By Dr. Douglas R. Briggs, DC, L.Ac., EMT and Kayci Manuel, LMT
Scars are the end result of the body’s natural healing processes. All kinds of injuries – burns, cuts, surgical incisions and trauma – form scars when they heal. These scars can be of different shapes, sizes and colors. Sometimes scars are raised from the surrounding areas of skin. Such a scar stands out and is very noticeable. Whether the scar is raised or not, its rehabilitation is necessary.
Our bodies possess an amazing capacity to heal and regenerate, the skin forms a 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 three months to over a year before it returns to full strength. Additionally, some diseases or skin disorders (such as acne) may also result in scar tissue formation.
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, the thickness of the scar tissue’s fibrous tissue prohibits adequate circulation (think of gristle in your steak). In addition to the physical limitations of collagenous tissue, the lack of blood flow and lymph drainage occurring in scar tissue makes the tissues vulnerable to dysfunction. The resulting abnormal stress on a scar’s surrounding structures may include:
- Nerve impingement
- Pain
- Numbness
- Limited range of motion and flexibility
- Postural misalignment
- Muscle atrophy
- Tissue hypoxia
- An increase in the potential for future injury
By addressing scar tissue early in its development you can minimize the secondary scar tissue problems.
- Immediately after a wound heals, the scar is still considered immature. During this period it may be painful, itchy or sensitive as nerve endings within the tissue heal. While it is typically red in appearance, most scars fade to normal flesh color with maturation. Exercise, massage and heat application will have the greatest positive effect on an immature scar.
- Depending on the size and depth of the wound, scar tissue will cease production 3 to 18 months following wound healing. When scar tissue is no longer produced, the scar is then considered mature. While techniques to reduce scar tissue in a mature scar are effective, a more disciplined and vigorous approach is necessary.
The dense collagen fibers laid down during healing that form the scar is part of the body’s natural response to an injury – working on these fibers during the early healing process will help them to lay smoothly. Old tight scar tissue can be worked, but it takes time to break up the old congestion, stretch and re-orient the fibers, improve motion, and promote the healing process. Regardless of how the injury or how the scar was formed, all scars share some common characteristics. As a general rule, the earlier and more consistently scar tissue is exercised, massaged and warmed, the less possibility of developing any long-term concerns such as:
- Becomes hard and non-pliable
- Bands of fibers on or below the surface
- Skin tightens or shortens. When crossing a joint, this contracture may limit range of motion, comprise function or cause deformity.
- Becomes dry and reopens to form a wound if not managed properly. This is especially true for skin grafts, which do not produce oil or sweat.
There are a number of options to treat scar tissue, as noted, the earlier you can begin treatment the better and quicker the outcome.
Massage - working with a therapist to stretch the fibers, break up the adhesion and congestion, and work the circulation through the tissues is a great place to start. Your therapist may also use different oils to help soften the tissues to help this process.
Acupuncture - acupuncture is another tool used to introduce circulation through the injured area to move the healing process forward. It will also help to warm the tissues to increase pliability and motion.
Chiropractic care - dense scar tissue is quickly associated with limited motion. As the tissues loosen, make sure the underlying joint mechanics are at their best. Again, this will help motion and promote the ongoing healing process.
Exercise - scars are tissue. Tissue gets tight – especially scar tissue. A focused, controlled protocol of stretching the tissues and actively moving the muscles and joints will again help pliability and motion, and also work to retrain the fibers to be less tense and more functional.
Diet - Get enough to drink. (NOT SODA or sugar/caffeine-laden beverages!) Hydrate with water and fresh juices. The more you work a scar, the more debris your body has to flush out – you can’t do that without water. In addition, make sure you are eating good foods that nourish and heal. Eating foods that cause irritation or inflammation can actually work against you. A diet rich in whole-foods combined with high-quality supplements containing non-addictive, anti-inflammatory ingredients can help boost your body’s nutrient status to facilitate healing and reduce pain.
While scar tissue is “normal” and is the body’s natural reaction to heal itself through a build up of collagen, care and correction should be taken to repair the damaged tissues to optimum strength. With massage, heat, acupuncture, manipulation and exercise, the strength and flexibility of the tissues can be restored. Although scars cannot be completely removed, there are many ways to help heal scars heal and make them less noticeable. This process takes some patience and effort, but the results are worth it.
Dr. Douglas Briggs
Dr. Douglas Briggs, Chiropractic Physician and Acupuncturist, is the senior associate of First State Health & Wellness—Wilmington, which is recognized by the American Chiropractic Association Rehabilitation Council and the Laser Spine Institute as an approved post-surgical spine rehabilitation facility. Kayci Manuel is a Licensed Massage Therapist in the Wilmington office. To schedule a complimentary initial consultation, visit www.firststatehealth.com or call 302.654.4001 to learn how our award-winning team can support your wellness goals.
