Regardless of the age of your scar
tissue, scar massage techniques can help to improve or lessen the
appearance of your scar and may reduce the possibility of developing
long-term problems due to scar tissue or adhesions.
The body’s natural response to an “injury that damages the dermis (deep, thick layer of skin)” is to form scar tissue. A normal “scar will usually flattens and the redness gradually disappears”. Sometimes you will form a “keloid, or abnormally enlarged, raised, and thickened scar may fade and flatten slightly with the passage of time."
Unknown to many is that you may also form “an adhesion, an internal band of scar tissue that abnormally holds the scar against adjacent structures. Adhesions do not always resolve with the passage of time and they can become worse” (2) causing you long term dysfunction in your body
Scars develop as the result of a variety of injuries or traumatic events:
Your skin will usually “form scab over a wound within three to four days following an injury. By day ten the scab typically shrinks and sloughs off as the body focuses on laying down collagen fibers to strengthen the former site of injury. The damaged tissue can be in recovery between six weeks to over a year before it returns to full strength.” (3)
The resulting fibrous mass your body creates over your wound is “composed primarily of collagen”. Your “scar tissue's fibrosity prohibits adequate circulation. In addition to the physical limitations of collagenous tissue, the lack of blood flow and lymph drainage occurring in scar tissue makes it vulnerable to dysfunction.” It also impairs oxygenation or hypoxia to your tissues!
"The resulting abnormal function of a scar or its surrounding structures may include” (3):
“In fact, some professionals believe that scar tissue is the root of a majority of physical imbalances.” (3) "Research supports the use of scar-tissue massage in resolving these functional problems." (1)
Generally speaking, the earlier and more consistently a scar is massaged, the less likely you are to develop problems with it! Scar healing and scar reduction techniques have many goals.
“The goals of any scar massage are to render the scar stable, manage the development of scar tissue, keep the connective tissue as pliable and flexible as possible by reducing adhesions between soft tissue layers, reduce discoloration and itching, reduce the scar to normal skin levels, eliminate fibrosis and myofascial stress patterns, and encourage an emotional connection with the site of the trauma.” (4) Additionally, scar massage may help to desensitize the scar area.
In the initial immature phase of your scar, soon after the wound heals, it may be “painful, itchy or sensitive as nerve endings within the tissue heal”. Your scar may “typically be red in appearance, most scars fade to normal flesh color with maturation.” It is always best to get permission from your doctor or surgeon during this phase to ensure the scar has healed enough to be worked with. Your therapist will not begin working with you until sutures have been removed and there are no open wounds or signs of infection. Scar massage, Lymph Drainage Therapy and exercise, may have the best effects on the scar in this phase.
After 6 weeks to “18 months following wound healing” (3), and scar tissue is no longer being formed, your scar is considered mature. Scar massage, Lymph Drainage Therapy, rigorous myofascial techniques, deep tissue fascial techniques, kineseo taping, stretching and self care will have the best effects in this phase.
Scar massage techniques used with both new scars and old scars may include:
Lymph Drainage Therapy “optimizes lymphatic circulation and drainage around the injured area.” (3) This technique should not hurt the affected area but will likely be performed in other areas of the body to ensure the scar has a healthy lymphatic pathway to drain to.
Myofascial Release techniques are more aggressive. Your therapist will likely stretch the skin of and around your scar holding for extended periods of time. Often times the tissue is lifted and rolled or worked with friction across the scar fibers. Your therapist will spend more time on areas of the scar that feel “stuck”. These techniques will be kept to your comfort level.
Kinesio taping techniques for scars is something your therapist may apply before the end of you session. The tape will be applied in a way to create a soft connective tissue pull in the direction the scar is having trouble moving. Additionally, Kinesio tape may be applied to allow the fluid circulation or lymphatics to flow more easily around or across the area.
Ice and Heat Application can manual aid in improving the circulation around your scar. Apply ice for 2 minutes, then heat for 2 minutes, then ice again for 2 minutes. This can be done with hot packs and ice packs or just a cold and warm wash rag against your skin if no open wounds exist.
Self care exercises given to you by your massage therapist should be continued when you return home. You may also choose to continue utilizing any scar creams or lotions your doctor recommends.
(1) LaFrano, Chuck, Scar-Tissue Massage, Massage Magazine, May/June 2001.
(2) www.lymphnotes.com, Scar Therapy and Lymphedema, Lymph Notes, 2006.
(3) http://www.integrative-healthcare.org/mt/archives/2007/07/six_massage_tec.html, Six Massage Techniques to Remove Scar Tissue, Nicole Cutler, L.Ac., July 20, 2007.
(4) http://massagetoday.com/mpacms/mt/article.php?id=14234, Cesarean Scar Massage, Elaine Stillerman, LMT, Massage Today, June, 2010, Vol. 10, Issue 06.