Scar Tissue 101

Scars- to some people they are trophies, war wounds to be proud of, reminders of traumas that they wish to forget, and to many, just something they have already forgotten. The truth of the matter is scars, and the restrictions they cause, can affect every system in the body.  Recognizing them can be the key to unlocking mysterious pain and other issues that have been interfering with the body’s ability to function and balance.

Historically scar tissue has been ignored or been viewed as having no consequence by the medical world.  With all of the current ongoing research and information compiling on the importance of fascia the medical world is starting to recognize the significance of scar tissue in the body.  As with most new fields of interest there have been many new versions of therapy popping up, which for the most part is a very good thing.  Unfortunately, the negative side of new frontiers is that many therapies are being administered without proper understanding of the subject matter.

I have been a massage therapist specializing in scar tissue release for over 20 years. In this time I have seen Scar tissue work go from being dismissed by doctors and a general population completely in the dark as to what is really causing their issues, to consideration by the medical profession that it may be a problem to some extent. Still there are many doctors ignoring the affects, while some have taking to using it as an excuse:  “I know I told you it would take 6 months for recovery but you have developed scar tissue.” Trust me on this – I get at least one phone call a week with that one.

The internet is now flooded with inaccurate information about scar tissue and ways to cure it.  Therapies are being applied with total lack of understanding of the physiology of scar tissue. There is little or worse no knowledge behind the events that caused the scars i.e. surgeries, accidents and what the corrective procedures actually did to the body. No attention is paid to the psychological & emotional trauma surrounding the event. Few look for the possible compensations the body may have complied in response to restrictions and what releasing those restrictions without proper rehab would do. Honestly it is terrifying to me.

So I thought we could take a moment to clear up some of the misinformation:

1)     Scar tissue cannot be broken down nor can it be removed. – Anyone who claims to breakdown scar tissue does not understand what scar tissue is.  Scar tissue replaces normal tissue that is damaged.  If you break it down you are essentially saying that you are causing a new wound. The only person who can remove scar tissue is a surgeon who is literally cutting it out – only for new scar tissue to form.

The goal of working with scar tissue is to release the adhered layers, attempting to re-establishing homeostasis, releasing and correcting the compensations from fascial restrictions all the while being acutely aware of possible emotional release.

 

2)     Scar tissue is dead fibrous tissue. This could not be further from the truth.  Scar tissue composition and structure are different than that of the normal tissue it replaces. Because of changes in the relative amounts, type and structure of collagen, it is inferior in function.

  • Scar tissue has less elasticity.
  • Scar tissue is not as strong as normal tissue.
  • Scar tissue does not oxygenate well, creating a low (acidic) PH:
  • Scar tissue is different neurologically.
  • Scar tissue does not contract.
  • Scars are less resistant to ultraviolet radiation.
  • Scar tissue does not contain sweat glands and hair follicles.
  • Scar tissue is prone to injury.

 

3)     Scars are only an esthetic issue.  Most people are only concerned with how the scars alter their appearance and have no idea how their scars and adhesions are affecting their bodies on so many different levels, or that scars are can be a major trigger for PTSD.

 

4)     Anyone can treat a scar.  Acknowledging that scar tissue may at the root of the problem is the first step in any therapy. After that simply massaging the affected area will bring about change.  However, that being said I want to caution therapists.  You need to thoroughly understand the event which caused the scar i.e. surgery, accident etc. and all the goes with it.  This includes emotions, all of the physical ramifications for the body, what type of rehab will be need once the massage is done.

I am not saying that one should never massage a scar I am saying that as with all diseases, disorders and dysfunctions (yes scar tissue is a cause of dysfunction), you need to understand what you are working with before you lay hands on.

 

5)     Physical scars cannot and do not show how much pain or suffering a person has experienced. Every scar has an emotional history surrounding it.

