Scar mobilization
Damage to the continuity of the skin and deeper tissues, whether through trauma or surgery, is associated with the formation of a scar. There is no chance to avoid it, but to a large extent we can influence its appearance and, more importantly, its proper healing.
Scars are the result of the physiological process of tissue healing, which leads to the formation of new tissue(fibrous connective tissue) at the site of injury. It would seem that the problem ends when a scar is formed, as the tissue is already fused and “repaired.” However, unfortunately, it is very common for the scar itself as well as the adjacent tissues to be disrupted, which interferes with the functionality of the area. Therefore, it is worthwhile to work with scars, both fresh and older ones, as their appearance, elasticity and mobility can be significantly improved.
The outer layer of the scar that we see, or scar tissue, appears to be an inconspicuous and mostly “harmless” structure. Unfortunately, in most injuries or procedures, there is also damage to the internal tissues within which scar tissue also forms.
The main problems of the newly formed tissue are that its formation is chaotic, irregular, and very often other structures become entwined with the scar fibers. All this adversely affects the functioning of the traumatized area. The type of disorders and their extent are certainly influenced by the location of the scar and its size, as well as its healing processes (overgrowth of the scar, lack of elasticity).
Possible complications provoked by scarring:
- Muscle contractures - restriction of mobility resulting from disruption of the mobility of tissues in relation to each other (adhesions between tissues at different levels),
- postural disturbance (e.g., scar tissue in the shoulder complex can provoke forward extension of the shoulder),
- Proprioception disorders - scars can falsify the image perceived by sensory receptors,
- disruption of movement patterns,
- pain complaints of an acute and excruciating nature - are due to the collagen fibers "pulling in" the muscle and fascial tissues,
- Transmission of excessive mechanical loads to other areas (such as the spine), which manifests itself in pain complaints
When can scar therapy begin?
Scar therapy should be started as early as possible, i.e. from the first days after injury or surgery. It is important to follow several rules, especially in the case of fresh scars, so as not to disrupt the regenerative processes and prolong the healing time. Therefore, in the initial stage, the therapy includes the tissues adjacent to the scar, while working with the scar itself is possible after the wound has healed (3-4 weeks).
The main technique for working with scars is scar mobilization, but techniques for soft tissues (PIR – post-isometric muscle relaxation, deep massage, functional massage), which are performed within structures functionally related to the scar area, prove to be equally important.
Mobilization of the scar can begin even while the sutures are still in place. Of course, this condition requires great care and working towards the healing wound to prevent the spread of the forming scar.
However, it is also worth working with scars at a later stage, even old scars (several years old) that show hypertrophic changes, with limited mobility or a tendency to retract (concave scars).
