[libribook.com] Traumatic Scar Tissue Management 1st Edition
Clinical ConsiderationChronic and/or fully matured scars, much like significant spinal deviations,may not be significantly changed by manual manipulation. However, muchlike Stecco’s approach to working with scoliosis (see Box 9.5), treating thescar-mediated impairment can result in changes that positively impact theclient’s pain and functional deficits.Thinking about and putting a global approach into action will ultimately assistthe client in achieving more sustainable outcomes. As noted in Chapter 2,myokinetic or myofascial chains/meridians are a grouping or sequence of tissuesand structures – structurally and neurologically linked together to supportfunctional and perceptive continuity. Restriction or fixation at any point alongthe chain/meridian can impact function at distant segments resulting in tensionalcompensations along the chain/meridian. Additionally, antagonisticchains/meridian components can be impacted, and often are.Myers’ Anatomy Trains (2013) and the Steccos’ Fascial Manipulation forMusculoskeletal Pain and Fascial Manipulation – the Practical Part (Stecco &Stecco 2009) both provide excellent illustrations of the myofascial global pictureand excellent assessment protocols. The authors highly recommend studyingsome form of global assessment and treatment approach.Box 9.5
Myofascial meridian exampleSuperficial Front Arm Line: pectoralis major, latissimus dorsi, medialintermuscular septum, forearm flexor group, carpal tunnel/flexorretinaculum.Using Myers’ meridian example, one can surmise the global consequencesfollowing breast cancer procedures. Even less invasive lumpectomy orpartial mastectomy incisions can result in shoulder, elbow and wristimpairments.Adapted from Anatomy Trains (Myers 2013).Boxes 9.5 and 9.6 provide two examples: one from Myers and the other fromStecco. In both examples muscular terms are used as a common reference, but itis to be noted that the corresponding myofascial envelopes are inclusive in thecontinuity from component to component.Box 9.6
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Myofascial meridian example
Superficial Front Arm Line: pectoralis major, latissimus dorsi, medial
intermuscular septum, forearm flexor group, carpal tunnel/flexor
retinaculum.
Using Myers’ meridian example, one can surmise the global consequences
following breast cancer procedures. Even less invasive lumpectomy or
partial mastectomy incisions can result in shoulder, elbow and wrist
impairments.
Adapted from Anatomy Trains (Myers 2013).
Boxes 9.5 and 9.6 provide two examples: one from Myers and the other from
Stecco. In both examples muscular terms are used as a common reference, but it
is to be noted that the corresponding myofascial envelopes are inclusive in the
continuity from component to component.
Box 9.6