  • Shock
  • Guilt
  • Failure
  • Loss
  • Detachment
  • Trauma
  • Anger & Resentment
  • Low Self Esteem
  • Fear
  • Hopelessness/ Depression
  • Disgust when seeing or touching the scar
  • Sadness about the limits the scar places on everyday life
  • Humor – yes there can be funny stories behind accidents

The emotions surrounding the physical scars can and do have a direct emotional and psychological effect. It can bring about significant self-image issues and lower self-confidence.  Research on the after care of burn survivors or those with severe facial scarring has proven this. In the cases of patients with severe scarring suffering from depression (between 13-23% of cases) or post-traumatic stress disorder (between 13-45% of cases) have been documented.

 

6) Tools: There are many instruments and tools out there that are effective on scars but they are not the end all be all.  Rather they should be considered part of the therapy.

An example would be cupping. When a cup is placed on the scar tissue and its surrounding areas, the vacuum lifts the scar tissues above and below the skin, essentially pulling them apart so that fresh blood and lymph can circulate freely through them. This improved circulation in turn makes movement easier and as a result, healing of the scars is induced.

It is a great tool but again you should not just cup over a scar without full understanding of what you could be opening up (both emotionally and physically) and how altering that scar will affect the person in the long run.

 

7) Scars and adhesions are the same thing.  Not true as you can have adhesions without scars but you cannot have scars without adhesions.  Both need to be recognized and treated.

 

8) All scars need to be released. A very dangerous statement indeed.  What if the only thing holding that knee replacement together is the adhesions formed around it?  Something to consider before pulling out that cup or edge tool.

 

9) All scars are a problem.  Not necessarily, but all scars have a potential to be one and should be considered and examined.

 

10) Scars only affect the tissue. Again not true, but even if it is was, this is still cause to treat them.  Scar tissue can affect every system of the body:

  • integumentary
  • muscular-skeletal
  • nervous
  • circulatory
  • lymphatic
  • respiratory
  • endocrine
  • urinary/excretory
  • reproductive
  • digestive

Understanding how each of these systems can be affected by scar tissue can lead you to unraveling the mysteries of the pain and frustration your client/patient has been suffering, in some cases for years.

 

If your chosen area of therapy is to give relaxation massage then more power to you.  Not every massage need be a medical one and everyone needs to take time to release and relax.  But if you are administering a medically oriented therapy then it is imperative that as a therapist you know who the person is, what they went through and how they came to be on your table before putting your hands on them. Once you are informed of the specific surgery the client/patient has had your next step should be to watch videos of that type of surgery to see the extent of the damage done. You need to consider all of the possible emotional, psychological trauma you are tapping into before working on the scar. Most importantly you need to be prepared for the possible reactions and how to handle them for the protection of your client/patient and yourself.

There are so many wonderful forms of therapy available today to help people on their journey to balance health & wellness.  No one is better than the other, rather we have to find the right one, or combination thereof, that works for each individual.  That being said, there is nothing more important than recognizing the effect scars are having on a person. In order for any therapy to be fully affective you have to clear and release any and all scars that are impeding the body’s function. In other words, scar tissue release is the first step then you may proceed with any and all therapies that resonate with the patient.

4 thoughts on “Scar Tissue 101

  1. Marjorie is an awesome teacher full of wonderful bits of experienced hands on wisdom! I continue to learn so much from her! Her insight into how the body works as a whole and not just as pieces and parts is especially sacred in this field of bodywork and healing. The fact that she includes body psychology (addressing emotions in the body) is so key to establishing homeostasis so the body can heal!

  2. Great blog!
    This is why I refer all my scar clients to you. Great information as always.
    In my opinion Marjorie is the expert in the feild d of scar work. I’ve taken class’s from and with Marjorie and consider her my friend so I might be a bit biased in saying she is one of the best massage therapist and instructors that I know.
    I highly recommend taking Marjorie’s scar workshops, to really learn the depth of knowledge that Marjorie has to share!

    Sincerely Gerald Basile LMT

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