You're Not 'Breaking Up' Scar Tissue

 

If you’ve had a surgery or been injured at some point you may have heard that you need to break up scar tissue to improve your mobility or to reduce your pain. I hear the same thing when I talk with massage therapists, trainers and other physios (physical therapists) and when I hear people say these things I often have this reaction. 👉🏼👉🏼👉🏼

Now here’s the thing, scar tissue can be a problem; unfortunately there is no real evidence to suggest that you are breaking up scar tissue. Additionally you don’t have the time to see a physio as much as you would need to in a week to “break up” scar tissue. Improving the mobility and pliability of the scar and the surrounding tissue is not exactly skilled work and is something a good physio should be doing. Ya know? Getting you as an active partner in your own healthcare.

However, I am not entirely sure you’d want to break up scar tissue anyway. You see when you have an injury or surgery that scar tissue is your body healing and repairing tissue. It’s part of what is holding you together and let’s be honest, you more than likely want to keep things supported and intact.

So what are we changing? We are more than likely changing two things:

  1. Fluid Dynamics (lymph and blood decongestion from tissues)

  2. Tissues ability to slide and glide around the surrounding structure in the neighborhood.

For the purposes of this post we are going to mostly address #2. We will address #1 in another post later on. ‘

But we can’t continue until we have a conversation about something that we’ve been dealing with for quite some time but is more recently getting a little more love from the social media influencers and health/fitness gurus out there. FASCIA.

What the H-E🏒🏒is fascia? Well, a picture speaks a thousand words.

The white spider webby stuff just below is fascia and it surrounds and is in between all of muscles, tendons, and ligaments. It can seriously limit our tissues ability to slide, glide and move around each other. In fact, I remember when working in the cadaver lab tearing muscles as we tried to separate them from each other due to the fascial restrictions binding them.

 

what are we changing?

If we have had an injury or surgery scar tissue develops from the inside out. So when we start working on scar tissue mobility and pliability we are attempting keep the fingers of scar tissue from interweaving with fascia we already have and limiting the mobility of the skin, muscles, fascia and everything else there in the area. If we have limited mobility of the skin and fascia in one area it will affect the entire system and fascial lines up and down the limb.

Now the question: what is happening and what are we affecting when we work on pliability and mobility around scar tissue? According to a systematic review done by Deflorin et al in 2020 physical scar treatments have a significant impact on scars in 6 different areas:

  1. Decreased Pain

  2. Improved skin pigmentation

  3. Scar pliability

  4. Itching

  5. Scar Thickening

  6. Scar Surface Area

It’s important to remember that scars need to be fully healed prior to engaging in hands on manipulation. Basically, “Don’t screw with your scar till it’s healed.” Now when you go to work on your scar you have plenty options to work on your scar. Here are some things you can do to improve scar and soft tissue mobility and pliability. The other great thing is you can use the opposite limb as a reference limb to see if you’re making progress and getting closer to symmetry.

  1. Heat up scar and surrounding tissues

  2. Skin rolling at the scar and surrounding tissue (roll, pinch, pull, slide and glide tissues)

  3. Use Voodoo Floss with lighter compression and use it to slide and glide tissue as well as do active range of motion with the voodoo band on.

  4. Use a foam roller or something else to mash, shear and floss that area.

  5. Get out the old cocoa butter and massage the area.

Summary

Scar and soft tissue mobilization are something that you, as a patient, and someone who is just interested in optimizing your movement and performance can do at home. All you need is your hands and some lotion and a good Netflix series to watch while you do it.

Want to talk more about your mobility deficits or pain you still experience from an injury or surgery? We offer free 15-minute consults.

You can book your FREE Discovery Call Here or contact us directly at (480) 808 - 4995.

Trust the process and keep moving,

Dr. Brig Woods PT, DPT, OCS

 
Physical TherapyBrigham WoodsPolarisPT, physical therapy, scar tissue, pain