The Good and The Bad of Scar Tissue with Marjorie Brook

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Marjorie Featured on Original Strength Bodcast -The Good and The Bad of Scar Tissue

Tim Anderson speaks with Marjorie, creator of the S.T.R.A.I.T Method™ or Scar Tissue Release and Integrated Therapies, about scar tissue release. From mastectomies and c-sections to understanding the impact of past injuries to how to look at the whole picture of medical care.

(excerpts from podcast)

Tim:

Marjorie travels all over the world teaching her techniques to bodyworkers, massage therapists, and physical therapists. She’s an expert in scar tissue and today we’re talking about the good, the bad, and the ugly of scar tissue.

Marjorie you travel all over the world teaching about scar tissue release and the stretching the body and you developed the S.T.R.A.I.T Method™ so this is probably a ridiculous question to you but I thought scars were a healing process.

Marjorie: 

They are. They’re a major healing process and that’s part of the problem. People really do not understand about scars. First off, other than a minor injury or lesion, every wound heals with scar tissue. It’s part of the healing process. We’re supposed to scar. But what people don’t realize about scar tissue is that it replaces the normal tissue that’s injured.

We have to scar. It’s there so the first thing I want to say about scar tissue is that anybody who says that they need to break up scar tissue or get rid of scar tissue doesn’t understand what scar tissue is. 

We’re supposed to scar. It replaces the tissue that has been damaged. It’s only 70-80% as strong or as effective as normal tissue if it’s at its best state.

The problem that we have is because of this misunderstanding about scar tissue or just ignoring of scar tissue to just let the body heal, they don’t realize all the things that scar tissue can do.

Scar tissue affects every single system in our body. You know every system – not just your skin. It affects your nervous system, it can affect the organs, it can affect your circulation, it affects the lymphatic system, and the polarity. This last one is a big one.

What you want to do is let the body heal. In most places across the world, they tend to jump in and try to prevent and break-up scar tissue. Your typical rehab for a knee replacement or knee surgery is to put the patient on their belly and try to take that knee and shove it within 6 weeks or less towards the glutes. They try to force mobility. All that’s going to do is cause more tension and separate the scar and healing area because it’s over that bending surface which is going to cause it to scar more and create more scar tissue. If there’s something wrong metabolically or we do too much or too little or we do something inappropriate towards the wounded area, the scar tissue wound can reopen and then it’s got to reheal. And this builds more scar tissue. Other times the scar tissue isn’t given chance to properly heal and it’s creating more of a wound in a different direction from the tension which is then causing scar tissue to “spread”. It’s not just where you see the visible scar. It’s not where you see the visible scar or adhesions which are two separate things.

Most people consider scar and adhesions the same thing but they’re similar but they’re not the same thing. So the problem is that you’re supposed to let the body heal for the first 3 months when a scar is immature – when the body’s healing (and mind you the body produces scar tissue for up to 18 months past the original wound but after 3 months you can do more manipulation).

In the first 3 months, you can do myofascial release, lymphatic gentle range of motion, gentle stretching. The myofascial release is very, very important because you want to re-guide. It’s not just your muscles and the tissues that are being cut, the nerves are being cut. The lymphatic vessels are being cut and while the lymphatic vessels will regrow and heal in 2 weeks, where they are growing they’re getting entangled in the scar tissue unless you do the lymphatic and myofascial release to encourage it to go towards the nodes or the proper flow of what it needs and where it needs to go.

After those 3 months, as you’re gently doing range of motion and myofascial release and lymphatic, is to be a little more aggressive. That’s a relative term meaning more aggressive than lymphatic – not meaning go in and tear apart. Then you want to start working the tissue and separating the tissues where it’s getting stuck. Getting it to release and increase proper flow. Give it more range of motion and work with the body. You have to understand what the injury is doing, where the tension pulls, what the person’s metabolism is like, how their skin color impacts the keloid and scar.

There’s just so much involved that people don’t understand and they don’t understand how much scar tissue is affecting the rest of their body. 

Listen to the podcast or watch the video above for the rest of Marjorie’s advice on scar tissue.

original strength bodcast featuring marjorie brook lmt

》A B O U T   M A R J O R I E   B R O O K

marjorie brook lmt author headshotMarjorie Brook, LMT is a massage therapist, author and international educator. For over 21 years, she has specialized in scar tissue release and massage therapy. She works from the fundamental belief that your body is intuitively aligned with the thoughts you think, the emotions that you feel and the things that you do. She founded Brooks Seminars in 2007 after working as a decade as a nationally recognized massage therapist with a private practice on Long Island. She is the creator of the Scar Tissue Release and Integrated Therapies (S.T.R.A.I.T Method™) and offers continuing education courses on this method all over the world. Her articles have appeared in magazines such as Massage Today, American Fitness and Massage World. She’s approved by the National Certification Board for Therapeutic Massage and Bodywork, the Massage Therapy Association of Alberta and the College of Massage Therapists of British Columbia.

