How to assess and treat your scars

Have you had an injury or even surgery that left a scar? Have you ever worked on your scar? And do you know why it is so important in your healing? 

Today, we will discuss scars, how to assess them, how to treat them, and why it is so important that we do both.

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Understanding Scars

Let’s first talk a little bit about what scars are. If you look at a tensegrity model, you want to think about our fascial tissue as our three-dimensional network, our glue that holds us all together, our force transmission system. 

What’s fascinating about the fascia, among many things, is that we are able to create tension and elasticity. This is what happens in dynamic movement, whether that is walking, running, stairs, breathing, or whether that’s the motility and mobility of our viscera and our organs.

When we have scars, we form cross-links, which is what makes the tissue strong. That’s exactly what we want from a scar. But it is not elastic. We need this elasticity of the tissue to move freely and generate and transmit force through our body.

Scar Releases

Now, let’s dive into what we do when we’re doing scar releases. First, a lot of times, we think that we’re breaking up scar tissue. Well, we are not breaking anything up because fascial tissue requires thousands and thousands of pounds of force to break. We would have to actually go in with a cadaver and cut the tissue. So, we’re not breaking it up. However, we are influencing it from the sensory aspect because there are tons of sensory nerves in the fascia, and we are helping to improve the elasticity of the tissue by helping to realign the collagen fibers and create elasticity in the tissue. That’s the main goal.

Who Should Undergo Scar Work

Scar assessment and scar work do not need to be aggressive, but they should be very intentional. Who should do this? Anyone that has a scar. It doesn’t matter how small or old the scar is or why you have it. All of these can influence the surrounding tissues.

For example, if you have a C-section, there is the obvious superficial scar, but then there are effects of cutting through seven layers of tissue. In that particular area where the actual scar is on the outside, it can affect all of your abdominal muscles and your viscera, too. That’s one of the underlying potential root causes of something like SIBO (small intestinal bacterial overgrowth) or any gut dysregulation. 

If you’ve had a tummy tuck, breast implants, or a scar from an injury, all of these things can affect the surrounding tissues as well as distant tissues. Our fascial lines connect us from the bottom of our feet to the top of our toes. Something to consider before you even assess your scar is recognizing the emotional component and potential trauma of scars. 

Depending on why you have the scar, significant emotional responses can occur when addressing it. Make sure that you either work with a professional to do this or do this in a safe place and honor any emotions that may come up because, ultimately, every scar has a story. This is a really important part of scar work.

Scar Assessment Techniques

Imagine you have a scar on your hand. It could be from a recent injury or a past surgery. The first step is to examine the scar closely. Using your fingers, gently pull in different directions around the scar. Notice how the tissue responds. Is there any resistance? Does one side feel tighter than the other? You can pull in different directions, and essentially, you’re looking at the elasticity of this tissue because we want our tissue to move freely.

Now, sensitivity is another important factor to consider. So, does it feel very hypersensitive? As I mentioned, we have a lot of sensory nerves on our fascia. So, it could feel almost burning or super hypersensitive, and in this case, we would do some scar desensitization before performing the actual scar massage. 

Next, if the scar is sensitive, you can use a washcloth and gently massage it over the scar. This will help desensitize the scar. Typically, you only need to do this for a few days—maybe not even—but it could be very, very helpful. It can also be an opportunity to connect with the scar and help with nervous system regulation as it relates to the scar and the injury or surgery that you might have had.

Scar Treatment Techniques

General Technique

To begin, we’ll start with a more general technique. Instead of directly massaging over the scar, we’ll focus on moving the skin over the tissue surrounding it. This allows us to gauge how the scar tissue moves in various directions. As you perform this technique, pay attention to any areas where you feel tightness or restriction. It’s normal for certain areas to feel tender or uncomfortable.

Smudging Technique

Once you’ve identified areas of tightness, you can transition to the smudging technique. This involves applying pressure to the skin and moving it up and down or side to side over the scar. By doing so, you’re promoting better tissue mobility. This technique can be applied to the entire scar area for maximum effectiveness.

