PHYSICAL THERAPY

tion and pain and preventing internal adhesions when friction is not successful. It is also effective in the chronic stage when there are adhesions to the bone. The injection, when properly given, ruptures the adhesions and prevents additional adhesions from forming.

5. Proliferant injection If the ligament has been excessively stretched and weakened, massage, exercise, oral medication, manipulation, or other meth- ods of treatment cannot, to my knowledge, tighten the ligaments. Proliferant injections cause the ligaments to tighten and strengthen. A proliferant is usually composed of dextrose (a sugar), glycerine (which helps the blood congeal), xilocane (the stuff the dentist uses to numb your mouth) and phenol (which acts as a sterilising agent). The dextrose is the main active sub- stance; it irritates the ligament or tendon tissues and tricks the brain into producing (proliferating) many like cells of tissue. There are three goals of the proliferant treatment procedure: first, to break up adhesive scar tissue, second, to tighten the stretched ligaments and third to strengthen the weakened ligament fibres.

6. Surgery If the ligament has been completely ruptured, surgical repair is best performed as soon as possible. After the initial recovery peri- od, rehabilitative exercise therapy and deep massage aid in the healing process.

JOBS AND CLASSIFIED

A full time position has become available for a fully qualified Sports Massage Therapist at London Wasps rugby club. ■ 25 hours per week plus attendance at all home and away matches.

■ Minimum 3 years experience needed. Dedicated, confident professional required to join our championship winning team. Must have SMA membership and Insurance

■ Salary 25K All Applicants please send c.v. to roger.knibbs@wasps.co.uk. Closing Date for Applications 29th April 2005.

CONCLUSION The principles discussed here not only changed the way I view injury and the healing process, but also changed the ways in which I assess, verify and treat the people who come to me with acute and chronic pain. I hope you have gained a picture of the importance these principles can have in your day-to-day work with your own clients.

The techniques described here take time and practise to master. These who wish to gain proficiency in this very precise approach to pain and injury may wish to pursue further training. As you gain more experience with orthopaedic massage - performing assessment tests, locating injured structures and practising fric- tion therapy - your treatments will be more effective and your clients will improve more quickly.

THE AUTHOR Ben Benjamin holds a PhD in sports medicine and education and is the founder and president of the Muscular Therapy Institute in Cambridge Massachusetts. He studies with Dr James Cyriax the ‘father of orthopaedic medicine’ and has applied his insights to the healing of soft tissue injuries through skilled massage therapy. He has been in private practice for more than 40 years and teaches extensively.

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