Lymphatics vs. Scar Tissue Release

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The Scar Tissue Release and Integrated Therapies method —S.T.R.A.I.T™ Method,  for short — is a three-dimensional, fascial-release system that works to minimize scar-tissue development and the subsequent physiological restrictions. Utilizing multiple manual techniques Adhered tissues are released and then realigned from their starting point, which is the visible scar, to their endpoint — where the line of frozen fascia stops. Once the scar is released the rehab phase where ROM Stretching/strengthens and body mechanics exercises are applied in order to reset the body.

How does this differ from Lymphatic massage treatment or scar tissue?

When surgery is performed the initial lymphatic vessels are cut, these initial lymphatic vessels are located just under the skin the fluid is then transported to the pre-collectors, then to the collector channels which are located deep in the body running parallel to the arteries and veins. Over time the initial lymph vessels will reform to continue working but as scar tissue forms they can be inhibited in their function to reduce swelling.

Scars and adhesions disrupt the network of lymph capillaries that lie just under the skin. … When performing manual lymph drainage or simplified lymphatic drainage, scars can interrupt the lymph flow. When there is a scar in the stroke pathway, it is recommended that you stroke around the scar and not through it. This is recommended because lymph vessels within the scar tissue have been disrupted the transfer of fluid across a scar is usually ineffective … Lymphedema Caregiver’s Guide by M. K. Kearse, PT, CLT-LANA, E. McMahon Ph.D., and A. Ehrlich, MA. Lymph Notes 2009, page 91.

HUTZSCHENREUTER has demonstrated in a study that MLD improves wound healing and optimizes the scarring process. Damaged lymph drainage routes can be restored in existing scars. If post-surgical scars interrupt the lymphatic pathways and local edemas form, they can be drained away, while MLD scar treatment reconnects the interrupted drainage routes. MLD also has a salutary effect on large scars, such as those caused by burns. Hyperkeratotic scars cease their itching, the deep reddening of the scar area pales and the scar tissue softens. However, with lymphatic drainage, much time must be spent on scar therapy.

The S.T.R.A.I.T™ Method opens the tissue quickly allowing for a more effective and flowing lymphatic treatment.

“Lymphatics isn’t for scar, different systems. At best, lymphatic drainage would decrease tension on a scar. I’d have it another way round, scar work for lymphatics, both are important and often related, but different i.e writing vs mathematics-great tools but different languages.” Jocelyn Kope, Capetown, South Africa

scar tissue release therapyTherapies are being applied with a 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.

“The S.T.R.A.I.T™ Method includes the psychology of the body and incorporates a full spectrum whole body experience vs just tackling the scar tissue as taught by other modalities.” Jen Adams, Alabama, USA

There are so many wonderful forms of therapy available today to help people on their journey to balance health and 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 effective, 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.

》A B O U T   M A R J O R I E   B R O O K

marjorie brook lmt author headshotMarjorie Brook, LMT is a massage therapist, author and international educator. For over 21 years, she has specialized in scar tissue release and massage therapy. She works from the fundamental belief that your body is intuitively aligned with the thoughts you think, the emotions that you feel and the things that you do. She founded Brooks Seminars in 2007 after working as a decade as a nationally recognized massage therapist with a private practice on Long Island. She is the creator of the Scar Tissue Release and Integrated Therapies (S.T.R.A.I.T Method™) and offers continuing education courses on this method all over the world. Her articles have appeared in magazines such as Massage Today, American Fitness and Massage World. She’s approved by the National Certification Board for Therapeutic Massage and Bodywork, the Massage Therapy Association of Alberta and the College of Massage Therapists of British Columbia.

Words can cut like a knife – leaving deep wounds and scars….

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At this past weekend’s Scar Tissue Release, class we were fortunate to have a Registered Nurse volunteer as the demonstration client. She was incredibly generous with her feedback on what she was experiencing during the treatment and answered questions for the students. Two of her scars were from 18 & 20 year old C-sections, respectively. As she told us the stories of the surgeries, the conversation turned to the trauma, both physical and emotional that the events caused.

Apparently, as the surgeons were preparing to cut her open, they were busy discussing their golf game. The surgerical nurse stopped the banter and gave them a what for. Just think how you would feel at that moment, laying on a cold operating table, about to have your abdomen sliced open in order to bring your child into the world, being denied the experience of natural birth. As she told her story, you could see that even after 18 years, she was still very emotional about it.

Since she is a cardiac recovery nurse, I took the opportunity to emphasize a few points I had made during the class lecture. Specifically how “donor” sites, areas where skin or veins are removed in order to repair another injured area of the body, are ignored once they have healed. When I asked her opinion on this matter, she agreed whole heartedly that no further thought is given to these areas; however, she referred to these areas as the “harvest” site.

Everyone in the room took a breath. I knew what they were all thinking as I looked at each of them. The Nurse looked around puzzled, and I explained to her that I refer to the area as a “donor” site. She thought about it for a minute and shook her head. “I never even thought of that, but you are totally right…how horrible.”

How we–doctors, therapists, trainers, family and friends–refer to someone, something, or situation sets the intent. This, in turn, dictates how we regard, and therefore treat or not treat. Most often when we think of harvesting an organ, we think of cadavers. So of course an area that was used for “harvest” does not need further care or concern.

