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

Deep work
The deep techniques noted in this book are not appropriate for the following
situations: acute neural distress and hard nerve pain; when a client is in
emotional distress (to the degree that deeper work would elevate their anxiety or
distress); osteoporosis; vascular pathologies; and cervical rheumatoid arthritis.
Use sound judgment and proceed with appropriate consideration in such cases.
Some other general and local CI considerations for forceful and deep techniques
include:
• Bone fractures or acute soft tissue injuries: wait for full healing (6 weeks – 3
months) – local
• Cortisone injections: local/2–3 months
• Inflammation: local/during acute stage
• Phlebitis, embolism, thrombus – local
• Newly forming scar tissue (including surgeries) – local/wait until the tissue is
stable (about 6–7 weeks)
• Patients who have low blood platelet counts (e.g. as seen with splenomegaly,
leukemia, chemotherapy), who are taking anticoagulant medications such as
heparin or warfarin, or who have locally any potentially weak area of the skin
such as near wounds (NIH 2015).
Additionally, acute inflammatory flare-ups may present with flu-like symptoms
(malaise, unwell) which may be contraindicatory if treatment seems too
overwhelming for the client that day.