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

Clinical Consideration
Significant neural-mediated mechanisms or neurobiological functions have
been identified as potential catalysts for tissue changes that occur as a
result of manual manipulation. Of particular interest is CT and fascia’s
ability to change its fluid ratio. A change in local fluid dynamics can result
in a change in the viscosity of ground substance in the ECM. The shift
involves the nervous and vascular systems and CT cells (e.g.
myofibroblasts found in fascia). It has been determined that many of the
IRs can apparently influence plasma extra-vasation (i.e. the movement of
plasma from blood vessels into the ECM (Kruger 1987), see Figure 4.10
and Table 4.1.
With manually applied techniques, the degree, direction and duration of
application factor significantly into the desired therapeutic outcomes as each of
these elements influence the various mechanoreceptors in a variety of ways.
Golgi receptors and Golgi tendon organs
Golgi receptors and Golgi tendon organs (GR/GTO) are:
• Found in dense fascia, joint related tissues, and near myotendinous junctions
• Known, thus far, to respond to contractile tension and active moderate,
sustained stretch – to what extent manually applied load can elicit Golgi
responses remains unclear (Schleip 2003a, 2003b)
• Therapeutic outcome is a tonus decrease in related motor fibers.
Large Pacini and paciniform corpuscles
Large Pacini and paciniform corpuscles:
• Are found in layers of deeper skin and deeper, dense fascia
• Have an affinity for vibration, pressure changes and light, brief tangential
loading