Specific Technique

The most targeted approach involves focusing on particularly tight or restricted scar tissue areas. If you notice a specific area that feels especially constricted, gently apply pressure and hold it there. As you maintain this pressure, you may feel the tissue gradually soften and release. This indicates a successful fascial release, allowing for improved movement and reduced discomfort.

Key Takeaway

These are some basic techniques for assessing and treating scars. It doesn’t matter how old your scar is. It is important to honor any emotions that may come up with compassion. Scar massage is an extremely important part of your emotional and physical healing.

For example, if you’ve had shoulder surgery and experience shoulder pain, neglecting scar treatment can impede muscle function, particularly stabilizing muscles, due to potential neurological effects on the scar. Similarly, addressing a C-section scar can be vital for addressing gut issues, and knee scars from falls may relate to hip or knee pain. So, the impact of scars isn’t limited to their immediate location; it can affect distant areas, too. It’s essential to recognize the importance of scar treatment, including tattoos, which are essentially scars, as part of maintaining healthy movement and organ function.

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How To Assess and Treat Your Scars

Did you know that your scars, whether from surgeries, falls, or even tattoos, can provide significant psychological and functional consequences? The great thing is that scars are a normal part of healing, but what happens is our collagen fibers that are normally aligned in a parallel fashion, lay down in a haphazard direction. Because of this, the myofascial tissue is much stronger, however, it is not as elastic and typically not as functional.

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Our fascial tissue is considered our ectoskeleton—the glue that holds us together. It surrounds all of our muscles and organs. It has seven times more sensory nerves than our muscles do. Therefore, these scars are very sensory driven so they can disrupt the information coming from our tissue to our brain. Ultimately that can change different types of movement patterns that might be happening in the body, contributing to pain or even injury.

For example, if you have had a C-section or other type of abdominal surgery, the scars and adhesions from that can affect how the deep core is stabilizing as an integrated unit. This will affect the transverse abdominous, diaphragm, pelvic floor, and so on.

If you’ve had back surgery and you have scars in the back that can attribute to how the tissues around the spine are stabilizing and firing. If you’ve had a chemo port scar, that can attribute to the way that your shoulder is firing. The list goes on. You want to just recognize that scars are a very integral part of a movement and it’s something that can be assessed and addressed.

What To Look For When Assessing Your Scars

Here are some things to look for when assessing your scars:

1) Color – Red or white?

2) Scar height – What is the thickness?

3) Pliability – How extensible is the tissue? You can move your scar in different directions to see which direction is more restricted.

4) Surface texture – How does the scar feel overall as you glide over the tissue?

5) Sensitivity

6) What is the story that it tells? 

After you’ve assessed your scar, the next step would be to begin to treat it. You want to think of this as a very gentle, yet intentional approach.

How To Treat Your Scars

Here is how to treat your scars:

1) Desensitization

You can use a washcloth and just gently rub it over the scar. That is to desensitize any type of hypersensitive scar if you found it to be painful. 

2) Feathering and Gliding

This is used as a great general technique to warm up and relax the tissue.

3) Smudging Technique

After you’ve done that, if needed, then you can begin by a basic smudging technique where you put pressure with your hand into the skin and you’re moving the skin over the tissue. You are moving the skin gently in the direction where it felt more restricted and hold that for a period of time.

4) Circles

Then you could do gentle circles on the scar as well as around the scar to make sure you improve the elasticity of the scar.

5) Long Holds

Lastly, long holds can be used when there are noted restrictions in the elasticity of the tissue.

6) Rocktape

You can also use rock tape.

Remember when working on scars we are not breaking up the tissue. Forces over 2,000 pounds per square inch are needed in order to actually break up the tissue.  What you are doing is helping to make the tissue more elastic and pliable. You are also helping to reorganize those collagen fibers so that they are aligned properly as opposed to that haphazard direction. This can help improve how the tissue is moving in that general vicinity and beyond. 

7) Integration 

The last step is integration. You want to integrate whatever type of scar work you did into healthy mindful intentional movement. For example, if you were doing some type of scar work on the abdomen, you would want to do breathwork perhaps pelvic floor activation, and then some type of integration into an actual movement where you can put all those things together. This could be something like a dead bug exercise, bird dog exercise, or some kind of basic stabilization exercise. 

Now you know how to assess your scar, as well as treat it.

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