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[libribook.com] Traumatic Scar Tissue Management 1st Edition
Clinical ConsiderationAs is the case with other tissues, neural tissue functions best when free ofrestriction or compression. Neural compression is linked to variousneuropathies (e.g. carpal tunnel, sciatica, thoracic outlet). Neural sensitivityto compression ought to be taken into consideration during manualtherapies. It is important to approach distressed neural tissues gently andfrom angles that avoid compressing the nerve further. Additionally,distressed nerves do not tolerate much stretch – treatment considerationsare covered in more detail in Chapter 9.
Proprioceptive DisinformationDensification, adhesions, fibrosis or excessive scarring can impactproprioception (Stecco et al. 2006, Stecco et al. 2010, Fourie 2012). Bindingmay occur among layers that should stretch and slide/glide on each other,distorting myofascial relationships which, in turn, can alter muscle motorfunction and proprioception (Fourie 2009, Stecco & Stecco 2009).Recall from Chapter 2, when challenged by stretch or movement, dense and/orrestricted fascia may alter proprioceptive afferent signals that lead to eventualabnormal biomechanics, aberrant movement patterns, muscle compensation,joint distress and pain (Bouffard et al. 2008, Stecco et al. 2010).Normal tissue viscoelasticity is essential for proper neurological functioning,including proprioception (Stecco 2004, Stecco et al. 2010). In the absence ofnormal physiological elasticity, receptors embedded within the fascia may alsobe in an active state, even at rest. Any further stretching – even that produced bynormal muscular contraction – could cause excessive stimulation withconsequent propagation of nociceptive afferents. Further, over a certainthreshold (i.e. consistent stimulus over time), all receptors can potentiallybecome algoceptors (pain receptors) in response to consequent propagation ofnociceptive signals (Ryan 2011).
- 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 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
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Clinical Consideration
As is the case with other tissues, neural tissue functions best when free of
restriction or compression. Neural compression is linked to various
neuropathies (e.g. carpal tunnel, sciatica, thoracic outlet). Neural sensitivity
to compression ought to be taken into consideration during manual
therapies. It is important to approach distressed neural tissues gently and
from angles that avoid compressing the nerve further. Additionally,
distressed nerves do not tolerate much stretch – treatment considerations
are covered in more detail in Chapter 9.
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