Massage & Bodywork

NOVEMBER | DECEMBER 2024

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78 m a s s a g e & b o d y wo r k n ove m b e r/d e ce m b e r 2 0 24 Too Much Tone Massage Therapy and Spasticity: Can We Help? By Ruth Werner Critical Thinking | Pathology Perspectives Spasticity—the progressive, involuntary tightening of voluntary muscles—can be painful, limiting, and eventually permanent. Can bodywork influence spasticity? It's an interesting question. Spasticity, hypertonicity, and rigidity are three distinct issues (see "Muscle Tone Vocabulary," page 81). Logically, manual therapy should not substantially impact damage to the central nervous system (CNS) that leads to motor neuron deficits. Yet many massage therapists report improvements in pain, function, and range of motion for their clients affected by spasticity. And research findings, while limited, support those observations. In this article, we take a closer look at spasticity: what situations cause it, what happens to the involved nerves, muscles, and connective tissues, and how that information might shape some decisions about massage therapy. ANATOMY REVIEW The CNS comprises the brain and spinal cord, and the peripheral nervous system (PNS) comprises the cranial and spinal nerves. Each of those nerves is composed of thousands of long nerve cell fibers or neurons. The motor and sensory neurons of the PNS have extensions that reach into the spinal cord to synapse with ascending (sensory) neurons going toward the brain and descending (motor) neurons coming from the brain, but the terminal points of motor and sensory nerve fibers in the PNS are found in the skin, connective tissue, muscles, and organs. In this discussion, we will focus on the motor neurons of the PNS, all of which terminate in either muscle tissue or glands. When we decide to move, for instance to shift in our seat or scratch our nose, the brain initiates voluntary motor messages. These are passed on to motor neurons in the descending tracts of the spinal cord, which pass them onto the spinal nerves, where KEY POINT • The ways central nervous system injury leads to spasticity are still being explored. Massage therapy may help, if it is done with care.

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