Why Scar Tissue Massage Is Important- August 21, 2016

Scar tissue from an injury, surgery or c-section can have impacts on the body, even years after. A scar forms from the natural healing process whereby new collagen is laid down to replace the damaged tissue.  When the collagen is laid down, instead of being in an orderly fashion, the new collagen is often disorderly, like tangled yarn. Additionally, there can be too much collagen or the collagen bands get stuck to structures it is not suppose to, all of which create problems.

The good news is that scar tissue undergoes remodeling and can be influenced by massaging the scar. Giving attention to the scar can help reduce the thickness of the scar and the underlying adhesions, but will not make the scar disappear.

When clients come in and I find out they have scars from surgery or pregnancy, I ask them, “Do you massage your scar? Or were you told to massage your scar?” The response a majority of the time is, “No” to both questions. Clients will often say they don’t even touch their scar. The reason I ask these questions is because scar tissue can lead to pain, restricted range of motion around a joint or muscle, reduced mobility and function and can adhere to internal tissues such as organs.

Adhesions are a problem because they can contribute to low back pain, pelvic pain, pain with intercourse and urinary frequency/urgency.  It can contribute to back pain because there is fascia that runs from the front of the pubic bone to the back of the sacrum (the bone that connects the 2 pubic bones and connects to the lower back). If a scar is attached to this fascia it can pull and restrict motion, which can contribute to pain. This fascia also wraps around the bladder, uterus and rectum.

So a c-section scar or abdominal scar that adheres to the bladder will restrict how much it can expand. This lack of expansion by the bladder means the brain will receive the signal that you need to pee more often. For some clients, this can be every 15-20 minutes. If the scar adheres to the uterus, it can lead to pain with intercourse because during thrusting the uterus moves upwards to create space, but if it is stuck, it will not move and can be a source of pain.

If the scar tissue adheres to the bowel, it can cause an obstruction making it difficult to go, or can cause pain with bowel movements. Additionally, restrictions around the bowel can also cause frequency/urgency, much like the bladder. The scar itself can be a problem. For some clients the scar becomes so sensitive, it cannot be touched by the hand or even clothes.

To help reduce these possible complications, scar massage can be utilized. You can start touching and massaging your scar as soon as it has fully healed (no scabs). If the scar is too sensitive to massage, you can start with just running a finger across the scar very gently (no pressure) until the tissue is a bit less sensitive, then work your way up to massaging the scar. Check out our YouTube video demonstrating one type of scar massage. https://www.youtube.com/watch?v=0I9pr3dPcss

It is always best to check with your primary care practitioner (doctor, surgeon, trained physiotherapist) before starting scar massage. It is important to note that massaging the scar should not produce pain greater than 6/10, where 10 is the worst pain. If you are experiencing this level of pain, back off the pressure or amount of stretch. The scar may change colour after massaging, but should not bleed or have any puss coming out.

Written By: Madelaine Golec, Registered Physiotherapist/ Pelvic Floor Physiotherapist/Owner

References:

Diegelmann, RF and Evans, MC. 2004. Wound Healing: An overview of acute, fibrotic and delayed healing. Frontiers in Bioscience, 9:283-289.

Schulte-Leech, Lynn. 2013. The importance of massaging your c-section scar. From, www.intuitivehandspt.com/the-importance-of-massaging-your-c-section-scar Accessed on August 21, 2016.

Lorenz et al. 1997. Pathophysiology and Classification of Adhesions. Peritoneal Adhesions. K.H Treutner et al (eds). Springer-Verlag Berlin Heidelberg.

Monk et al. 1994. Adhesions after extensive gynecologic surgery: Clinical significance, etiology and prevention. American Journal of Obstetrics and Gynecology. 170(5): 1396-1403.

Why Scar Tissue Massage Is Important