Body Sense

Winter 2011

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Inflammatory Response Purpose Signs & Symptoms * Clean up debris * Combat infection * Prevent further injury Swelling Heat A loss of function Redness Pain (global) Goals * Rest injured area * Limit or modify activity * Manage pain to maximize sleep of applying mechanical stress, adjusting, and adapting is the last step in healing. Ideally, the new tissue will offer maximal flexibility and strength, according to the demands placed on it during the remodeling phase. Decreased mobility and a migrating pain sensation characterize the remodeling phase. Blood flow decreases and tissue becomes less pliable as dense networks of fibrous tissue replace fragile granulation tissue and blood vessels are deconstructed. Mobility may be further decreased as mature scar tissue shrinks and various tissue layers bind or adhere together. Poor blood supply to an area creates a dull ache, sensation of tension, or feeling of stagnation in the injured and surrounding areas. This type of pain may be felt in broad areas and improves with movement or any modality that increases circulation, like massage, exercise, and application of heat. If compensation has been necessary throughout the healing process, chronic dysfunction may occur in structures not injured directly. This includes tight muscles, abnormal movement patterns, and pain that seems to move around. It can be very frustrating to experience new types of pain, decreased mobility, and decreased function after a period of improved function and reduced pain. Again, this is a normal part of the process and indicates progress with healing. Tissue remodeling occurs continuously throughout life in order to adapt to new activities, much like roads need constant maintenance. The reconstruction process increases dramatically following an injury and may take months or years to complete, Repair * Increase circulation * Produce granulation tissue * i Inflammation * i Pain (localized) * h Mobility * h Function Remodeling * Arrange mature scar tissue for maximal strength and mobility * Ø Inflammation * i Mobility * i Strength and endurance * Morning stiffness * Dull pain that improves with movement or increase in temperature * Increase circulation * Continue to modify or limit aggravating activities * Manage compensation * Improve mobility and circulation * Progressively return to activity * Eliminate compensation depending on the severity of injury and demands placed on the tissue. It is important to return to activities previously modified or avoided slowly and progressively, with the intention of retraining the tissues to tolerate each new stress (with physician permission, of course). Support remodeling by improving circulation and pliability to injured and associated tissues, decreasing tissue binding, and recognizing and altering dysfunctional movement patterns associated with compensation. THE HEALING PROCESS While it's not always possible to avoid injury, you can support the healing process afterward. Listen to your body and discuss your experience so you and your health-care team can recognize where you are in the healing continuum. Be consistent with treatments and support strategies, even when you are feeling better. Make informed decisions about activity, treatment, and progression to support each phase and prevent re-injury. Work with your massage therapist and other members of your health-care team to successfully achieve full return to your job, hobbies, and life with less pain and worry along the way. B S Christy Cael is a licensed massage therapist, certified athletic trainer, and certified strength and conditioning specialist. Her private practice focuses on injury treatment, biomechanical analysis, craniosacral therapy, and massage for clients with neurological issues. She is the author of Functional Anatomy: Kinesiology and Palpation for Manual Therapists (Lippincott Williams & Wilkins, 2009). Contact her at functionalbook@hotmail.com. Body Sense 11

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