Research Review: Peripheral Nerve Entrapment & Massage Therapy
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Peripheral Nerve Entrapment & Massage Therapy
Massage Therapists may be aware of some of the research behind peripheral nerve entrapment from Michael Shacklock and his book Clinical Neurodynamics. In this book the author provides insight into how mechanical irritation can lead to localized nerve inflammation.
Running parallel to this work - Geoffrey Bove and Mary Barbe have investigated how trauma and ongoing inflammation can be a contributing factor to connective tissue changes (increased collagen and TGF-β1 deposition).
This process has been described as a progression from densification (alterations of loose connective tissue) to fibrosis (alterations of collagen fibrous bundles).
Functionally, these changes may influence biomechanical properties secondary to tissue adherence or tethering structures to each other. It may also induce chronic compression of peripheral nerves (ie. carpal tunnel syndrome, hamstring syndrome, meralgia paresthetica, infrapatellar syndrome etc...).
What Are The Implications for Massage Therapy?
The underlying mechanisms of massage therapy are complex and multifactorial. In addition to endogenous pain modulation, soft tissue mobilization may help diminish intraneural edema, and expedite clearance of pro-inflammatory cytokines.
Additionally, an interesting area of research is to what degree can soft tissue mobilization mitigate the development of post-inflammatory connective tissue fibrosis, and how does this effect epineurial and perineurial structures.
Then if massage therapy is applied with an optimized dosage, what are the implications for patients with repetitive strain disorder or peripheral neuropathy.
More to Explore
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https://www.ncbi.nlm.nih.gov/pubmed/28734168
Bove, G.M. (2008). Epi-perineurial anatomy, innervation, and axonal nociceptive mechanisms. J Bodyw Mov Ther.
https://www.ncbi.nlm.nih.gov/pubmed/19083672
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