Traumatic muscle fibrosis: From pathway to prevention
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Cholok, D., Lee, E., Lisiecki, J., Agarwal, S., Loder, S., Ranganathan, K., Qureshi, A.T., Davis, T.A., Levi, B. (2017). Traumatic muscle fibrosis: From pathway to prevention. J Trauma Acute Care Surg.
This is a great research paper to follow up my last post - Sports Massage - The Science is Emerging. My last post was a brief look at the psychological & physiological responses to massage therapy.
In this post I wanted to share some excerpts from a recent review of traumatic muscle fibrosis published in The Journal of Trauma and Acute Care Surgery. This paper may provide some insights for therapists wanting to learn more about the interconnected adaptive responses within the nervous system and soft tissue structures.
Introduction
"Skeletal muscle is a dynamic organ that mediates voluntary movement and aids in the protection of vital structures. The unique functional demands placed upon skeletal muscle confer susceptibility to frequent and persistent injury. Accordingly, skeletal muscle exhibits significant regenerative capacity, and is capable of repair and replacement of injured or damaged myofibers with little to no decrement in function."
Traumatic Musculoskeletal Injury and Repair
"Traumatic injury is often sufficient to disrupt the regenerative capacity of skeletal muscle, and the resulting fibrosis remains an often overlooked sequelae of pathologic healing."
Current and Novel Therapeutics
"Skeletal muscle is a tissue innately responsive to mechanical force. The specificity of directionality and magnitude of mechanical forces perceived by muscle tissue modulate multifactorial responses including attenuation of inflammatory response, glucose uptake, and activation of satellite cells. It is no surprise, then, that mechanical manipulation of injured and regenerating muscle can augment healing; the use of massage and other therapeutic manipulation of muscle after injury has been shown to improve outcomes. .... Taken together, the use of focused mechanical manipulation, uncomplicated by biologic, can serve as a translatable treatment modality to improve muscle healing after trauma."
Conclusion
"increased knowledge into the cellular mechanisms that drive fibrosis can be used to optimize treatment protocols for patients suffering from fibrotic muscle and guide specific prophylactic therapies for those who have suffered traumatic injury. More generally, the elucidation of the cellular effectors and responsible signaling pathways in the development of muscle fibrosis will not only help to develop nascent therapy after traumatic injury, but will also establish a paradigm through which the balance of stromal and parenchymal healing following injury can be better understood."
Link to the pubmed listing: www.ncbi.nlm.nih.gov/pubmed/27787441
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