Traumatic Scar Tissue Management

Nancy Keeney Smith is a Licensed Massage Therapist, Certified Manual Lymph Drainage Therapist, and a Florida and NCTMB Provider of Scar Management Workshops. Nancy's Working with Matured Scar Tissue workshop has been taught internationally to massage school students, LMT's, PT's and OT's. Nancy is a member of the Associate Research Team at the Florida School of Massage in Gainesville, Florida, founder and Director of The Happy Plus Foundation, 2nd Vice-President of the AMTA Florida Chapter, member of the American Burn Association, the National Lymphedema Association and the Phoenix Society for Burn Survivors. Her private practice in Gainesville, Florida includes treatment of burn survivors, clients battling cancer, mastectomy scar management, as well as others with traumatic scarring. Nancy consults with physical and occupational therapists on burn massage techniques and on developing a long term protocol for scar management after care programs. Catherine Ryan is a Canadian trained Registered Massage Therapist with over 20 years of clinical and Massage Therapy (MT) educator experience. Embracing a firm commitment to life-long learning, her extensive postgraduate roster includes training in various approaches to myofascial therapy and scar management. Cathy is the Managing Editor and a course provider at TouchU.ca, an online portal for MT continuing education. Her online courses and hands-on workshops are accredited with various professional regulatory bodies and associations across Canada and with NCBTMB in the USA. As a regularly featured writer for Massage Therapy Canada and RMT Matters Canada magazines - she may be best recognized for her fascia enthusiasm and voracious interest in all things massage therapy. A proponent of professional regulation, over her career she has worked with Canadian MT regulatory organizations - previously as a subject matter expert for the College of Massage Therapists of Ontario and was recently elected as Chair of the Board of Directors of the College of Massage Therapists of British Columbia. As a clinician, educator and writer she upholds a strong interest in research translation and evidence informed practices and is committed to the delivery of safe, effective and ethical care. Where MT is concerned, Cathy is never at a loss for words and is driven by a passion for the profession - co-authoring a book seemed a logical next step in her professional explorations!

• 1. Intro chapter outlining the reasons for the book; What if - the Value of Early Intervention; What Defines Traumatic Scarring - How they Differ from Other Scars; Reverence for the Person [emotional and physical being]; Why Isn't Massage Therapy More Accessible for Those in Need? The Quest for Scientific Data to Support What is Happening in the Tissue and the Effects of the Work; Reverence for the Heart and Science of the Work 2. Scars: Adversary or Ally? Basic Skin and Fascia Histology; How the Body Responds to Injury [basic process/physiology, purpose, strength and matrix of healthy scar formation; Scars are Not Surface Dwellers - The Dermis and Beyond [what is happening beneath the surface]; What Constitutes and Contributes to Healthy and Unhealthy/Problematic Scars; Types of Abnormal Scars [hypertrophic, keloids, contracture and burns] 3. The Lymphatic System; Basic Lymphatic System Anatomy & Physiology; The Lymphatic System's role in healing and scar formation; How the Lymphatic System Heals 4.The Nervous System; Basic Nervous System Anatomy & Physiology; The Nervous System's Role in Healing and Scar Formation; Comparisons of Depth of Scar Tissue and Nerve Insult; Types of Pain [acute, chronic and the Effects of amyelinated Nerve Cells and Phantom Pain]; How the Nervous System Heals 5. Burns, Mastectomy and other Traumatic Injuries; A Deeper Look at Hypertrophic and Keloid Scars; How "Tacked-down" Scar Tissue Effects the Body [functional impact on various tissues and organs]; Anecdotal Evidence From a Clinical Perspective 6.Trauma - the Physical and the Emotional; The Effects of Trauma on the Tissues; The Cortisol Dump and Other Brain Mediated Chemical Reactions; Brief Over-view of the Inflammatory Process [acute and chronic]; The Psychological Impact 7.Traumatic Scars and Massage Therapy; What Our Hands Can Effect; Appeasing the Amplified [SNS distress, central/peripheral sensitization]; Diluting the Soup [inflammation]; Un-sticking the Stuck [fibrosis, contracture] 8.In the Treatment Room - On the Table; Connecting the Dots - Putting it all Together; Assessment/Evaluation [how to use pressure scales to help guide the therapist, tissue excursion]; Treatment Protocols; Guidelines for Different Depths of Scar Tissue; Critical Thinking [staying flexible in the approach & making informed decisions]; Safety, Precautions and Contraindications 9.Communication is Key; The Power of Hope the Power of Words [communicating with the client, Foley Poem]; Ethical Considerations [patient-focused care, boundaries]; Interprofessional Communication and Collaboration 10.The Road to Recovery and Restoration; Stories From the Other Side of the Table - The Client's Perspective; From the Therapists Perspective - Clinical Experiences 11.Beyond the Table; Client Self-Care; Therapist Self-Care 12.Appendices A: Glossary of Terms, B: FAQ's, C: Research Resources, D: Communication and Psychological Support Resources