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

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Clinical ConsiderationBecause therapeutic agents that target the TGF-β signaling pathway havebeen shown to improve wound healing and reduce scarring (Finnson et al.2013), targeting the TGF-β signaling pathway represents a viable strategyfor improving wound healing and reducing pathological scarring (Finnsonet al. 2013). Transforming growth factor beta-1 (TGF-β1) activation is – inpart – influenced by tissue tension (Wipff & Hinz 2009, Meyer-ter-Vehn etal. 2011). It is suggested that the manual manipulation of fascia has thepotential to change the cell-matrix tension state (i.e. restoration of tensionalhomeostasis) and possibly influence localized TGF-β1 activity (Grinell2008).
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Traumatic Scar Tissue ManagementMas
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Letter to NKS - from Camp Amigo cam
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Important noticeNeither the publish
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FOREWORDEveryone has scars: visible
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stories about how basic massage the
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to the events that resulted in the
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PREFACEMore people are surviving tr
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and
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ACKNOWLEDGEMENTSA thank you to the
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Lastly, thank you, the reader; the
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GLOSSARY AND KEY CONCEPTSAll the wo
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AdhesionsScar-like tissue that form
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Alphabet techniquesCs, Js, and Ss -
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AngiogenesisGrowth of new blood ves
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AponeurosesDense, sheet-like fascia
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Autonomic balanceHomeostatic and co
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BarrierIs defined as the point wher
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Best research evidenceThe best avai
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Body AwarenessConscious, attentiona
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BradykininInflammatory mediator - a
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Capsular contractureEnvelopment of
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ChemokinesSmall molecules released
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CicatrixAnother term for scar - the
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Collagen crimpThe wavy formation se
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Compassion fatigueThe profound emot
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Compression techniqueA therapeutic
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Consolidated edemaChronic stage ede
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CortisolHormone released in respons
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CreepA time-dependent response of v
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DebridementRemoval of foreign mater
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Degloving injuryA form of avulsion
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DermatomeAreas of skin supplied by
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Direct release techniqueCommonly us
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Dry needlingA procedure involving i
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Empathy strainA healthcare provider
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EndoneuriumFascia surrounding indiv
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Endothelial cellsSimple squamous ce
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EndoscopeAn instrument that is used
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EpidermisThe tough, outermost layer
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EpineuriumOutermost covering of fas
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Epithelial cellsCells that line the
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FasciaFibrocollagenous CT, its morp
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FibrinFibrous protein involved bloo
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FibroblastsSynthesize the component
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FibrosisA process culminating in th
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Fluid techniquesTechniques employed
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Gentle circles techniqueCircular mo
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Gross stretch techniqueCombination
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HomeostasisState of physiological e
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HyperalgesiaHeightened pain sensati
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HyperexcitationNeurons firing too e
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Hypertrophic scarA thickened, red a
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HysteresisA property of systems (ti
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Indirect release techniqueMechanica
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Informed consentProcess involving t
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Intense versus invasiveAn important
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InteroceptionIncludes a wide range
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KeratinA structural protein that pr
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KininsPeptides (e.g. bradykinin) pr
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Linking fasciaPlays a role in augme
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Lymph nodesFilter and clean the lym
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LymphangiogenesisFormation of new l
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Lymphatic drainageThe movement of f
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Lymphatic returnVolume of lymph ret
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Lymphatic transportThe movement of
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Lymphatic vesselsTri-laminar vessel
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LymphocyteThe main cell type found
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MacrophageA type of phagocytic whit
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MastectomySurgical removal of all b
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MechanotransductionThe mechanism by
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MucopolysaccharidesSee GAGs.Myofasc
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Nerve receptorsNerve terminations t
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NeurofasciaTri-laminar, continuous
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Neuropathic painPain due to damage
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NeuropeptidesSignaling molecules th
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NociceptionThreatening stimuli acti
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Nociceptive painPain that arises fr
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OxytocinHormone that plays role in
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ParesthesiaAltered sensations; e.g.
