2014 – Reducing Forearm Contractures with Myofascial Massage

Posted:Monday, February 27, 2017

Renee Stenbjorn

Purpose: Investigate the use of myofascial massage therapy as treatment for longstanding contractures.

Introduction: Contractures develop when the soft tissues in the muscle and surrounding fascia are replaced by inelastic, fibrotic tissue, making it hard to stretch the area and prevent normal movement1.
Contractures are a concern for patients with strokes, spinal cord injuries and other debilitating diseases. Severely limited range of motion inhibits many activities of daily living. The usual care for contractures include surgery, medication, braces and botulinum toxin2.

Prevalence: The prevalence of contractures varies widely among patient population. The prevalence of contractures among Multiple Sclerosis patients was found to 56%3. In one study, contractures were a complication for 73% of stroke survivors at the one year mark4.

Methods: Subject was 23 year-old male massage student with history of contractures of the left arm and wrist since age six, when he suffered three left arm injuries over a one year period.

A series of six myofascial massages was applied over the course of two months, focusing on eliminating fascial adhesions and restrictions. Direct fascial strokes were applied including compartment separation, fascial wringing and spreading, cross fiber friction, muscle energy techniques and compression of myofascial trigger points. Approximately 80% of the strokes were applied to anterior and posterior forearm, with the balance applied to upper arm and pectoral regions.

Results: Range of motion increased from severely limited supination, starting at approximately 70 degrees, to normal range of 182 degrees following the last massage5. Other measures focus on daily living, such as an ability to play the banjo without pain, have more fluid movements while massaging and more successfully complete small tasks such as using the brakes on his bike & open doorknobs.

This significant result warrants a more thorough investigation of massage therapy as a treatment for contractures.
1: http://www.nlm.nih.gov/medlineplus/ency/article/003185.htm
2. Farmer, SE. Contractures in orthopedic and neurological conditions. Disability and rehabilitation. 2001 Sep 10;23(13):549-58.
3. Hoang PD, Gandevia SC and Herbert RD. Prevalence of joint contractures and muscle weakness in people with multiple sclerosis. Disability and Rehabilitation. 2013 Nov 18. [Epub ahead of print].
4. Sackley C, Brittle N, Patel S, Ellins J, Scott M, Wright C and Dewey ME. The prevalence of joint contractures, pressure sores, painful shoulder, other pain, falls, and depression in the year after a severely disabling stroke. Stroke. 2008 Dec;39(12):3329-34.
5. Measured with Goniometer Pro app for iPad.