There is the formation of fibrosed tissue (scar tissue) in the process of a derangement such as bulging disc and herniation being reduced and healed in our spine.  If there is nerve root involvement in the episode–i.e. radiating or referred neurological symptoms occur, the scar tissue would likely to involve the nerve root, causing nerve root adhesion.  A typical symptom behavior of a nerve root adhesion is that one would consistently experience neurological symptoms (anywhere down from the spine) whenever he reaches the limited end range of a certain movement. Then the scar tissue that is adhered to the nerve root is stretched and thus pulling the nerve root together with it.  Such symptom is very consistent with movements reaching the end range, and it immediately subsides as you return from that range. None of the radiating symptoms would sustained for a prolonged period of time, unless the range of motion is severely limited.

The way to eliminate this phenomenon is by stretching the scar tissue, and thus to elongate, or line up, the fibrous scar tissue.  Therefore one would need to stretch progressively and carefully beyond the limited end range once the derangement is completely healed.  The reason why it is important to eliminate nerve root adhesion is that scar tissue is shortened and tightened over time. It limits range of motion of that spinal segment and causes the neighboring segments to compromise for the restriction.  Such compromise makes those segments more vulnerable for future injuries.

Stretching the nerve root adhesion should be done when the derangement is completely healed and with proper precautions.  If it is performed appropriately, the range of motion would be full and free, re-injury can be prevented, and functional abilities can be greatly increased.

Written by Irene Acevedo, PT, MS, Cert MDT for Core Rehabilitation and Spine Center

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