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Peripheral sensitizationIncreased r
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PerineuriumFascia surrounding/inves
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Pitting edemaAn edematous region wh
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Proprioceptive disinformationRecept
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Provisional matrixDuring the early
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Pumping techniqueA lymphatic techni
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Referred painPain perceived at a lo
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RetinaculaeDense fascial bands that
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ScarMark left in various tissues or
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Secondary lymphedemaOccurs as a res
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Self careThose practices and activi
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Selfcare managementResponse to sens
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SensitizationChanges in the PNS or
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SerotoninNeurotransmitter involved
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Shear techniqueA therapeutic loadin
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Skin graftMedical procedure where a
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SomatizationA tendency to experienc
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State anxietyThe experience of unpl
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Stress response adaptationAny of th
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Stress responseAny cognitive, physi
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Substance PA neuropeptide acting as
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Therapeutic environmentEncompasses
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Therapeutic relationshipEncompasses
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Trait anxietyA more intense degree
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TraumaInsult or injury to the physi
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Traumatic scarPathophysiological sc
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ViscoelasticityThe ability of a med
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Nowadays it is common to see massag
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A Reasonable NexusPrecise etiologic
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integration of art and science are
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Diamond M (2012) Scars and adhesion
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General HistologyExtracellular Matr
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Clinical ConsiderationVitamin C has
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Ground substanceGround substance (G
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Pathophysiological ConsiderationIn
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HyaluronanThis hydrophilic, viscous
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Clinical ConsiderationHA and its fr
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Figure 2.1Layers and components of
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Skin HistologyThe skin comprises:
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Figure 2.2The delicate, well-hydrat
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DermisThe dermis is made up of laye
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Fascia Structure and FunctionsIn th
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fundamental characteristic is its c
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tensional properties co-exist in bo
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HistologyFascia comprises:• ECM (
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Clinical ConsiderationManual therap
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Clinical ConsiderationTransforming
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CollagenCollagen is the most abunda
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Clinical ConsiderationSignificant c
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Fascia Layers and FunctionsFascia t
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Clinical ConsiderationSuperficial a
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Clinical ConsiderationWhen thickene
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LinkingLinking fascia is sub-divide
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FascicularFascicular fascia augment
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Clinical ConsiderationMuscle spindl
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SeparatingSeparating fascia provide
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Clinical ConsiderationFascia suppor
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Andrade C-K (2013) Outcome-based ma
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Ingber D (2008) Tensegrity and mech
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tendons: organisation in vivo and r
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Zorn A, Hodeck K (2011) Walk with e
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Discovery of the Lymphatic SystemTh
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Hematic SystemThe heart, blood vess
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Lymphatic System Structure and Func
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Clinical ConsiderationNerves, blood
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Figure 3.1Lymph tissue structure.In
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Lymphoid OrgansThe lymphoid organs
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ThymusThe thymus is a lymphoid glan
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Lymphatic Drainage and TransportIn
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SuperficialThe superficial layer is
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Primary upper lymphatic structuresT
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Primary lower lymphatic structuresT
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Left side lymphatic drainageThe lef
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Lymphatic System FunctionsA brief o
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Fig 3.5Brain lymphatic vessels.Give
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ImmunityLymph nodes play an importa
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Wound HealingAs with the blood vasc
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Clinical ConsiderationFour continuo
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Lymphatic InadequacyInadequacy in t
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EdemaEdema - the medical term for s
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Lymphatic treatment protocols will
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CHAPTER 4NeurologyEach human nervou
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NS StructureThe human NS comprises
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Figure 4.1B Functional composition
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Pathophysiological ConsiderationWhe
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Figure 4.2Dorsal and ventral compon
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Figure 4.3Neuron anatomy: most neur
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Figure 4.4Classic axon to dendrite
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Figure 4.6PNS efferent (motor) and
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Clinical ConsiderationPSNS afferent
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Clinical ConsiderationSNS activatio
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Figure 4.8Anterior and posterior di
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Figure 4.9Neurofascial envelopes.
