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

Pressure Level 4 – Strong pressure/light to medium amount of lotion
Movement of deep layers of muscle, fascia, tendon, adipose, blood vessels,
if present.
Movement of adjacent joints is noticeable with this pressure if there is no
scar tissue impeding movement. Significant upper body strength or good
body mechanics may be necessary to introduce therapist body weight and
deliver this pressure with the full hand. Caution is advised if the client has
had scar release within the last 72 hours. Overworking a particular area
could establish micro tears and inflammation in scar-released area.
Squeezing tissue with fingers requires significant hand strength at this
pressure. Therapists commonly switch from the full hand to smaller areas,
such as the knuckles or forearms, in order to apply this pressure with less
effort. Extreme caution is warranted if this pressure is used to release a scar
mound that has encapsulated a nerve, artery, vein or more than one muscle
group.
Pressure Level 5 – Deep pressure/light to medium amount of lotion
Movement of deepest layers of muscle, fascia, adipose, blood vessels, if
present. Through the compressed soft tissue, the therapist engages the
bones of the massage site with the bones of their hands (or elbow, forearm,
or other massage surface), and the two move as a unit. Substantial upper
body strength and excellent body mechanics, using the therapist’s own
weight, are needed to apply this pressure with the full hand; often one hand
must be braced with the other to deliver this pressure. Used with healthy,
robust clients preferring the deepest pressure. Extreme caution is warranted
if this pressure is used to release scar mound that has encapsulated a nerve,
artery, vein or more than one muscle group.
Adapted from Walton 2011.
Box 9.8