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

Box 9.4
Over-use/impairment example (Ryan 2013)
When we are not able to change the scar itself, we still may be able to
significantly impact the client’s pain and assist with improving function.
At the Level I Fascial Manipulation (FM) training in Vancouver 2013, Dr
Antonio Stecco was asked about the effectiveness of FM in treating
scoliosis. Stecco’s approach to treating scoliosis is to address the over-use
type impairments that occur as a result of the spinal deviation, and is not
specifically aimed at correcting the deviation.
Stecco shared one of his clinical cases and used an X-ray image to
illustrate this. The X-ray showed a patient with a dramatic, 87° spinal
deviation. Prior to treatment by Stecco, the patient had experienced
significant neck, headache and low back pain, resulting in missed work
time and preventing her from engaging in recreational activities. Following
FM treatment the patient was able to function (return to work and resume
activities of daily living and sport/recreation) with significantly less pain.
When asked about how much the actual curvature of her spine changed
post FM treatment, Stecco replied:
There was no significant change in the degree of her scoliosis
following treatment. Scoliosis [spinal deviation] is not necessarily
correlated with pain. With this patient, there are 3 important
components to look at; the scoliosis, hyperkyphosis and hyperlordosis.
The impact of the spinal deviations essentially present as ‘overuse’
type syndromes in the paraspinal and other associated musculature’s
sliding mechanism, which appears to be the predominant source of the
presenting musculoskeletal pain and dysfunction. This patient still
experiences some low back pain but not at the debilitating degree she
experienced prior to FM treatment (e.g. missing time at work,
stopping all activity). Occasional use of paracetamol (mild analgesic)
(2–3 times a month) manages her back pain well, while FM treatment