Issue link: https://www.massageandbodyworkdigital.com/i/434495
Medial epicondylitis and carpal tunnel syndrome are both examples of a local tissue dysfunction where pathology develops in those tissues as a result of chronic overuse. Focal dystonia is quite different. In a 2013 article, researcher H. S. Lee described the condition as "characterized by abnormal involuntary sustained muscle contractions in a single body part," generally specifi c to a particular type of task, such as playing the piano. 1 The symptoms are experienced in the forearm and hand, similar to a local tissue dysfunction, but the root of the problem is actually in the brain. In focal dystonia, the brain sends incorrect information to the muscles and abnormal muscle recruitment patterns develop. When various movements are performed repeatedly, as happens in playing a musical instrument, correct neuromuscular programming is disrupted and the motor signals given to the muscles are no longer properly coordinated. The improper motor coordination leads to painful muscular spasms, problems with coordination, and a sensation of muscles seizing. An analogy frequently used to describe focal dystonia is that of a hard drive crash or computer virus, where the instructions from the main processing center, in this case the brain, are seriously disrupted. TREATMENT STRATEGIES Today, we have a better understanding of the role of massage in treating chronic overuse disorders that involve local tissue dysfunction such as local nerve entrapment, muscle strains, tendinosis, or tenosynovitis. But a clinician would be right in questioning whether massage would be benefi cial in Dustin's case, since focal dystonia is a brain and neurological system disorder and not a soft-tissue overuse issue. There is very little in the research literature about the use of massage in treating focal dystonia. However, there is no physiological reason that massage shouldn't be used within normal precautionary parameters. In fact, there are some concepts we now understand about myofascial anatomy and physiology that would help create a benefi cial massage treatment strategy for this problem. Robert Schleip, a well-known fascial researcher and bodywork therapist, wrote about sensory mapping in the brain from the myofascial system in his groundbreaking articles on fascial physiology. 2 He states, "It commonly comes as a big surprise to many people to learn that our ABMP Member SPECIAL $99 per course Buy 2, get a FREE book 18 CEs • NCBTMB www.omeri.com/abmp $31.95 FREE with any Package