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

Pathophysiological Consideration
Fascial restrictions (i.e. altered elasticity due to pathophysiological
scarring) can exert an adverse effect on free nerve endings (functioning as
mechanoreceptors), resulting in changes in tissue viscosity. This is
particularly evident when the restricted fascia is challenged. Stretch or
tensioning of restricted or dense fascia appears to trigger incoherent
afferent signaling which in turn leads to aberrant firing sequences (i.e.
muscle incoordination) along the myokinetic chain. Incoordination can lead
to abnormal biomechanics, eventual abnormal muscle compensation and
pain. ‘Normal’ fascial elasticity is essential for sound biomechanical and
neurological functioning (Schleip 2003a, 2003b).
Impaired mechanoreceptors (e.g. receptors entrapped in dense, fibrosed tissue)
react to mechanical forces by disinforming local, regional, or central nerve
centers. Under or overestimation of the mechanical stimuli may occur. This
proprioceptive disinformation causes inappropriate muscular reactions which
endanger the patient’s general equilibrium and can lead to alterations in
contraction force, mistiming of myofascial contraction activation or muscular
incoordination. Proprioceptive disinformation can also lead to subsequent
secondary injuries such as tendinopathies, sprains, strains, falling and fractures.
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