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

Pathophysiological Consideration
Immobilization
As noted in Chapter 5, immobilization can lead to the formation of
pathological cross-links and microadhesions between the pre-existing or
non-injured collagen fibers as well as newly forming fibers, which in turn
can impact slide/glide potential between the tissue layers. Impaired sliding
between layers can result in tissue strain and subsequent inflammation.
Immobilization also has a negative impact on tissue hydration and fascia’s
viscoelastic capabilities (e.g. underhydrated and more viscous GS) and the
resultant stiffness can further impact mobility. Immobilization has also been
shown to cause a decrease in correlating gray matter and to negatively
impact relative neuroplasticity (Granert et al. 2011). As tissues become
more stuck, the potential for movement diminishes even further,
constituting a vicious cycle. Cramer et al. (2010) confirmed that inactivity
and immobilization result in the development of adhesions in the facet
joints. Duration of immobility was shown to correlate with the size, and
frequency of the adhesions – longer duration is linked to more extensive
adhesions.