Adhesions (scar tissue) is a dead fibrotic tissue that forms mostly in muscles, tendons, ligaments, fascia, and joints.
Scar Tissue occurs as a result of injury , surgery, or repetitive motion. When a muscle, tendon, or ligament is torn (strained or sprained) or nerve is damaged, healing occurs in three stages called the inflammatory response: acute inflammation, repair, and remodeling. In acute inflammation, redness, swelling, heat and pain occur. This phase lasts approximately 72 hours. After the inflammation recedes, repair begins. The damaged tissues heal with adhesions or scar tissue formation rather than the formation of brand new tissue.
When a muscle tightens up-- through a repetitive motion such as typing, or after it has been injured-- swelling occurs, and it restricts the oxygen supply to the muscles and connective tissues (hypoxia). The lack of oxygen also causes scar tissue to form.
That scar tissue can adhere to muscle fibers, preventing them from sliding back and forth properly. It can adhere to connective tissues, limiting the flexibility of a muscle or joint. And it can adhere to nerve cells, leading to carpal tunnel syndrome, chronic back pain, and other conditions.
Scar tissue can bind up many layers of muscle and connective tissue, causing varying degrees of limited movement and pain.
Research has proven scar tissue to be weaker, less elastic, more prone to future re-injury and as much as 1000 times more pain sensitive than normal, healthy tissue. Chronic pain is the result, pain that could remain for years after the initial injury.
To avoid the formation of adhesive scar tissue after an injury, surgery, or excessive muscle's overuse, healing must take place in the presence of a full range of movement.
While the body’s formation of scar tissue is an awesome demonstration of self-preservation, the resulting fibrous mass can set the stage for problems down the road. Composed primarily of collagen, 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. The resulting abnormal stress on a scar’s surrounding structures may include:
· Nerve impingement
· Limited range of motion and flexibility
· Postural misalignment
· Muscle atrophy
· Tissue hypoxia
· An increase in potential for future injury
In fact, some professionals believe that scar tissue is the root of a majority of physical imbalances. Bodyworkers addressing scar tissue early in its development can help minimize any of the preceding secondary scar tissue problems.
Now there are different methods of use to help get rid of unwanted scar tissue. One of those ways would be Myofascial Release and Deep Tissue Massage. Ultra-sound is used to heat the injured area hot but the heat doesn't help to remove scar tissue. But the heat from the ultra-sound can make the scar tissue more pliable, massaging with deep cross fiber friction will do that.
The scar tissue protocol includes a three-step approach:
First, strokes to release the fluids and toxins and relax the surrounding tissues to reduce the pressure on the scar tissue and adhesion and release some of the sensation in the area.
The second step is directed myofascial unwinding strokes that involve slow, constant, steady pressure that only move as the tissue releases. Due to the multi-directional aspect of scar tissue and adhesions, these strokes are applied in any direction that adhesions can be felt. Sometimes the stroke directions may cover as many directions as the lines found in an asterisk.
The third step is applying specific individual fiber strokes. These strokes are very slow and only move with the release of tissue, usually moving along the fibers since the directed myofascial unwinding strokes have already spread the fibers apart.
Patience is required with these strokes being careful not to apply too much specific pressure on scar tissue and cause tearing which results in the reformation of scar tissue. I find it is best to do less rather than more in the first couple of sessions. It’s like peeling an onion—we take several layers off in each session until there are no layers blocking the core. Sometimes even with the best techniques there will be a reformation of adhesion in the fascia after we have released it. When this happens we will need to come back to this area weekly to release this tissue before it becomes hardened and more extensive. Usually, a point will be reached where the body will quit forming adhesions.
- Don McCann, MA, LMT, LMHC, founder Structural Energetic Therapy
The scarring processes after radiation can continue as long as six months after the last radiation treatment. Massage of the affected area should not begin until at least six weeks after the last radiation treatment and when no scabs are noticeable.
Radiated tissues are delicate and the skin can break easily. Take extreme care when massaging this area. Never massage these tissues if this causes pain or increased redness of the tissues. Perform only brief massage sessions at first. As the tissues continue to heal, gradually increase the length of the massage.
 Living Well with Lymphedema by A. Ehrlich, A. Vingé-Harrewijn PT, CLT, and E. McMahon PhD. Lymph Notes 2005, pages 159-160.
© LymphNotes.com 2006. This information does not replace the advice of a qualified health care professional.