Bodywork: Scar Tissue and Adhesions
By Sarah Costa, CMT
Most people think of scar tissue as that stuff that is left behind after a cut, scrape or incision on the surface of your skin. We all have scars that can be seen whether they be on your knee from falling off your bike when you were five years old, or on your abdomen from a cesarean section or appendicitis. What a lot of people don’t realize is that scar tissue can form at any of the many layers of connective tissue in our bodies. The occurrence of scar tissue is extremely common in the skin, fascia, and muscle fibers. Bodyworkers refer to internal scar tissue as adhesions. Adhesions can have a great impact on a person’s range of motion, as well as cause chronic dysfunction and discomfort; and it is something that bodyworkers use specific techniques to address.
So what are adhesions exactly and why do they cause so much trouble? Adhesions form in muscles, tendons, ligaments, fascia, and joints as a result of injury, surgery or repetitive motion. When muscle, tendon, ligament and nerve are damaged the body responds for approximately 72 hours with inflammation, redness, swelling, and heat. After these symptoms recede, the body starts the process of repairing the injury. It cannot replace the damaged tissue with brand new tissue, so it uses adhesions or scar tissue as a patch. These patches are not the same as the living tissue around it; comprised mostly of collage, adhesions are fibrous and lack adequate blood flow and lymph drainage. In addition, they are rather inflexible, making them vulnerable to dysfunction. Adhesions can lead to nerve impingement, pain, numbness, limited range of motion and flexibility, postural dysfunction, and an increased potential for future injury.
You may be thinking you are in the clear because you have never had a major injury or surgery. However, adhesions can be formed due to repetitive motion as well. If your job requires long hours at a computer for example, your arm and hand muscles may experience some swelling due to overuse. Swelling leads to hypoxia, when your muscle fibers don’t get enough oxygen, and then adhesions start to form. Adhesions can form in between muscles, making them stick together; restricting their range of motion. Once muscles are stuck, all it takes is quick or strenuous movement to make them tear at the site of the adhesion and the body’s process of repairing with scar tissue begins. Adhesions can also adhere to connective tissue around a joint limiting its mobility, as well as nerve cells that can lead to chronic pain.
It is at the beginning of the repair process that massage is most beneficial. The best way to avoid the secondary problems caused by scar tissue is to make sure that it is formed in the most favorable conditions possible. By receiving massage immediately after that initial 72 hours, when the repair process begins, treatment can ensure that the scar tissue is laid down in a more organized way. Massage can encourage the scar tissue to align itself according to the forces placed on the scar; it will hold up better over time and allow for a greater range of motion from the very beginning. If you are living with old adhesions or your adhesions are products of repetitive motion over a long period of time, massage can also be very beneficial. It can take many sessions to break up existing adhesions and regain range of motion, but the remaining scar tissue will create less problems and any new scar tissue will be laid down in a more organized way.
What are the specific techniques used by massage therapists to treat scar tissue and adhesions? It is a layered approach that takes patience and a skilled touch. First the surrounding tissues are softened and relaxed with gentle Swedish strokes that release fluids and toxins, reduce pressure on the scar tissue and desensitize the area of any intense sensations that may be present. The next layer is called myofascial release and involves the slow steady unwinding of tension in the skin surface, underlying fascia and deeper muscles. It incorporates many different holds, stretches and strokes that encourage the tissues to relax fully. The third and most commonly used technique for reducing adhesions is called cross fiber friction. Once the borders, shape, and depth of the scar tissue or adhesion are established through palpation, therapists apply pressure directly and precisely to this area and move across the fibers without sliding over the skin. This part of the process can be uncomfortable, but skilled therapists are trained to work within their client’s pain tolerance. Any discomfort will subside as the scar tissue is broken down and the remaining scar tissue realigns.
All of the therapists at HOPE Wellness Institute are well trained in the specialized techniques used to treat scar tissue and adhesion. Please call with any questions regarding this treatment or to book a session; we would be happy to help you start your journey to comfort, a greater range of movement and improved flexibility today.