Massage Tutorial: Mature scar tissue (myofascial release)
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Working with a client who has substantial scar tissue that has fully healed? Here are some strategies for working with that scar, and with that whole human, to reduce pain and dysfunction.
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While I demonstrate on a friend who has scarring of her low leg, this can apply to any long-standing scar tissue: An old shoulder reconstruction, scarring from broken bones, or even a hip or knee replacement. See this as an opportunity to remind the body of its own capabilities, assisting your client in using the area to its fullest.
As I discuss in the video, there isn't any "scar release" that we can do. Collagen, especially in mature scar tissue, isn't just glue that we can break down with our hands. It's one of the strongest substances that our body produces, and it infiltrates and joins with all the surrounding structures. If two sliding surfaces are adhesed, they are, for all intents and purposes, now one single structure.
So what can we do? We can communicate with the local nervous system to reduce pain and spasm. We can use movement to prove to the body that it is capable of contracting nearby muscles, and of achieving a useful range of motion. Over time, the client should see an improvement in symptoms, even though we've created very limited change on a histological level.
Is that to say that we make no changes in the tissue? Not necessarily. It's likely that we create some local inflammation and cause an increase in fibroblast and fibroclast activity. It is plausible that, over time, there may be some subtle changes to the scar. This is especially likely if we introduce the client to a gentle self-massage protocol that they can do between sessions.
Do you have any tips for working with scar tissue? I'd love to hear about them in the comments!
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