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Pathophysiological ConsiderationA n
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Clinical ConsiderationThere is an e
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Clinical ConsiderationDiane Jacobs
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Clinical ConsiderationIt appears th
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Clinical ConsiderationAlthough musc
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Clinical ConsiderationThe form of s
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Example 2Ruffini stimulation result
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Table 4.1Summary of receptor typolo
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• Therapeutic outcome include enh
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NS FunctionThe primary functions of
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Clinical ConsiderationMechanorecept
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Clinical ConsiderationIn addition t
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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 440 and 441: Figure 5.1Hypertrophic scar example
Page 442 and 443: This continues what began in Stage
Page 444 and 445: yield an innocuous scar that exhibi
Page 446 and 447: Scar ChronologyThe wound healing pr
Page 448: Types of Pathophysiological ScarsIn
Page 451 and 452: Pathophysiological considerationIt
Page 453 and 454: Clinical considerationMechanical di
Page 455 and 456: Figure 5.2Keloid scar example.Patho
Page 457 and 458: Clinical ConsiderationAs discussed
Page 459 and 460: Box 5.1Factors that drive excessive
Page 461 and 462: Pathophysiological ConsiderationIn
Page 463 and 464: Clinical ConsiderationDrainage of e
Page 465: Clinical ConsiderationFascia hydrod
Page 468 and 469: Clinical ConsiderationImmobilizatio
Page 470 and 471: NeuropeptidesUnder physiological an
Page 472 and 473: Pathophysiological ConsiderationNeu
Page 474 and 475: Clinical ConsiderationExcessive neu
Page 476 and 477: Clinical ConsiderationAs noted abov
Page 478 and 479: Nerve density in pathophysiological
Page 480 and 481: alleviates patient discomfort but a
Page 482 and 483: Clinical ConsiderationMassage thera
Page 484 and 485: Clinical ConsiderationIn the treatm
Page 486 and 487: Clinical ConsiderationOff-loading w
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are covered in greater detail in Ch
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Carano A, Siciliani G (1996) Effect
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rehabilitation and injury preventio
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Ramos ML, Gragnani A, Ferreira LM (
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CHAPTER 6Burns, mastectomies and ot
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Excessive ScarringExcessive scarrin
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size/depth, anatomic region, and lo
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Clinical presentationExpanded dermi
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Keloids are typically pink to purpl
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Clinical ConsiderationThe margins o
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Degree of InjuryBurn injuries are c
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Sequelae and ComplicationsA critica
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Pathophysiological ConsiderationApo
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Clinical ConsiderationHypertrophy t
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Skin GraftsAs previously noted, the
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vasoconstrictor pathways. The same
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As noted in Chapter 4, neuropathic
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Clinical ConsiderationBurn rehabili
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Breast CancerThe breast is made up
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Early detectionBreast cancer is typ
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effectively prevent or reduce unnec
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Table 6.2Types of mastectomiesAs ma
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Capsular contractureCapsular contra
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Implants and necrosisNecrosis - the
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Table 6.3Baker scaleCancer treatmen
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Clinical ConsiderationEarly detecti
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Table 6.4Stages of lymphedema: 0-3A
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Clinical ConsiderationIt has been d
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Figure 6.2Nerves plexuses in the ch
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Degloving InjuryDegloving - named f
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LiposuctionBrief consideration is g
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Neurological SequelaeHypoesthesia i
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Traumatic Scars and MTWhen working
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207-227.Derderian CA, Bastidas N, L
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Monocryl vs. Vicryl-rapide. Annals
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CHAPTER 7TraumaThe quality of outco
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Traumatic Events and Traumatic Resp
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Psychological ResponsePsychological
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StressDay in and day out, our hands
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Stress Adaptation ResponseA vast ar
Page 571 and 572:
Stress Response PhysiologyStress pl
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Figure 7.2Summay of the normal stre
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Pathophysiological ConsiderationA s
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Pathophysiological ConsiderationVar
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Clinical ConsiderationStress and th
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Silverstein 1992, Leproult et al. 1
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Pathophysiological ConsiderationEle
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Pathophysiological ConsiderationTho
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Clinical ConsiderationMultiple stud
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Clinical ConsiderationListing and c
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Clinical ConsiderationRapid develop
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Clinical ConsiderationData demonstr
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physical impairments that fall with
Page 598 and 599:
Clinical ConsiderationAccording to
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Clinical ConsiderationMainstream tr
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ASD can occur as a result of medica
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The critical care phaseA patient ma
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physical sensations). The inability
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Clinical Considerationvan der Kolk
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Clinical ConsiderationMT is commonl
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amygdala that is primed to go into
Page 614 and 615:
Scope of Practice ConsiderationsWe
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may feel unsettled or distressed an
Page 618 and 619:
Clinical ConsiderationFollowing an
Page 620 and 621:
Box 7.2Basic strategies for navigat
Page 622 and 623:
Clinical ConsiderationFor some who
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InteroceptionDamasio (2003) and Cra
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Clinical ConsiderationA number of s
Page 628 and 629:
psychotherapy and psychotherapy is
Page 630 and 631:
order to complete tasks that once w
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0248-y.Crane JD, Ogborn DI, Cupido
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Interlandi J (2014) A revolutionary
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without massage. Neuroscience Lette
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Van Der Kolk B (2014) The Body Keep
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Pamela Fitch’s book, Talking Body
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Informed Consent and IntakeInformed
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Providing a Safe Therapeutic Enviro
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There is no hierarchy in a client-c
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be detrimental to the therapeutic p
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countertransference, which can dimi
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Professional EthicsThe purpose of p
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CommunicationEthical and profession
Page 656 and 657:
enhance follow-up questions during
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gather information for the session.
