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

Keep in mind that the therapist’s interpretation of the client’s non-verbal and
verbal communication can help to clarify a clinical impression, but interpretation
is subjective. It is important to confirm impressions with the client and alter the
clinical observation as needed.
Be mindful that therapist-to-client communication also occurs in a
direct/physical manner via our hands and in an indirect/energetic manner
through our touch and that this conveys our presence, state or mood.
Posture and Movement
Observe the client as they enter your treatment room. Watch their walk, how
they hold their purse, briefcase; what is the body trying to tell you? It is possible
to observe imbalances and asymmetries that the client carries daily if you pay
attention to their postural cues.
Traumatic scar tissue may have adhesion tentacles that reach in any direction and
depth. And even seemingly minimally invasive key-hole incisions can result in
adhesion formation that may result in chronic pain, obstruction and functional
deficits (Lee et al. 2008). For example: a teenage ballet dancer with a small
appendectomy scar complains of difficulty in raising the leg on the side of the
scar. Ask the client to demonstrate the movement. Is there compensation for the
pain? How is her posture? Consider which muscles are involved in that
movement (e.g. iliopsoas, quadratus abdominis, gluteal muscles, abdominals).
Are adherences impacting the intestines? Ask the client if they are having bowel
or voiding problems. This will give you the necessary answers about depth and
length of the scar, and adhesions, without benefit of an ultrasound or other
imaging technique, although access to diagnostic reports is helpful.