Adhesion formation is the result of inflammation which lays down fibrotic tissue mostly composed of collagen. This brief article will not describe details of how this process occurs, and is intended to point out that massage therapy is one of the most effective treatment applications for helping to prevent inflammation from causing excess undesirable adhesion formations, and in many cases dispelling formed adhesions.
Properly applied manual pressure and movement strokes can help loosen and break up undesired adhesions from forming and developing, while also helping direct normal, smoothly striated, better aligned connective tissue formation in many instances, especially those involving more superficially located inflammatory responses.
This process is analogous to a broken ceramic piece that’s glued back together, and removing the excess glue that splayed out beyond the repaired site and is not desired.
One might argue that leaving the excess, overlaying glue would add even greater strength. While this may be true for a ceramic piece (as unsightly as it may be), the problem with excess adhesions forming in the body is that they bind to other, undesirable tissue besides those being repaired, which restricts normal mobility and can cause undesired neurological tugging, compression and pain.
Proper massage is especially helpful in reducing adhesion formation in the early stages. The sooner an injured area can be treated, the better the results will be, because the adhesion formation hasn’t become as widespread, hardened and detrimental.
“Early mobilization, guided by the pain response, promotes a more rapid return to full activity and functional recovery – based on the premise that the stress of movement on repairing collagen is largely responsible for the orientation and tensile strength of the tendons and ligaments.”
– Cyriax J, Russell G: Textbook of Orthopaedic Medicine, Vol 2, 1969 Ed 10. London: Bailliere, Tindall & Cassell Ltd, 1980
Even during late stage healing, or in chronically established cases, manual therapy can often provide much therapeutic treatment in releasing adhesions to varying degrees, thus minimizing their negative consequences.
“Adhesions leading to painful scarring cannot appear and later interfere… if the damaged structure is moved by human fingers in imitation of its normal behavior – for it is thus freed from adhesions both actually present and in the process of forming.”
– John Kellett, MD, Medicine and Science in Sports and Exercise; 1986
So when clients have been diagnosed with adhesion formations that may be residual results of acute or chronic injuries, or other causes, it’s important when managing their care to qualify telling them something like this:
“Massage can help dispel micro-adhesion formations in many instances. I can’t guarantee how much it can help you, but i can assure you that we will apply proper pressure to help dispel them the best we can.”
It’s beyond the scope of this article to discuss how to work with or below acceptable discomfort tolerances when dealing with adhesions, and how to best communicate this with your clients, but it is another very important part of properly managing their care.