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

16.06.2020 Views

Figure 9.8Tension. The lower leg is being anchored by the therapist’s right hand, while the left hand engagesthe tissue by applying compression (begin at pressure grade 1–3 (see Box 9.8) and slowly increaseuntil barrier is felt), then glide slowly, creating drag and tensioning in a proximal direction.

ShearOblique or laterally applied gliding type movement of one tissue or layer inreference to another. Intended outcome is to influence fluid dynamics (e.g. GSand HA changes: shift GS viscosity and increase the lubrication potential of HAin the sliding layers), generate heat and mechanical cleavage/disengagement ofundue cross-links – culminating in improved tissue mobility and slide/glidecapabilities (see Fig. 9.10).Torsion/rotationTorsion/rotation is twisting-type loading; essentially, a combination ofcompression and tension where there is simultaneous compression of somefibers with elongation of others. Multiple intended outcomes associated withcompression and tension as noted above, as illustrated in Figure 9.11.

Shear

Oblique or laterally applied gliding type movement of one tissue or layer in

reference to another. Intended outcome is to influence fluid dynamics (e.g. GS

and HA changes: shift GS viscosity and increase the lubrication potential of HA

in the sliding layers), generate heat and mechanical cleavage/disengagement of

undue cross-links – culminating in improved tissue mobility and slide/glide

capabilities (see Fig. 9.10).

Torsion/rotation

Torsion/rotation is twisting-type loading; essentially, a combination of

compression and tension where there is simultaneous compression of some

fibers with elongation of others. Multiple intended outcomes associated with

compression and tension as noted above, as illustrated in Figure 9.11.

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