Adhesion – Uncommon Knowledge About Common Pain

Why many therapy approaches fail

The uncommon knowledge in health-care about fibrous adhesion as a source or factor in pain leaves many patients frustrated and grasping for solutions. Fibrous adhesion that restricts your tissue mobility is very likely to be associated with your pain or even the source of your pain. Fortunately there are uncommon providers that specialize in this uncommon knowledge that can provide solutions to this pain.

There is a multi billion dollar industry of massage thumpers, taping techniques, creams, oils and other such solutions that miss the mark in addressing pain symptoms. We’ve all gotten to the point of trying something, anything to stop the aching, throbbing, numbness or pain with movement. This includes grinding that shoulder blade into the door knob or trying to find just the right stretch to make it go away or at least better. Pain that shows up to interrupt or lives can be so frustrating.

Adhesion formation is a common cause of pain that is very common but unfortunately uncommon knowledge in health-care. Muscular pain obviously has many causes . Pain generators such as inflammatory, immune, neurological or systemic disorders need to be recognized and referred to an appropriate specialist. Pain that is associated with tissue damage such as muscular tears, ligament tears or nerve damage need a specialist’s attention. Adhesion needs to be understood and recognized and attended to as well.

In my experience about 85% of the clients that have come to me for help have symptoms that are completely or partially due to adhesion formation in tissue. What this means is that the moving parts such as muscle, ligament or nerve tissue has lost mobility. The pain that results is the proverbial “blinking engine light” of altered movement or increased pressure on our nervous system.

I have found that the brain is not very tolerant of pressure on nerves, the loss of joint movement, muscle movement or the damage of tissues. These problems result in a variety of responses such as pain, weakness, numbness or altered movement. These responses are the brain’s strategies for getting our attention so we can continue the task of movement, with pain minimization and energy conservation. Adhesion formation creates the necessity of new movement pattern strategies that often breakdown into more pain and frustration.

Adhesion forms in three key situations. These situations are all result in decreased circulation to tissues. Adhesion forms with repetitive motion (as I am typing on this laptop), direct injury (I hurt my wrist falling on the ice), or positional ischemia (my hip hurt after siting for two hours in a funky position on the couch). In these situations there is a primitive protective mechanism to address the problem of loss of intracellular oxygen concentrations. The result is a fibrous adhesion which is a scar that forms to address the threat . Fibrous adhesion increases tissue density and decreases mobility between the moving parts.

Many therapies and self care strategies are painful and miss the mark in addressing adhesion. Adhesion is a problem that is unlikely to be solved with most therapies, massage techniques, mechanical thumpers, foam rolling or muscle mashing strategies. Adhesion cannot be detected with an MRI, X-Ray or Ultrasound. It is most effectively recognized and addressed by a skilled provider who can feel the movement of the tissue texture and tension of those moving parts.

Adhesion can often be resolved very quickly and effectively. With careful identification of the problem, adhesion can be released or reduced with a simple technique that can be difficult to learn and master. With this technique the identified tissue lesion (adhesion) is gently and strategically pulled across a point of tension created by a part of a skilled hand. I have found that for the most part adhesion is a relatively weak bond that forms between the moving parts and therefore the bonds release pretty rapidly.

Adhesion that restricts tissue mobility is pretty likely to be associated with your pain. Fibrous adhesion of tissue may even be the reason for your pain. A multi-billion dollar industry of a variety of remedies only seem to offer temporary relief. Frustration is the common result. I find that the best solution is to find an expert that has the knowledge-base and experience to address it the problem. A specialist focused on identifying problems in tissue mobility is currently hard to find. You’ll be glad when you do.

Dave Edwards-Smith
LMT-NSCA-CPT

Fibrous Adhesion Formation Pathways
The Hypoxic Pathway to Fibrous Adhesion
There are four critical steps in the hypoxic production of fibrous adhesion.

  1. Repeated or sustained contraction of skeletal muscle results in decreased intracellular oxygen concentrations.
  2. Decreased oxygen concentrations leads to the production of oxygen free radicals.
  3. Oxygen free radicals are very fast, specific and sensitive triggers for attraction and replication of fibroblasts.
  4. Increasing fibroblast density leads to increased collagen production and other ultrastructural changes forming fibrous adhesion.Modulation of fibroblast proliferation by oxygen free radicals
    G A C Murrell, M J O Francis, L BromleyBiochemical Journal Feb 01, 1990
    Fascia Research from a Clinician/Scientist’s Perspective
    Thomas W. Findley, MD, PhD

The Inflammatory Pathway to Fibrous Adhesion

  1. Acute injury is sustained by muscle or fascia, the precipitating events are those of acute inflammation.
  2. Acute inflammatory process often leaves a residue of edematous exudates (a mass of cells and fluid that has seeped out of blood vessels or an organ, especially in inflammation)
  3. A highly vascular mass of granulation tissue develops which leads to the infiltration of fibroblasts and endothelial cells
  4. The fibroblasts gradually create a matrix of collagen fibers, which become fibrous, or scar, tissue adhesions.United States Sports Academy
    America’s Sports University®
    The Sport Digest – ISSN: 1558-6448

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