Pre and Post Surgery
Massage can be utilized at various stages in your surgical journey.
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Before surgery it is sometimes advisable to do lymphatic drainage to "clean up" the waste products that accumulate with swelling and inadequate drainage.​​
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3 - 5 days after surgery lymphatic drainage is once again recommended as this will help to limit swelling, as well as the pain that accompanies it, while at the same time providing your open wound with a rapid immune response should infection occur.
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Once the incision has closed completely scar tissue can be manipulated in a gentle manner to encourage remodeling that is not restrictive or hypertrophic
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Surgical Treatment Options
Where you are at in your healing will cause the treatment options to vary considerably.
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If this is your first appointment please book in as an
Initial Surgical Treatment as this allows for a detailed intake to determine what treatment and plan will work best for you.
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Our treatments plans work with you through the healing process and can span several weeks to months. Appointment timing typically involves shorter treatments 2-3 times a week in the early stages and progressing into weekly or biweekly massage for longer periods of time.
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Should time constraints or finances be a limiting factor, please talk to your therapist, as there are many at home activities and supports we can suggest that will provide guidance and allow you to reduce your reliance on in-clinic treatment.
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The Stages of Healing and How Massage Can Help
1
Inflammation
The first stage in healing -
Blood vessels are repairing and connective tissues are starting to close the incision. The spaces between cells are flooded with a fluid that contains the building blocks of regeneration. This fluid is also needed as an immune response in case of infection. This is a necessary and normal part of the healing process.
But...
Pressure can build up which can cause pain. As well the lack of fluid movement means that cellular waste is not being removed efficiently.
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Lymphatic Drainage Massage -
Helps to flush the area and clean out the old fluid so that it can be replaced by new. It can ease the pain caused by pressure of excessive fluid in the area. It can also help to create positive associations of touch that greatly affect the central nervous system
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Ideal Treatment Schedule -
30 minute treatment 1-3 x/week for 4 - 6 weeks
(later treatments will probably be less frequent but might possibly be longer sessions as compensatory problems can arise that need to be addressed)
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2
Rebuilding
Granulation of scar tissue -
The initial and inflammatory part of this process is messy. The body lays down tissue in a disorganized fashion with the goal of closing the incision. The scar at this point can be raised and red and it generally feels warm to the touch.
As the healing progresses (granulation) the framework provided by the initial scar becomes the anchor point for the stronger, elastic, and more organized collagen fibers.
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Therapeutic Intervention -
Physiotherapy is used quite extensively for joint replacements at this stage. Full range of motion is the goal and this is achieved through exercise and, often painful, assisted stretching. The stress and movement applied to major joints can lead to raised, red, and hard scar tissue.
Massage of the scar tissue can help to prevent this type of scarring which is called hypertrophic.
As well, hypersensitization of the scar is common, therapeutic touch with an intent to desensitize might be needed.
A combination of scar massage and lymphatic drainage is useful for all surgical incisions at this point.
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Ideal Treatment Schedule -
30 - 60 minute treatment
1x/week for 1-3 months
3
Remodeling
Scars with integrity -
As the integrity of the scar tissue increases you will begin to challenge the area with movement and weight bearing or building activities.
This is a vital progression in the journey and it is often much slower than many people expect.
The rebuilding of trust, in a joint or surgical scar, is often as important mentally as the scar tissue is physically.
The more that you can move your body in ways that cause discomfort, though not pain, the greater opportunities for the scar to remodel with integrity and your brain to understand the full range of "safe" movements.
Fibers that limit movement are broken when you stretch a joint into discomfort. Motions that your mind learned were painful while you waited for surgery are being reassessed and might now feel fine.
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Ideal Treatment Schedule -
60 - 90 minute treatment 1-2x/month
(This treatment is mostly to address the muscle complaints that arise from strength training and overall increased healthy movement. Progression of treatment goals move towards a maintenance schedule if needed)
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