The next day, one of my current clients was among the volunteers for the student practice session. He had burns over 2/3rds of his body from a car fire. He is one of the most balanced and centered people I know. He shared two very important points with the group. First, that he never even considered that there was any kind of restriction, much less a need for therapy, on the areas where they took skin for grafts and that he was blown away by the resulting treatment’s effects all of the areas, grafted and donor. Second, while still recovering in the hospital, a representative of a burn group came by to help him understand and deal with how his life was about to change. “How everyone was going to stare at him and treat him differently…” You can imagine the rest of the conversation. He could not believe this person was there to help him and fortunately he choose not to listen to her doom-and-gloom speech.

I had another client, a massage therapist, who, while filling out her intake form, said to me in regard to the question asking her to list all surgeries, “Well, I did have a C-Section, but I do not really consider that a surgery.” Unbelievably, she was not the first woman to make this statement to me either.

As health care providers we must take care of how we phrase our words, and just as or more importantly, we need pay attention to and assist in altering how our clients refer to themselves. The first step on the road to healing is understanding and awareness.

The children are our future…So how about we pay attention now!

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I received a call the other day from a fellow Massage Therapist. He was
referring one of his clients, a 15 year old male athlete ( lacrosse
goalie and football linebacker) with severe pain in his right knee. The boy’s coach told his mother he needed an MRI and that he most likely tore
something. My friend did not agree and wanted to see what I
thought and if Integrated Therapeutic Stretching would help. He had tryouts in two days and they were concerned about injury.

According to the client he only felt the pain when he was crouching in goalie position. I had him do it for me. He had all of his wait on the outside of his feet which were not wide enough apart to support his weight properly.

I ran him through some quick range of motion & muscle tests as he lay on the table with no resulting pain but revealed very limited ROM throughout the boy’s lower body. As we started to stretch it was quickly discovered that his left glutes were locked up. Hip rotators on both sides were in as bad a shape. IT Band and hamstrings were at 60% ROM and his quadriceps were down to 45%. This is 15 years old folks!

It is terrifying to see the physical shape of children today. Either they are overweight and under exercised or they are over worked, participating in multiple sports where proper strength and flexibility training is nonexistent.

Sports injuries are on the rise in children and teenagers. Each year more than 3.5 million sports-related injuries requiring medical treatment occur in children under age 15. Today, as more and more children and adolescents participate in the same sport year-round, many young athletes are developing overuse injuries. In fact, overuse is responsible for about half of the sports injuries that happen to middle and high school aged students.

We worked together through each stretch, showing him how his body is supposed to move utilizing body proper form and mechanics. He was very eager to learn as was his mother. I assisted and guided him through the stretches focusing especially the ones which really opened his restrictions. Both he and his mother were surprised at how tight he was in the beginning and at speed with which he loosened up.

Now as we were working I observed a deep scar about 1inch in length on his left knee which he claimed was “no big deal” and said it was over a year old. His mother chimed in “the bad one was on his foot”. Three years prior he flayed his right foot open on a fence. There was a huge c shaped scar on the sole of his foot which upon palpation showed to have spread and attached into the arch.

I asked if he wanted to see something cool and then I proceeded to release the scar on his knee. When I asked him to bend his knee his eyes opened wide and said “That’s Sick!”. His knee flexion had increased by 20% . Next with his mother’s permission I went to work on his foot. When I was done I had him stand up. He laughed out loud and said “No Way! Thats Totally Sick! I can feel the bottom of my foot”. His mother , shocked at his reaction said ” I didn’t know you couldn’t feel your foot?!” “Neither did I” was his reply.

We followed this up with gait re-education and proper mechanics required for his respective sports positions (i.e. crouching and squatting). While he still had some minor pain he could see how adjusting his stance took the pressure off his knee. After having him go through the stretches once more I recommend to the mother that if the pain comes back or increases then she should indeed seek their doctor’s advice.

The mother was shocked at how much the scars were affecting her son. I explained to her that scars and adhesions are generally overlooked by health professionals because the extent of physiological affects they can have on the body have never really been acknowledged. The slightest restriction from falling off his bike at 4 could alter how he grows and have major repercussions from one end of his body to the other.

Four days later the duo returned, the tryouts went great and when asked about his knee he said “it still hurts every now and then but whenever I felt it start I shifted around until I felt right and the pain stopped.” I asked if had been stretching and he say before and after the games. (In the four days since I had seen him he had two lacrosse matches and two days of football tryouts). He was also very excited for more scar therapy “It was so weird but I could feel my foot moving better as I played!” His mother than asked if I had any extra time to look at her two scars that have been driving her crazy for years.

During the course of my career I’ve treated many patients whose problems could be traced back to a scar they had forgotten they even had. While not every scar presents a problem, very often they do. Doctors, along with basically everyone else, tend to ignore scar tissue from surgery and accidents especially in children.

Today children are playing more and more sports driven by the need of scholarships and future fame. It is time we start to pay attention to the adverse affects of training and playing so hard so young. We need to make sure that the fall off the bike or the cut from climbing over the fence does not lead to issues later on.