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changed since the last session; med
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would like to work on the chest wal
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Box 8.4According to Broas (2008), M
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Interprofessional CollaborationInte
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ReferralsFor MTs, knowing when to r
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Referral exampleA common example of
Page 672 and 673:
Barker K, Oandasan I (2005) Interpr
Page 674 and 675:
direct change. Minimization of the
Page 676 and 677:
Box 9.1Evidence-based and evidence-
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Clinical ConsiderationOne important
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Clinical ConsiderationIn a cancer p
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Clinical ConsiderationIt is hypothe
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Clinical ReasoningOver the life-spa
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Clinical ConsiderationAnything that
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Assessment and EvaluationIt is impo
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ObservationThere are many layers to
Page 692 and 693:
Box 9.2The MT’s ability to use th
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PalpationPalpation assessment ought
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Scar assessment toolsAs with other
Page 698 and 699:
• 10 reflects the ‘worst imagin
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understanding of the body’s adapt
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Soft tissue mobility and barriersIn
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Is gradualWhen engaged, the therapi
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Box 9.4Over-use/impairment example
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Clinical ConsiderationChronic and/o
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Myofascial sequence exampleAnatomic
Page 714 and 715:
Fig 9.1Yellow lines represent palpa
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Pathophysiological ConsiderationTo
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Clinical ConsiderationIt is suggest
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Treatment ProtocolThe therapist’s
Page 722 and 723:
• Be mindful when working with th
Page 724 and 725:
Postsurgical and other intervention
Page 726 and 727:
DosageArguably, one of the most com
Page 728 and 729:
Clinical ConsiderationA recent stud
Page 730 and 731:
Recall from Chapter 5: the inflamma
Page 732 and 733:
TechniquesTechniques commonly emplo
Page 734 and 735:
Clinical ConsiderationA correlation
Page 736 and 737:
Clinical ConsiderationA meta-analys
Page 738 and 739:
Clinical ConsiderationUnder physiol
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Clinical ConsiderationRecall from C
Page 742 and 743:
Pathophysiological ConsiderationA v
Page 744 and 745:
Clinical ConsiderationPruritus is m
Page 746 and 747:
Clinical ConsiderationMaximizing ox
Page 748 and 749:
Clinical ConsiderationThe ECM is a
Page 750 and 751:
Pathophysiological ConsiderationInc
Page 752 and 753:
General treatment guidelinesWhen wo
Page 754 and 755:
Table 9.2Principles to improve woun
Page 756 and 757:
Dosage considerationsThe presence o
Page 758 and 759:
Clinical ConsiderationsThe margins
Page 760 and 761:
Clinical ConsiderationsHypertrophic
Page 762 and 763:
Clinical ConsiderationsBurn rehabil
Page 764 and 765:
Pathophysiological ConsiderationImm
Page 766 and 767:
Clinical ConsiderationsPain-instiga
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Pathophysiological considerationIn
Page 770 and 771:
TechniquesTechniques commonly emplo
Page 772 and 773:
Depth and Pressure GradingThe sensi
Page 774 and 775:
Pressure levelsPressure Level 1 - V
Page 776 and 777:
Depth and grading of touchGrade 1-3
Page 778 and 779:
Grade 9 and 10• Deep• Client li
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Table 9.3Summary of manually mediat
Page 782 and 783:
• Initiate contact with a slow, s
