What Are Adhesions?
TL;DR
Adhesions are bands of fibrous tissue that form between two surfaces within the body that are usually separate.
These form as a part of the body’s normal repair systems after tissue damage has occurred.
We utilise therapies that are specifically targetting them, aiming to break them down.
**Updated 16/01/2023
Adhesions are made of scar tissue, a type of connective tissue that forms when the body repairs an injury. It is composed of collagen fibres, which are strong and fibrous proteins that help to hold tissues together. In contrast to the orderly arrangement of collagen fibres in normal tissues, collagen fibres in adhesions are haphazardly arranged. When they form they can prevent normal movement within and between the tissues of the body. When they "trap" a nerve, we may feel pulling, burning, itching, decreased sensation, painful movement, or shooting pain, to name a few symptoms.
When an injury occurs, the body releases inflammatory cells to repair the damage and promote healing. New collagen fibres are laid down and form a scar during the healing process. Scar tissue forms between tissues and organs in the case of adhesions, causing them to stick together.
Adhesions are made up of various types of tissue, including fibrous, fibromuscular, and fibrofatty tissue. The composition of the adhesions can influence treatment options because some adhesions are more difficult to remove than others.
In some cases, depending on the severity of the adhesions and the symptoms they cause, adhesions can be treated conservatively without surgery.
Adhesion treatments include:
Physical therapy: This can help to reduce pain, improve range of motion, and prevent new adhesions from forming.
Manual Release
Instrumentation (Shockwave Therapy, Graston)
Medication: Pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants can help manage adhesion-related pain.
Steroid injections: To reduce inflammation and pain.
Adhesions typically occur in response to one of two predominant sources of trauma.
Macrotrauma
Microtrauma
A single, severe injury to the body, such as a broken bone, a deep cut, or a severe burn, is referred to as a macrotrauma. These types of injuries are typically the result of a major accident or trauma, and they are frequently visible and easily diagnosed. Macrotrauma injuries typically require a significant amount of healing time and rehabilitation.
Microtrauma, on the other hand, refers to minor injuries or trauma that occurs repeatedly over time. These injuries are frequently caused by repetitive motions or prolonged stress on a specific part of the body. Tendinitis, stress fractures, and chronic back pain are examples of microtrauma injuries. The recovery process for microtrauma injuries may be less visible or immediate than for macrotrauma injuries, and the symptoms may be more subtle and take longer to appear. These injuries may also take longer to heal and necessitate more specialised treatment and rehabilitation.
At Southside Spine and Sport, we assess, diagnose, and treat these adhesions by hand or with instrumentation. When performed manually we break down these adhesions by combining compression, a directed force (tension), and movement. Compression alone requires more force than a practitioner could reasonably achieve and a patient could tolerate. However, adhesions can be more easily broken down when applied in combination with a directed force, tension, and movement of the tissue being treated.
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