Issue link: https://www.massageandbodyworkdigital.com/i/1256819
N e w ! A B M P P o c k e t P a t h o l o g y a t w w w. a b m p . c o m / a b m p - p o c k e t - p a t h o l o g y - a p p . 55 Therapeutic Loading The application of mechanical or manual force can influence neurophysiological and integrin-mediated responses. It appears that effects can differ depending on the type of therapeutic loading (e.g., tension, compression, bending, shear, and torsion/rotation). For example, fibroblasts, which play a prominent role in wound healing, are responsive to tissue tension and stretch—when stimulated, fibroblasts in skin and connective tissue down-regulate agents associated with fibrogenesis; 1 and fasciacytes, which regulate hyaluronan, appear to have an affinity for shearing type methods— hyaluronan plays a key role in fascial sliding, including sliding within neural interfaces. 2 Notes 1. Helene M. Langevin, "The Science of Stretch," The Scientist 27, no. 5 (May 2013): 32. 2. Carla Stecco et al., "The Fasciacytes: A New Cell Devoted to Fascial Gliding Regulation," Clinical Anatomy 31, no. 5 (March 2018): 667–76, https://doi.org/10.1002/ca.23072. Labor of Love In 2013, I had the great pleasure of meeting Mary Law of Handspring Publishing and Nancy Keeney-Smith, LMT, MLD, at the International Massage Therapy Research Conference in Boston. Knowing our professional interests, Mary suggested Nancy and I partner up to coauthor a book. 1 Nancy and I are often asked what it was like to write a book. For us, it was a labor of love . . . giving birth through our brain, heart, and hands. The love was working with Handspring Publishing and all the talking, thinking, and writing about massage therapy and scars. The labor was accumulating, reading, and trying to make sense of current research (wound healing, lymphatic, fascia/connective tissue, and manual therapy). We felt it vitally important to honor the credibility of our profession by providing an evidence-based body of work and to develop a deep understanding for—and to clarify—what truly is the issue, what needs to change, and how we can best use our hands to facilitate the needed changes to provide the best possible care for our clients. After reading a ridiculous amount of research, we found ourselves at the juncture of plausible and not, and this is how we arrived at the conclusion that mature scars/adhesions are not breakable by manual methods. Which brings us to: what is going on in there? Any of you who work with scar tissue in your practice know that your hands are doing something to improve your client's situation. Note 1. Nancy Keeney-Smith and Catherine Ryan, Traumatic Scar Tissue Management: Massage Therapy Principles, Practice and Protocols (Pencaitland: Handspring Publishing, 2016).