
Pathophysiological ConsiderationMec
Page 719 and 720:
Clinical ConsiderationStecco and co
Page 721 and 722:
Safety FirstMT appears to have few
Page 723 and 724:
Deep workThe deep techniques noted
Page 725 and 726:
Psychological considerationsIt is w
Page 727 and 728:
Clinical ConsiderationMT dosage and
Page 729 and 730:
Developing a sound treatment strate
Page 731 and 732:
Treatment outcomesEssentially, earl
Page 733 and 734:
Dosage considerationsThe presence o
Page 735 and 736:
Clinical ConsiderationNumerous syst
Page 737 and 738:
Clinical ConsiderationHeat in the t
Page 739 and 740:
Clinical ConsiderationBest and co-w
Page 741 and 742:
Pathophysiological considerationCom
Page 743 and 744:
Clinical ConsiderationTiming is eve
Page 745 and 746:
Clinical ConsiderationEvidence sugg
Page 747 and 748:
Clinical ConsiderationSeveral studi
Page 749 and 750:
Clinical ConsiderationPreventive me
Page 751 and 752:
Pathophysiological ConsiderationWit
Page 753 and 754:
TechniquesCommonly employed techniq
Page 755 and 756:
Treatment outcomesThe later stages
Page 757 and 758:
Clinical ConsiderationsNon-threaten
Page 759 and 760:
Clinical ConsiderationsIt has been
Page 761 and 762:
Clinical ConsiderationsMT may be a
Page 763 and 764:
Pathophysiological ConsiderationUnd
Page 765 and 766:
Clinical ConsiderationsIn the early
Page 767 and 768:
Clinical ConsiderationsAs the remod
Page 769 and 770:
Treatment outcomesEssentially, the
Page 771 and 772:
Dosage considerationsThe presence o
Page 773 and 774:
TechniquesAny carpenter will tell y
Page 775 and 776:
Pressure Level 4 - Strong pressure/
Page 777 and 778:
Grade 7 and 8• Firm, deep• Trig
Page 779 and 780:
Neutralize pHFacilitate healing pro
Page 781 and 782:
Manual Lymphatic TechniquesEarly ma
Page 783 and 784:
Table 9.4Treatment guideline summar
Page 785 and 786:
Clinical ConsiderationEdema, excess
Page 788 and 789:
Figure 9.2Half-moon/circles: cleari
Page 791 and 792:
Figure 9.3Pumping: clearing the ext
Page 793:
RotaryThe rotary technique is commo
Page 797:
Figure 9.5Rotary (thorax). Half-moo
Page 800 and 801:
One of the most obvious differences
Page 802 and 803:
Clinical ConsiderationVarious forms
Page 804:
Box 9.10Sensory amnesia and proprio
Page 808 and 809:
Clinical ConsiderationAs all of the
Page 810 and 811:
Compression techniqueCompression te
Page 812 and 813:
Figure 9.8Tension. The lower leg is
Page 814:
Figure 9.9Approximation-compression
Page 818 and 819:
Figure 9.11(A) Shear: begin by enga
Page 820 and 821:
Clinical ConsiderationIt is common
Page 823 and 824:
Figure 9.12Torsion/rotation. Begin
Page 826 and 827:
Figure 9.13Lifting. Begin by graspi
Page 828 and 829:
Gross stretchGross stretch techniqu
Page 830 and 831:
Figure 9.15‘Cs’. Begin as noted
Page 833 and 834:
Figure 9.17J-stroke. Begin at one e
Page 835 and 836:
Clinical ConsiderationIrritated ner
Page 837 and 838:
Pathophysiological ConsiderationCha
Page 839 and 840:
Clinical ConsiderationAs the mechan
Page 841 and 842:
Clinical ConsiderationIn various st
Page 843 and 844:
Chaudhry H, Schleip R, Ji Z et al (
Page 845 and 846:
principles and methods. Philadelphi
Page 847 and 848:
Pilat A (2003) Myofascial therapies
Page 849 and 850:
Yang G, Im HJ, Wang JHC (2005) Repe
Page 851 and 852:
Medial thigh 4th degree skin grafts
Page 853:
Figure B.2 Post-treatmentSurgical s
Page 857 and 858:
Figure C.2 Post-treatment2 December
Page 859 and 860:
and to be consistent with any selfc
Page 861 and 862:
ability to resume social responsibi
Page 863 and 864:
Clinical ConsiderationTrauma can be
Page 865 and 866:
MaintenanceSelfcare maintenance is
Page 867 and 868:
ManagementSelfcare management is de
Page 869 and 870:
Client and Therapist PartnershipTo
Page 871 and 872:
Box 10.1Factors affecting, effectiv
Page 873 and 874:
Strategies to Facilitate Engagement
Page 875 and 876:
Clinical ConsiderationThe authors u
Page 877 and 878:
instances. Make your clients aware
Page 879 and 880:
Relaxation MeasuresVarious relaxati
Page 881 and 882:
scope of practice, such as relaxati
Page 883 and 884:
Silicone gel and silicone sheetingS
Page 885 and 886:
Medicinal honeyThe use of honey for
Page 887 and 888:
Wise Use of Your BodyIt is not esse
Page 889 and 890:
Empathy Strain and BurnoutEmpathy,
Page 891 and 892:
Box 10.3A reflection on reasons for
Page 893 and 894:
Clinical ConsiderationIn the author
Page 895 and 896:
trauma are the therapist’s person
Page 897 and 898:
Care for the care providerIt is imp
Page 899 and 900:
body. Edinburgh: Churchill Livingst
Page 901 and 902:
Salvo SG (2015) Body mechanics, cli
Page 903 and 904:
Research databases and repositories
Page 905 and 906:
Funding for massage therapy researc
Page 907 and 908:
Journals and magazinesInternational
Page 909 and 910:
INDEX
Page 911 and 912:
see also parasympathetic nervous sy
Page 913 and 914:
breathing exercises 245burning sens
Page 915 and 916:
CGRP (calcitonin gene-related pepti
Page 917 and 918:
Ddanger (perceived) 135, 150fight-o
Page 919 and 920:
Eedema 40-1, 69burns-related 112-13
Page 921 and 922:
Ffascia 11-22assessment 186client-r
Page 923 and 924:
Gglia 48glucocorticoids 137, 138, 1
Page 925 and 926:
see also dehydrationhyperalgesia 63
Page 927 and 928:
JJ-stroke 221joint instability 190
Page 929 and 930:
Llarge Pacini and paciniform corpus
Page 931 and 932:
Mmacrophages 13, 63, 80, 81, 89lymp
Page 933 and 934:
Nnecrosisbreast implant-related 119
Page 935 and 936:
Oobservation 180-2occupational inju
Page 937 and 938:
peripheral nervous system 45, 49-50
Page 939 and 940:
Rradiation therapy 193breast cancer
Page 941 and 942:
interviewing 169-71skin 5-11fascia
Page 943 and 944:
TT cells 37technology 2, 242-3tempe
Page 945 and 946:
safety see safetysee also post-trea
Page 947 and 948:
Vvagus nerve 124polyvagal theory 14
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