Issue link: https://www.massageandbodyworkdigital.com/i/72098
UNDERSTANDING THE HEALING PROCESS Massage also supports healing by helping clients shift from a sympathetic nervous response (fight or flight) to a parasympathetic response (relaxation). Remodeling may take months or years, depending on the severity of injury and demands placed on the tissue. Success in this phase requires gradual progression of functional activities followed by appropriate tissue adaptation. Encourage clients to return to activities previously modifi ed or avoided with the intention of retraining the injured tissue (with physician permission, of course). Help them recognize compensatory patterns, improve body awareness, and return to more functional movements. Supervised activity may be necessary to restore full function, requiring assistance from physical or occupational therapists or fi tness professionals. SUPPORTING THE HEALING PROCESS There is no specifi c time frame associated with the individual phases of healing. Several factors, including the amount of damage, location, type of tissue injured, general health of the client, preexisting conditions, medications, nutrition, and hydration all infl uence the time needed to repair injured tissue. We must rely on signs and symptoms rather than time frames to determine when clients have moved from one phase to the next and how best to support the process at any given time. Support the infl ammatory response by limiting use of the injured tissue. This allows the body to isolate the injured area, clean up debris, and mobilize supplies necessary for repair. Focus your treatment sessions on associated structures while avoiding direct manipulation of injured tissues as the body completes this process. Traditional management of acute infl ammation includes protection, rest, ice, compression, and elevation of the injured area (PRICE), which minimizes further injury and decreases infl ammation. Massage also supports healing by helping clients shift from a sympathetic nervous response (fi ght or fl ight) to a parasympathetic response (relaxation). Stress associated with injury, whether from pain, physical reactions, or emotional responses, diverts energy and resources away from repair processes. It may also interfere with sleep, additionally limiting healing. During the infl ammatory response, work with clients and their health-care team to reduce pain and stress and achieve adequate sleep to maximize healing. As the infl ammatory response gives way to the repair phase, your efforts shift to maintaining function, minimizing compensation, and increasing circulation. Direct techniques continue to focus primarily on associated structures, but you may now begin addressing injured areas more specifi cally as infl ammation subsides. Remember, clients will experience less pain (localized and intermittent rather than global and constant) and improved function, but don't be tempted to work too aggressively on affected tissues. Remind them of the fragility of granulation tissue and the consequences of overuse. Once the remodeling phase begins, treatment becomes much more aggressive. Focus on breaking up scar tissue and adhesions, increasing range of motion and circulation, and eliminating compensatory movement patterns. Clients embark on a systematic return to normal activities as you work together to achieve optimal tissue alignment and coordinated movement. This may require professional oversight from therapists who specialize in therapeutic exercise and neuromuscular reeducation. CONCLUSION Recognize specifi c events that occur following an injury and common signs and symptoms associated with tissue damage and repair. This helps you identify where clients fall in the healing continuum and anticipate what sensations and functional changes they might expect. Reduce fear and frustration by explaining the events following an injury and highlight ways you and your client can both support the healing process. therapist and certifi ed strength and conditioning specialist. Her private practice focuses on injury treatment, biomechanical analysis, craniosacral therapy, and massage for clients with neurological issues. She is the author of Functional Anatomy: Kinesiology and Palpation for Manual Therapists (Lippincott Williams & Wilkins, 2009). Contact her at functionalbook@hotmail.com. Christy Cael is a licensed massage tune in to your practice at ABMPtv 53