It has been established that prolonged immobilization can delay recovery and adversely affect normal tissues. It has also been proven that mobilization will stimulate collagen synthesis, increase strength, and help align the repair cells and collagen fibers.1,2 Sutker, et al.,2 demonstrated an increase in cell number, DNA synthesis and collagen production in rat medial collateral ligament fibroblasts using cyclic load.
There are many studies corroborating the beneficial effects of manual loading on soft tissues. It has been proven that friction massage increases fibroblastic proliferation, which synthesize and maintain collagen, fibronectin, proteoglycans and other proteins of the connective tissue matrix.3 Even in the embryo, the joint differentiates from the interzonal mesenchyma under the influence of fetal motion.4 Motion enhances transsynovial nutrient flow, which provides nourishment to cartilage, menisci and ligaments. Immobilization of the adult rat knee with weightbearing showed muscle atrophy and fibrofatty connective tissue in the intercondylar notch within two weeks.5
Early or excessive motion can create strain at the cellular level, increase the inflammatory reaction, and damage repair tissue. Therefore, it is necessary to provide painless motion in the earliest stages of a lesion if possible. Light friction massage is often used after a strain/sprain and heavier friction at later stages.
An interesting study just appeared1 that attempted to determine the effect of mechanical strain on tendon cells, based on the amount of time the strain was exerted on the cells. Researchers mobilized (mechanically strained) human tendon fibroblasts from patellar tendons for different time intervals against controls, and found that the length of time of stress affected the amount of cellular proliferation. They stretched the cells for 15, 30 and 60 minutes and tested for fibroblastic proliferation after six, 12 and 24 hours. They noted a biphasic response. After 6 and 24 hours, there was increased cell proliferation, and less after 12 hours. After strain stimulation for 30 minutes, there was a lower proliferation rate of tendon fibroblasts. The authors hypothesized that when the cells were exposed to 30 minutes of cyclic-biaxial strain, cell damage may have occurred, and there was no longer an increase in cellular proliferation. They thought that the 30 minutes of strain might have lead to programmed cell death (apoptosis). But 60 minutes of cyclic strain caused an increase in cellular proliferation after 6 and 24 hours. They hypothesized that a longer strain time activated protective processes. Further studies are needed to determine the necessary time.
Although English medical pioneer Dr. James Cyriax wanted his therapists to friction for 20 minutes, in practice they frictioned for about 10 minutes. I usually friction areas for about five to eight minutes, but find myself increasing the friction time if results do not occur in expected time.
References
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
