By: Jocelyn Kope
The Red Hot Chilli Peppers were onto something when they released a song called Scar Tissue in 1999. Everyone has scars, and all too often they’re overlooked as a potential source of pain or dysfunction. If you think an old injury or operation is contributing to any current problems you might have, speak up, and make sure that your healthcare provider really sees your scar tissue.
What are scars?
A scar is a visible line or mark on the skin caused by injury or surgery, followed by healing. Adhesions are the same as scars, but they form at a deeper level so we don’t normally see them. Scar formation is a natural and essential part of the healing process. Protein fibres are laid down by the body to repair a wound, and a chemical is released to make the fibres contract and pull together to close the wound. It’s an amazing repair system, but sometimes the scar itself can become a problem.
How can a scar cause complications?
Our bodies are made up of countless layers that all slide smoothly past each other. To see this in action, rest your fingertips on the back of your hand and move the skin from side to side. Notice how the skin slides over the veins, tendons, bones…. This sliding happens with every movement you make, every beat of your heart. Injuries and surgery typically affect several of these layers at once. Then, as the wound heals and new fibres are laid down, these layers can get stuck together. Nerves and small blood vessels in the area can get trapped within the scar tissue, and if the internal organs are involved, they can also become attached to each other. Normally this isn’t a problem – our bodies are fantastic at adapting to change – but sometimes too much is stuck together or the injury is in just the wrong spot and it leads to pain and loss of function.
What are some typical scar complications?
Scars over the belly, like those from a C-section or appendix surgery, can cause cramping and bloating, constipation, back pain, or even neck pain if severe. Scarring from knee surgery can interfere with normal walking patterns and eventually lead to foot problems and hip or lower back pain. Even the adhesions you cannot see can cause long-term problems such as chronic headaches from whiplash.
What about scars from cancer treatment?
Removal of tumours will leave behind scarring and adhesions, but radiation also causes extensive soft tissue damage that can lead to discomfort for years after treatment has been completed. And when a port isn’t used, repeat infusions of chemotherapy can leave a very tender area of localized scarring. All of this can be treated.
What treatment is available?
A lot more than you might think! Surgeons favour the “cut it out” route, which will of course leave another scar but hopefully with less adhesions and complications. Acupuncturists can use specialized techniques to help release and align scar tissue, and physiotherapists with the relevant training can use dry needling to soften broad bands of raised scar tissue. Some forms of laser can be effective, and depending on the scar, LPG Endermologie treatment can be used to stimulate lymphatic drainage in the area and mobilize the tight, stuck layers. Massage will also help initially, but there’s a point where a more specific intervention is required. Then of course there’s the STRAIT Method™, one of the only manual therapies designed specifically for scar treatment. This technique was developed by Marjorie Brook to release the layers of connective tissue or fascia stuck down by scarring. It’s short for Scar Tissue Release And Integrated Therapies, and is a non-invasive, hands-on technique to release fascia by separating and realigning the adhered tissues from the visible scar through to its end point.
Is scar treatment right for me?
If you’ve had numbness, tightness, a “pull”, lingering or unexplained pain following an accident or surgery, then there’s a good chance that work on your scar can help. It doesn’t matter how long you’ve had your scar, it can still be released. This will improve circulation and sensation, as nerves and capillaries are freed from adhesion, and also leave the scar looking smoother and flatter. Wound management is important from day 1, and physiotherapy is helpful from the beginning to ensure the formation of a healthy, supple scar. The STRAIT Method™ can be applied once your scar has had time to heal fully, about 10-12 weeks. If you have a problem that’s been bothering you for a long time and nobody has been able to help, think for a moment about any scars that might be contributing to your situation. Ideally you should consult with someone who specializes in hands-on scar work, but there’s a lot you can do by yourself.
Is there any self-treatment I can try?
Have a good look at your scars. If they’re older than 3 months, try sliding them like you did with the skin on the back of your hand, and notice if they move smoothly or if they stick. Check for hardness, puckering, and areas of increased sensitivity. If you find any of these, there’s a good chance your scar is causing other problems, so try and improve it. Touch your scar, just resting a flat hand on it if it’s new or very sensitive, and allow the nerves to calm down and regulate themselves. Next, only if the scar is more than 3 months old, gently rub into those areas that feel hard or lumpy. Imagine those hardened sections are made of very cold butter straight from the freezer, and you’re trying to melt it by rubbing it into the skin. With any luck, the scarring will start to soften. And lastly, ever so gently and only on 3 month + scars, rest your fingertips along the length of the scar and carefully stretch your hands away from each other. Listen to your body and if any of these techniques causes pain, respect that and stop what you’re doing.
For more information about scar treatment, you can email Jocelyn at physio@breathandhealth.net or go to www.breathandhealth.net.
Article originally published in Yogalife Middle East and www.yogalife-online.com
Jocelyn Kope is a South African physiotherapist. She studied at the University of Cape Town, graduating with Distinction in 2009. Jocelyn has a special interest in connective tissue, chronic problems, digestive dysfunction, and especially scar tissue. Her approach is based on working with the body rather than against it, and facilitating and supporting rather than causing further trauma. She looks at the body as a whole, and treats the person rather than the symptom. Jocelyn is currently based in Dubai at Breath & Health Alternative Medical Centre.
Image courtesy of: https://pixabay.com/en/back-pain-massage-pain-stress-hand-1491803/