Physiotherapy of scar in the light of the current reports about fascia

Agnieszka Sobierajska-Rek

A. Sobierajska-Rek – Physiotherapy of scar in the light of the current reports about fascia. FP 2017; 17(1); 64-71

Abstract

In view of the serious complications of healing process within certain parts of the body (visceral adhesions, adhesions within the chest disrupting respiratory patterns, entrapment of nerves in scar tissue) it seems necessary to introduce prevention and treatment of adhesions after any surgical procedures.

The aim of this study is to present the mechanisms, which accompany the formation of scar, on the basis of the current reports on fascia, and to show the possibility of therapeutic treatment of linear scars, on the basis of our own clinical experience.

When examining dysfunctions accompanying the healing process of soft tissues, three basic disorders may be defined: keloid scar, hypertrophic scar and tissue adhesion.

It has been established, that using the manual mobilization techniques on a scar, tissue mobility may be improved, pain sensation decreased and better functioning of internal organs achieved. In order to obtain optimal therapeutic results, it is essential to introduce a comprehensive scar treatment. The manual mobilization leads to certain reactions of tissue at the level of hyaluronic acid restructuring, breaking the adhesion or preventing its creation and relaxation caused by stress.

Key words:
scar, fascia, manual therapy

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Evaluation of the manual therapy effect on hand functional efficiency in the patients with systemic sclerosis – case description

Mateusz W. Romanowski, Maja Špiritović, Agata Zdanowska, Anna Kwaśniewska

M. W. Romanowski, M. Špiritović, A. Zdanowska, A. Kwaśniewska – Evaluation of the manual therapy effect on hand functional efficiency in the patients with systemic sclerosis – case description. FP 2016;16(4);14-23

Abstract

The systemic sclerosis is chronic systemic disease of connective tissue that is characterized by damage of blood vessels, presence of autoantibodies and progressing skin and internal organs fibrination, leading to their failure. The loss of mobility in hand and wrist joints, which often affects patients with the systemic sclerosis, significantly worsens their life quality.
Non-pharmacological treatment of the systemic sclerosis includes: physiotherapy, education, new therapeutic methods. Individually selected therapy counteracts and diminishes dysfunctions in the joints area, soft tissues and skin, and may improve efficiency of internal organs.
Manual therapy perfectly complements comprehensive in this group of patients, by influencing the following receptors: of Golgie, Ruffini, Pacini and interstitial. The manual therapy techniques directed to the skin, fascia, muscles, joints, improve hand efficiency and decrease pain in patients with systemic sclerosis.
Application of manual techniques (skin rolling, deep massage of superficial fascia and muscles responsible for straightening the wrist joint, postisometric muscle relaxation, mobilization in ridge direction in rediocarpal joint, side-to-side mobilization in finger joints) performed in the study improved hand functional efficiency in all tested parameters (Cochin Hand Scale, Hand Mobility in Scleroderma, finger-to-palm-distance).

Keywords:

systemic slerosis, manual therapy, soft tissue therapy, physiotherapy

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Phenomenon of the dominant and latent blocks of the sacroiliac joint in lateral curvature of the spine – problems related to the pelvis therapy

Daniel Olędzki, Andrzej Sadowski, Tomasz Sajko, Marek Kiljański

D. Olędzki, A. Sadowski, T. Sajko, M. Kiljański: Phenomenon of the dominant and latent blocks of the sacroiliac joint in lateral curvature of the spine – problems related to the pelvis therapy. Fizjoterapia Polska 2015;15(3);12-22

Abstract

The deviation of the spine from the long vertical line of the body can be detected from the early years of a child. The deviation is closely related to the position of the pelvic bones to each other and sacroiliac joints, especially their disfunction, play an important part in this process.
Even a slight shift of the sacrum relative to a hip bone causes the change in the spatial arrangement of the pelvis complex, spine segments located above as well as the hip bones. Early intervention by early diagnosis of the disfunction in little children gives us a chance to correct efficiently the pelvis relative to the spine at the level of so-called “compensatory scoliosis” when the problem lies only in the asymetric arrangement of the pelvis that affect the spatial arrangement of the vertebrae and is totally reversable.
The research team confirmed the fact of occurring “the dominant phenomenon and latent blocks of sacroiliac joints”. Its existance has been proven in 50% of subjects.
The examination and therapy of joints is relatively difficult taking into consideration the phenomenon described in this work. In case of a therapy of only one joint, no intended results can be expected in every second case.
There should be at least two manual examinations to assess the condition of both sacroiliac joints and comparing them with the primal examination. The rule of the manual therapy and examination before and after the therapy is applied in such a case.

Key words:
sacroiliac joint, manual therapy, scoliosis, block

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