Scar Massage and Healing
Do you need Scar Massage?
Regardless of the age of your scar
tissue, scar massage techniques can help to improve or lessen the
appearance of your scar and may reduce the possibility of developing
long-term problems due to scar tissue or adhesions.
The
body’s natural response to an “injury that damages the dermis (deep,
thick layer of skin)” is to form scar tissue. A normal “scar will
usually flattens and the redness gradually disappears”. Sometimes you
will form a “keloid, or abnormally enlarged, raised, and thickened scar
may fade and flatten slightly with the passage of time."
Unknown
to many is that you may also form “an adhesion, an internal band of
scar tissue that abnormally holds the scar against adjacent structures.
Adhesions do not always resolve with the passage of time and they can
become worse” (2) causing you long term dysfunction in your body
Scars develop as the result of a variety of injuries or traumatic events:
- Deep lacerations
- Radiation therapy, burns
- Cuts, Scrapes
- Plastic surgery
- Mastectomy, Tram Flap, Lat Flap, Breast Reconstruction
- Cesarean section surgery
- Joint replacement surgery
- Scar removal surgery
- Skin graphs
Your
skin will usually “form 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
six weeks to over a year before it returns to full strength.” (3)
The resulting fibrous mass your body creates over your wound is “composed primarily of collagen”. Your
“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.” It also impairs oxygenation or hypoxia to your tissues!
Thyroid removal scar before and after one scar massage session (please ignore the necklace in the photo on the right).
"The resulting abnormal function of a scar or its surrounding structures may include” (3):
- Scar becomes hard and non-pliable
- Bands of fibers are created on or below the surface of your skin
- Your skin tightens or shortens
- Pain
- Swelling
- Nerve impingement, sensitivity in the scar area
- Numbness
- Decreased mobility and flexibility of joints, muscles, and tendons
- Postural misalignment
- Muscle weakness
- Increased likelihood for future injury
“In fact, some professionals believe that scar tissue is the root of a majority of physical imbalances.” (3) "Research supports the use of scar-tissue massage in resolving these functional problems." (1)
Generally
speaking, the earlier and more consistently a scar is massaged, the
less likely you are to develop problems with it! Scar healing and scar
reduction techniques have many goals.
“The goals of any scar
massage are to render the scar stable, manage the development of scar
tissue, keep the connective tissue as pliable and flexible as possible
by reducing adhesions between soft tissue layers, reduce discoloration
and itching, reduce the scar to normal skin levels, eliminate fibrosis
and myofascial stress patterns, and encourage an emotional connection
with the site of the trauma.” (4) Additionally, scar massage may help to desensitize the scar area.
In the initial immature phase
of your scar, soon after the wound heals, it may be “painful, itchy or
sensitive as nerve endings within the tissue heal”. Your scar may
“typically be red in appearance, most scars fade to normal flesh color
with maturation.” It is always best to get permission from your doctor
or surgeon during this phase to ensure the scar has healed enough to be
worked with. Your therapist will not begin working with you until
sutures have been removed and there are no open wounds or signs of
infection. Scar massage, Lymph Drainage Therapy and exercise, may have the best effects on the scar in this phase.
After 6 to 8 weeks to “18 months following wound healing” (3), and scar tissue is no longer being formed, your scar is considered mature. Massage Cupping, Scar massage, Lymph Drainage Therapy, rigorous myofascial techniques,
deep tissue fascial techniques, kineseo taping, even Microneedling Scar Revision, stretching and self care will have the best effects in
this phase.
Scar massage techniques used with both new scars and old scars may include:
Lymph Drainage Therapy “optimizes lymphatic circulation and drainage around the injured area.” (3)
This technique should not hurt the affected area but will likely be
performed in other areas of the body to ensure the scar has a healthy
lymphatic pathway to drain to.
Massage Cupping or negative pressure massage to lift, separate, and bring in fresh circulation to the area. Massage cupping is particularly helpful with all other techniques have been tried, or when the scar impacts multiple layers of tissue, including organs.
Myofascial Release
techniques are more aggressive. Your therapist will likely stretch the
skin of and around your scar holding for extended periods of time.
Often times the tissue is lifted and rolled or worked with friction
across the scar fibers. Your therapist will spend more time on areas of
the scar that feel “stuck”. These techniques will be kept to your
comfort level.
Kinesio taping techniques for scars is
something your therapist may apply before the end of you session. The
tape will be applied in a way to create a soft connective tissue pull in
the direction the scar is having trouble moving. Additionally, Kinesio
tape may be applied to allow the fluid circulation or lymphatics to
flow more easily around or across the area.
Scar Revision MicroNeedling can be done after Skin Consult with our LymphWorks' Esthetician. Numbing cream is available but not required. A scar revision is a procedure done on a scar to alter the appearance of the scar, using a different kind of micro-needle tip formation, specially made for collagen and fibroblast build up. The revision may improve the cosmetic appearance of the scar, restore function to a part of the body that may have been restricted by the scar, and/or improve an itchy or tightened scar. This treatment promotes the formation of new skin cells and accelerates healing. At the same time, it breaks down old scar tissue, and can lighten hyperpigmentation. Great for keloid scars, post surgery incision scars, stretch marks, acne scars, burns and more.
Ice and Heat Application
can manual aid in improving the circulation around your scar. Apply
ice for 2 minutes, then heat for 2 minutes, then ice again for 2
minutes. This can be done with hot packs and ice packs or just a cold
and warm wash rag against your skin if no open wounds exist.
Self care exercises given to you by your massage therapist
should be continued when you return home. You may also choose to
continue utilizing any scar creams or lotions your doctor recommends.
References:
(1) LaFrano, Chuck, Scar-Tissue Massage, Massage Magazine, May/June 2001.
(2) www.lymphnotes.com, Scar Therapy and Lymphedema, Lymph Notes, 2006.
(3) http://www.integrative-healthcare.org/mt/archives/2007/07/six_massage_tec.html,
Six Massage Techniques to Remove Scar Tissue, Nicole Cutler, L.Ac.,
July 20, 2007.
(4) http://massagetoday.com/mpacms/mt/article.php?id=14234,
Cesarean Scar Massage, Elaine Stillerman, LMT, Massage Today, June,
2010, Vol. 10, Issue 06.