May 04, 2019 at 2:39 PM
I have had 4 cesarean sections. My youngest child is 8. My uterine scar has separated forming a tunnel. I have mild cramping, pinching, twisting sensations off and on continuously. I have spotting/bleeding 3 weeks of every month. I would like to try and heal this (before resorting to surgery). Do you have any suggestions for me? Thank you.
May 14, 2019 at 4:30 PM
We encourage you to call Dr. Briggs’ office at 302.654.4001 to inquire about a complimentary consultation to discuss your unique concerns. They will be happy to help answer your questions.
May 25, 2019 at 6:28 AM
Hi Angela. Sorry to hear about your discomforts. I hope you find a solution soon. I had a Myomectomy over 3 months ago. I plan to have Ivf done in a couple of weeks. I will have to get a C section when I am about to deliver. I'm just curious if they will cut me on the same Myomectomy scar to remove the baby. Did they cut you on the same scar for your 4 c sections or did they create a new scar?
May 10, 2019 at 5:49 PM
I have a small breast implant (1 year old, replacing the previous one a year earlier) that has scar tissue developed above the breast which is pulling the breast upwards and is most often painful in my shoulder, front and back. Pain can radiate to my neck and lower in my back. I had physical therapy for the shoulder/ neck which included some massage to the surrounding breast tissue at the second surgery with some benefit. I most definitely am in need of a break up of the deep scar tissue. Is there a specialized treatment? Thank you. Karen
May 14, 2019 at 4:29 PM
We encourage you to call Dr. Briggs’ office at 302.654.4001 to inquire about a complementary consultation to discuss your unique concerns. They will be happy to help answer your questions.
May 21, 2019 at 6:24 PM
is it okay to take collagen orally , daily when trying to break up scar tissue from a recent hand surgery???
May 28, 2019 at 6:06 PM
Gail, if the surgery was recent, I recommend taking the First State Repair supplement to help control inflammation and promote healing—not lay down more collagen and potentially make a thicker scar. If you would like to try Repair, please call our Wilmington office at 302.654.4001 and as always, we recommend checking with your doctor before using any supplements.
Jun 06, 2019 at 4:15 PM
What are the best foods to combat scar tissue in neck and shoulder joint pain. And the best supplements or enzymes to correct the condition
Jun 10, 2019 at 1:47 PM
You’re right! Nutrition plays a tremendous role in reducing pain and inflammation, in addition to chiropractic care and therapeutic massage. Increasing your intake of a variety of colorful fruits and vegetables, and staying well hydrated, is a great place to start. From there, our licensed integrative nutritionist can help identify targeted supplementation to meet your specific needs — a combination that will support your body’s natural healing capabilities. For more information, contact the Integrative Health Center at 302-384-7104.
Aug 11, 2019 at 11:09 AM
I have breast implants. One of my breasts has a nice slope. But my left one has a build up of scar tissue and has a line on the top from scar tissue. How can I work this out without another surgery? I hate wearing anything that shows any cleavage because it looks so bad.
Aug 12, 2019 at 10:01 AM
Thank you for that question Shannon. We would recommend a complimentary initial consultation with one of our chiropractic physicians to discuss your health history and the possible options for care. The article’s author, Dr. Briggs in Wilmington, Delaware, can be reached at 302.654.4001. We also have 5 other locations in Delaware should another office be more convenient. We wish you well!
Nov 28, 2019 at 2:49 PM
Hello. I have scar tissue to one or more of my adductor muscles on my thigh from an old dance injury. It is nearly 10 years old and limits some motions. Is it too old to breakdown and try get more motion?
Dec 02, 2019 at 2:20 PM
The older scar tissue is - the harder it is to work with. You can certainly still work with a a 10 year old muscle injury - but treatment will involve breaking up the old adhesions, and stretching and retraining the fibers into a more "functional scar" - this will take some time and some work but it can be done! If we can help, please come see us! -Dr. Briggs
Feb 17, 2020 at 7:15 PM
I had a total knee replacement done 7 months ago. I've been massaging it with a cream that the surgeon gave me and I've been exercising it. But getting up out of a chair or from any sitting position,my knee makes a lot of noise a crunching sound. They say it's scar tissue, but it's scary on how noisy it is. Is this natural?
Feb 19, 2020 at 11:38 AM
After a surgery like knee replacement - exercise and stretching is critical - the more you move your knee the better your range of motion will be long term. There will always be scar tissue after that kind of surgery. Stretching is important. If your doc gave you a Vitamin E cream to help soften the tissue and loosen the scarring that is important to keep up too. Usually clicking in a joint after surgery is something that needs to be addressed with the surgeon - it is possible that there is a scar tissue component, but I would recommend you follow up with the surgeon for evaluation. The condition of a post-surgical joint cannot be evaluated over an email or phone call - I encourage you to get back in and have the doctor take a look at your knee for a definitive answer. —Dr. Douglas Briggs
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