I admit it, not everyone is as excited about scars as I am. I collect and count them as badges of honor. Much like tattoos, scars are visual stories leaving their marks on our physical bodies reminding us how we survive and strengthen. However, some scare are viewed as unsightly and distracting and some might not want the reminder of the experience. Good news! Scars can easily be broken up and minimized.
Scar Tissue Overview
What is it?
Scar tissue is the growth of new tissue: skin or fascia, after injury.
How is it recognized?
Scar tissue on the skin often lacks pigmentation and hair follicles.
Is massage indicated or contraindicated?
Massage is contraindicated during the acute stage of any injury in which the skin has been damaged. In the subacute stage massage may improve the quality of the healing process.
What Is Scar Tissue?
Scar tissue is a special kind of fibrous connective tissue that forms when tissues are injured. It is unique because, unlike those in tendons and ligaments, the collagen fibers are not arranged in a parallel pattern. Because of the abundance of dense and irregular collagen fibers, scar tissue is strong but not as pliable as normal, healthy tissue. Serving as a replacement for other injured tissue, it cannot perform the functions of tissue it replaces, and its blood supply is minimal.
Extensive scarring can restrict normal movement, reduce or prevent normal circulation of blood and lymph, and impede or even prevent injured tissue from functioning properly. The structure of scar tissue depends upon where the injury occurs, but it usually has the same components as the original tissue, accompanied by an abundance of extra collagen fibers.
Types of Scar Tissue
There are two types of scar tissue, internal and external.
When soft tissues are compromised or injured, the body automatically responds to repair the damage. In phase II of the healing mechanism, collagen fibers are produced to splint the area and prevent further damage. New collagen fibers are relatively easy to align with the fibers of the original tissue, given gentle movement throughout phase III. Collagen fibers continue to be produced during phase III, and without enough movement, they become sticky and hard. As a result, the collagen fibers are difficult to realign and they easily develop into connective tissue adhesions, or scars, with far-reaching effects.
- External – the scars are visible when the integument (skin) is injured,
- Internal – but tissues beneath the surface of the skin can also develop scars. Invisible scars are equally capable of affecting structures in other areas of the body.
What Does Massage Do?
Once a scar or adhesion is created in one area, it begins to pull on the fascia throughout the body. Remember – it’s all connected!
In the subacute and chronic stages of a skin injury, massage is indicated and can be very beneficial. Soft tissue work is the recommended treatment for superficial scar tissue and may be initially applied.
The quicker the adhesion is treated, the less likely it is to affect the rest of the body. Because of its patchlike nature, there is a tendency for all other tissues to pull in the direction of the scar, which can lead to more compensation patterns and fascial restrictions.
Once the scar has formed, massage on and around the scar tissue can increase the speed of healing by increasing circulation to the area, which prevents fascial restriction and increases mobility of the tissue. Scar tissue may have reduced sensation, so providing the therapist with regular feedback throughout the session is extremely helpful.
Methods to Release Scar Tissue
Releasing scar tissue is a very specific technique, both for internal and external scarring. I use a few methods to breakup both kinds of tissues including cross fiber friction, massage cupping, and Gua Sha tools.
Client Study: LH, External Scar
Last year LH had skin cancer removed just under her right nostril. Obviously she wanted that scarring diminished. The raw, untouched before/after photos below shows our progress in only 3 sessions of 15 minutes within a five-day period.
“I had a basal cell carcinoma removed on my face that required 14 stitches. As I am in my 60’s, I was concerned about healing time and permanent scarring. Carmen has a scar treatment that gave me impressive results. With a small number of 15-minute sessions, Carmen was able to achieve rapidly discernable results. Carmen is competent, calm and gentle. In her hands the treatments were enjoyable and soothing, with no discomfort.”
Testimonial: Kim W., Internal Scarring
“Carmen is fantastic! After years of going to whatever massage therapist had an opening and always feeling underwhelmed I’ve finally found a keeper! Carmen believes in treating the cause of the problem rather than providing short-term relief and thank goodness she does. I have scar tissue and knots that have been around for half my life and have always caused me problems. Carmen worked with me to create a treatment plan that would address my problem areas and ultimately lead to an overall reduction in my scar tissue and muscle congestion. After only a handful of visits I’m already feeling relief where I’ve never felt relief before and am feeling better overall. Also, she doesn’t ask that you come in for an hour each time. She can spot treat your problem areas in 15-30 min if that’s all that’s necessary. The flexibility is key. I still have a long ways to go in my treatment but I feel I’m making great progress.”
Scars are just like pain, you don’t have to live with it and their effects can be greatly minimized.
See you on the table!
Introduction to Massage Therapy, second edition, Mary Beth Braun, BA, MT, NCTMB & Stephanie J. Simonson, BS, MT