Issue link: https://www.massageandbodyworkdigital.com/i/621015
TREATMENT STRATEGIES As with any nerve compression or tension injury, the key factor for success is reducing the mechanical load. That means getting pressure off the nerve if it is a compression problem, or relieving the excess tensile stress if it is a nerve traction injury. A thorough client history is extremely important in identifying the primary causative factors that may have led to nerve compression or tension injury. Keep in mind that, especially with compression injuries, the longer the force has been applied to the nerve, the slower and longer the healing time. Symptom relief may take many months or even a year or longer. 6 During the healing process, the person should avoid aggravating activities like carrying heavy loads on the affected side. When compression occurs from external forces such as heavy shoulder straps, removing the offending activity may be sufficient for healing. However, in many cases, there still may be soft-tissue involvement that can benefit from massage. There are a few key areas that are important to address to make sure the nerve has the greatest potential for proper healing. If LTN compression is occurring between the anterior and middle scalene muscles, it is often hypertonicity or taut bands within these muscles that are compressing the nerve. In these cases, the key treatment goal is to reduce muscle tightness to prevent further compression. However, diving in with deep pressure on these muscles when they may already be tight can be counterproductive and cause more irritation to the nervous system. Light, gentle pressure in this case can be even more effective in helping restore proper tone. Begin with the client in a supine position. Turn the client's head slightly to the opposite side and, if possible, laterally flex the head toward the affected side. This position will slightly shorten the scalene muscles and reduce any stretch tension perceived by the muscle. Place the fingertips of one hand near the superior portion of the muscle and the fingertips of the other hand near the inferior portion of the muscle near the clavicle and first rib (Image 3). Apply a gentle pulling force, separating your two hands, and hold for about 2 minutes. After holding this position, very slowly and gradually let go of the pulling force. Slowly releasing this force allows the brain to adapt to a different sensation coming from the muscles and is more likely to have a longer lasting effect. After pressure is released, take the client's head, then slowly and gently move it back and forth in slight flexion and lateral flexion toward the affected side, trying to keep from overstretching the muscles that have just been treated. These gentle and easy movement patterns help retrain the neuromuscular pattern perceived by the brain. If you're not forcibly stretching the muscle, the brain does not have to perceive any potential tissue damage and will not cause as much reactive resistance to the movement. A similar technique can be applied to the muscles on the top of the shoulder along the path of the long thoracic nerve. Place one hand near the base of the neck and the other hand near the distal 100 m a s s a g e & b o d y w o r k j a n u a r y / f e b r u a r y 2 0 1 6 Dive into training that takes you to new depths of learning Go beyond the surface! orthopedic massage Whitney Lowe's Online Training & Certification Personalized instruction from Whitney Lowe Interactive & dynamic learning activities Extensive video library with ongoing access Free clinical news & research newsletter Free CE sample courses Workshops: GA, DE, TX, CT, CA, ID "...the best course I've taken in 30 years of CE." "...one of the very best teachers I've had in the business." "...what an incredibly useful & accessible course!" Academy of clinical massage www.academyofclinicalmassage.com 866-744-8456 Visit us at: www.acmspecials.com save on courses, books, workshops ABMP Member Specials Training excellence in science-based clinical massage for over 2 decades.