Issue link: https://www.massageandbodyworkdigital.com/i/1476304
L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 23 Most patients with osteochondritis dissecans are young. Conservative treatment with this population is often effective because they are skeletally immature, and activity modifications can reduce biomechanical stresses. With older patients, conservative treatment appears to be less effective, and there is a greater likelihood that surgery will be necessary. Conservative treatment often includes patellar taping and exercises for the vastus medialis obliquus muscle. The primary goal is to improve knee joint biomechanics, which decreases aggravation of the osteochondral lesion. Surgical procedures for OCD are primarily arthroscopic. That means there will be minimal irritation and a quicker recovery. Chondroplasty is the preferred procedure and involves removing the damaged cartilage. However, in some cases, there may still be pain and crepitus with movement. In addition, once cartilage is removed in an area, there is a greater chance that the individual will develop osteoarthritis later in life due to greater friction between the joint surfaces. TO MASSAGE OR NOT? The first question to answer when determining if massage is appropriate for any condition is whether it can cause an adverse effect. With labral tears, there is no indication that massage or any gentle range- of-motion activities performed within normal limits would cause a problem or worsen the condition. The next question to consider is whether massage can help treat the injury. In the case of labral tears, they are too deep in the shoulder joint to be accessible with palpation. Also, the labrum is cartilage, so it doesn't respond to soft- tissue treatment. However, as in many situations, these facts do not mean that massage is not beneficial. Dysfunctional mechanics frequently accompany labral tears at the joint. Myofascial trigger points or other biomechanical imbalances may occur as the shoulder attempts to compensate for pain, instability, or loss of function associated with the injury. In many cases, massage can help restore biomechanical balance in the shoulder. Understanding labrum pathologies will help you ascertain when they might be occurring and aid in knowing when to make an appropriate referral. It is not clear whether massage is of significant benefit for OCD. However, there does not appear to be anything in the etiology of OCD that suggests massage can be harmful or contraindicated, as long as it is performed within comfort limits. Local and specific massage applications to the knee joint may prove beneficial in helping reduce corresponding soft-tissue pain in the region. It is still unclear if massage would restore or improve adequate blood flow in the region. However, massage has general pain relief benefits outside of the specific condition treatment. Time can be an essential factor in getting good results from treatment. The longer joint microtrauma persists, the greater the potential damage in the region. Therapists should refer clients exhibiting OCD signs to a physician as soon as possible so the condition can be appropriately evaluated and necessary treatment can begin. As noted, massage is not contraindicated for this problem and may reduce associated pain from the articular damage. It is imperative we understand the limitations of what we do so we don't give a client false hope about what massage can accomplish. Once conditions like these are diagnosed, massage is an excellent adjunct treatment that can help prevent further complications and lead to treatment success on a general level. Whitney Lowe is the developer and instructor of one of the profession's most popular orthopedic massage training programs. His text and programs have been used by professionals and schools for almost 30 years. Learn more at academyofclinicalmassage.com. TECHNIQUE Massage is not contraindicated for OCD and may reduce associated pain from the articular damage.