Page 784 and 785:
Traumatic scarring can be a cause f
Page 786:
For the sequence for clearing the h
Page 789:
PumpingPumping technique is mainly
Page 792 and 793:
ScoopingScooping technique is used
Page 795:
Figure 9.4Scooping: clearing the ex
Page 799 and 800:
Figure 9.6Alternating pump and stat
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Drag scale• 0: no drag• 1: move
Page 803 and 804:
addressed prior to global ones.When
Page 807 and 808:
Fig 9.7Traumatic scar formationGene
Page 809 and 810:
Tension techniqueTension technique
Page 811 and 812:
BendingBending technique combines c
Page 813 and 814:
ShearOblique or laterally applied g
Page 816:
Figure 9.10(A) Bend. Begin by grasp
Page 819 and 820:
OscillationsOscillation techniques,
Page 821:
Lifting techniquesThe techniques in
Page 824:
Alphabet TechniquesMost massage the
Page 827 and 828:
Figure 9.14Skin rolling. Begin by a
Page 829 and 830:
Gentle circlesGentle circle techniq
Page 831:
Figure 9.16‘Ss’. Begin by grasp
Page 834 and 835:
Clinical ConsiderationSome of the b
Page 836 and 837:
Clinical ConsiderationIt is importa
Page 838 and 839:
Clinical ConsiderationManual therap
Page 840 and 841:
intense verses invasive and distres
Page 842 and 843:
Aarabi S, Bhatt KA, Shi Y et al (20
Page 844 and 845:
Journal of Plastic Surgery 10: 354-
Page 846 and 847:
Lewit K, Olsanska S (2004) Clinical
Page 848 and 849:
massage for chronic neck pain. Anna
Page 850 and 851:
Comparison of before and aftertreat
Page 852 and 853:
Figure B.1 Pre-treatmentOpen carpal
Page 855:
Figure C.1 Pre-treatmentDe-gloving
Page 858 and 859:
CHAPTER 10Client and therapist self
Page 860 and 861:
Self CareSelf care as an all-encomp
Page 862 and 863:
Clinical ConsiderationClients can f
Page 864 and 865:
Clinical ConsiderationTrauma can be
Page 866 and 867:
MonitoringSelfcare monitoring compr
Page 868 and 869:
Clinical ConsiderationAccording to
Page 870 and 871:
Client EngagementAll healthcare pro
Page 872 and 873:
Others, however, view self care as
Page 874 and 875:
their care.In addition to meeting p
Page 876 and 877:
likelihood of engagement is highly
Page 878 and 879:
Thermal and CryotherapyIt is sugges
Page 880 and 881:
Clinical ConsiderationThe authors s
Page 882 and 883:
tissue fibers (e.g. collagen and el
Page 884 and 885:
Topical onion extractOnion extract
Page 886 and 887:
Therapist Self CareSimply put, prac
Page 888 and 889:
Box 10.2Tips for reducing work rela
Page 890 and 891:
best/healthier answer, to support s
Page 892 and 893:
resentment every time you see the c
Page 894 and 895:
Compassion Fatigue and Indirect Tra
Page 896 and 897:
PreventionWays of coping and curren
Page 898 and 899:
management 6: 63-71.Boyera N, Galey
Page 900 and 901:
management/in-depth/stress-relief/a
Page 902 and 903:
Appendix Massage therapy research r
Page 904 and 905:
Massage Therapy Research Conference
Page 906 and 907:
BooksMenard MB (2009) Making sense
Page 908 and 909:
Research literacy coursesIt is impe
Page 910 and 911:
Aabdominal breathing 245abdominal l
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BB cells 37back and knee relationsh
Page 914 and 915:
CC (alphabet technique) 221calciton
Page 916 and 917:
communication (therapist-client) 15
Page 918 and 919:
in late stages of wound healing 201
Page 920 and 921:
extent of trauma and scar 96-7, 103
Page 922 and 923:
fluidslymphatic transport 32manual
Page 924 and 925:
Hhabits (client) 241hair follicles
Page 926 and 927:
Iimmobilization, prolonged 89-90imm
Page 928 and 929:
Kkeloid scars 87, 91, 94-5, 104-8hy
Page 930 and 931:
inadequacy 40manual work 207-15radi
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motivation (client) 241motor (effer
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autonomic see autonomic nervous sys
Page 936 and 937:
PPacini and paciniform corpuscles,
Page 938 and 939:
professionalscollaboration between
Page 940 and 941:
Ssafety 192-4, 225therapeutic envir
Page 942 and 943:
stretch, gross 222-3structural prot
Page 944 and 945:
time (temporal/chronological dimens
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Uultrasonography 184, 186
Page 948:
Wwater 6-7lymphatic transport 32see
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