internally or on the surface of the skin—it can entrap, irritate, and restrict nerves, leading to chronic pain. The rest of this discussion will focus on some subtypes
of scarring run amok where massage has been demonstrated to have a particularly useful role. The articles where this information is documented are listed in the Resources section.
Burns Burns that penetrate through the dermis leave permanent scars that become elevated, reddened, and rigid. They are especially likely to contract and pucker, leading sometimes to a major loss of range of motion and function in nearby tissues. Skin grafts aim to prevent this, but with only middling success. Massage therapy for burn survivors has multiple benefits. In addition to providing pain relief during the excruciating initial treatment and healing
process, it can improve the long-term outlook as well. It doesn't radically change the appearance of scars, but it can reduce vascularization and itching, and improve pliability, especially if it is applied as soon as the skin can tolerate shearing forces. In addition, massage can be a helpful part of treatment for depression (and accompanying self-esteem challenges) in severely burned patients.
Surgery The role of postsurgical massage for scar tissue varies a bit by location. In this context, we will consider two subgroups that have been researched: massage for postmastectomy and lymph node dissection surgery, and massage for postabdominal or pelvic surgery.
Resources
eMedicineHealth, "Adhesions, General and After Surgery." Accessed May 2012. www. emedicinehealth.com/ adhesions_general_and_ after_surgery/article_ em.htm.
Alpay, Z. et al. "Postoperative Adhesions: From Formation to Prevention." Seminars in Reproductive Medicine 26, no.4 (2008): 313– 21. www.medscape.com/ viewarticle/580001.
Beurskens, C. et al. "The Efficacy of Physiotherapy upon Shoulder Function Following Axillary Dissection in Breast Cancer, a Randomized Controlled Study." BMC Cancer 7 (2007): 166. www. biomedcentral.com/1471- 2407/7/166/prepub.
Bove, G.M., Chapelle, S.L. "Visceral Mobilization Can Lyse and Prevent Peritoneal Adhesions in a Rat Model." Journal of Bodywork and Movement Therapies 16, no. 1 (2012): 76–82.
Fourie, W.J., Robb, k.A. "Physiotherapy Management of Axillary Web Syndrome Following Breast Cancer Treatment: Discussing the use of Soft Tissue Techniques." Physiotherapy 95, no. 4 (2009): 314–20.
Fourie, W.J. "Considering Wider Myofascial Involvement as a Possible Contributor to upper Extremity Dysfunction Following Treatment for Primary Breast Cancer." Journal of Bodywork and Movement Therapies 12, no. 4 (2008): 349–55.
Patino, O. et al. "Massage in Hypertrophic Scars." Journal of Burn Care and Rehabilitation 20, no. 3 (1999): 268–71.
Syed, F. et al. "Fibroblasts from the Growing Margin of keloid Scars Produce Higher Levels of Collagen I and III Compared With Intralesional and Extralesional Sites: Clinical Implications for Lesional Site-Directed Therapy." The British Journal of Dermatology 164, no. 1 (2011):83–96. www. medscape.com/ viewarticle/735009.
Young, S.R. "Effects of Skin Rehabilitation Massage Therapy on Pruritis, Skin Status, and Depression in Burn Survivors." Journal of Korean Academy of Nursing 37, no. 2 (2007): 221–26. www.ncbi.nlm.nih.gov/ pubmed/17435407.
44 massage & bodywork july/august 2012
