Massage for Scar Tissue

One kind of massage therapy that I offer which many of you may not be aware of is scar tissue therapy.  We all have scars.  Scar tissue is the result of your body trying to heal itself quickly, so any time we injure ourselves, scar tissue can build up even if we don't see it or are not aware of it.  The larger the injury, the more scar tissue builds up.  In this blog post, I will talk about what scar tissue is and how massage therapy can be used to help.

What is Scar Tissue?
As I said above, scar tissue is the result of the body trying to heal itself quickly.  Let's use the analogy of a brick wall.  In order to build a wall, first the bricks and mortar must be created.  Once you have those, you begin by laying down some mortar and placing the bricks evenly along it.  You are careful to line them up properly and apply more mortar between each brick and the next, and you smooth the mortar out making sure that it isn't sloppy.  When you are finished, you have a strong wall that looks pretty nice.  Your body is constantly renewing itself.  Old cells die and are replaced by new ones.  This happens over time and your body can make sure that all of the cells are well formed and lined up properly

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Remember that brick wall?  Imagine that something has made a significant hole in it and a flood is coming.  You must quickly patch the hole in order to keep the flood waters out.  You quickly gather materials.  They may not be exactly the same as the materials there before, but you need to close the hole.  You quickly start stacking bricks and mortar.  There is no time to make sure that everything lines up properly, and you certainly don't have time to make sure that the mortar is smooth.  Chances are, you will have something that looks very haphazard and probably doesn't match the rest of the wall very well. It is also likely that that spot in your wall, because it wasn't built with the same care and precision, will always be a weak point.  It may keep out those flood waters, but it won't be as strong if something else tries to break it.  When considering our bodies and things that can get in (bacteria, fungi, pathogens...), even a tiny hole in tissue can be enough to let in microscopic organisms.  So, when you get injured, your body rushes cell building materials to the site to start to close it up as quickly as possible.  New cells are laid down very quickly and a bit haphazardly.  It likely doesn't match the rest of the tissue in the area, and even though it seems like a lot of build up, it is actually a much weaker section of tissue.  I use the word "tissue" here instead of "skin" because you can get scar tissue anywhere in your body.  You can have scar tissue on your bones, organs, muscle, etc.  

How Can Massage Therapy Help?
So, now you have scar tissue.  How can massage therapy make a difference?  Well, when your body creates scar tissue, there tends to be a lot of extra build up.  This is partly because of the fast manner in which it was created, and partly because when creating a section of tissue that is much weaker, more tissue is laid down for support.  What massage therapy can do, is break down some of that extra build up, warm the area, and coax the new cells into a nicer pattern.  Remember how I mentioned that cells are constantly dying and being replaced by new cells?  As this process is taking place, massage can help those new cells that are being created to normalize.  What happens when we have scar tissue is that our cells are still being broken down and replaced, but the replacements are most similar to the scar tissue that was there before.  Over time, these newer and newer cells will begin to revert back to a more normal size/shape/type, which is why we see scars get smaller and less pronounced over time, but this can take a while.  Massage just helps to speed up that evolution of the cells.

Guidelines and Precautions for Scar Tissue Therapy
​Before you start work on massaging scar tissue there are some things to keep in mind.

1. The older the scar tissue, the longer it will take to work on.  If you can work on scar tissue that is still being formed, it will be much easier to change quickly
2. Make sure that the techniques you are using are appropriate.  If the area is still red or warm, you should limit yourself to the first 2 techniques, or choose to wait
3. If something hurts, stop!  Remember to work within your own tolerance.  Tolerance is not the same as endurance.  If you start to feel soreness, tenderness, or pain, your body is not tolerating it and telling you to stop.  This applies to all of the techniques listed below.
4. If you have any questions, ask a massage therapist or your doctor for clarification.

Method for Working with Scar Tissue
​The first 2 steps may be done immediately following an injury or procedure.  If there is open skin, I highly recommend applying a clean bandage before beginning, and ALWAYS wash your hands.

1.  First, apply feather light touch to the scar using your hand or fingertips providing heat and healing intention.  This can be done over bandages.  Remember, you are not applying pressure, just resting your hand or fingertips.  Stay here as long as it is comfortable, or until you feel ready to stop or move on.
 
2.  Lightly drum fingers over incision as if playing a piano that needs only a feather light touch.  This can also be done over bandages.  With this technique you will begin with the lightest of touch of there is an open wound.  On older scar tissue, feel free to use a bit more pressure with the tapping, but never so much that it feels sore or tender.
 
For techniques 3-7, feel free to move forward for older wounds/scars.  For fresh wounds or incisions, make sure that it is fully healed before moving on.  There should be no open skin, it should not feel tender, and if you are seeing a doctor, make sure the doctor tells you that it is fully closed.
 
3.  Begin using light vibration to the wound or incision site to the level of tolerance physically or emotionally.  This can be done by lightly patting the incision with fingertips.  You can either keep your fingertips in contact with the skin or not.
 
4. Begin moving the fascia over the scar.  You do this by lightly sinking in either on or around the wound or incision site and begin gliding over the skin.  Think about moving over the skin and not digging in.  You should sink in slightly with your fingertips and palm and then begin moving your hand until you feel like the skin is taut.  Hold with the intention of moving over the skin.  As the fascia (connective tissue) begins to melt, it will guide your fingertips.  Don’t force it.  This can be done in any direction.
 
5.  Create tensile stretch in multiple directions on the incision.  Hold each stretch for 30 seconds minimum.  Basically similar to the last step, but you don’t move.  Just hold the skin taut.
 
6.  Apply fingertip cross-fiber friction to scar.  Place your fingertips on the scar.  Your fingers should not move from the skin that you place them on.  Begin moving your fingertips back and forth over the tissue underneath.  You should move over underlying tissue, while keeping your fingers in one spot on the skin. 
 
7.  Use skin-rolling technique over the scar.  Basically use your fingertips to pinch a chunk of skin.  You should not feel the bulkiness of underlying tissue underneath, only the skin and connective tissue.  While holding that pinch, begin to walk your fingers or thumbs so that the skin is rolling underneath. Some good places to practice this technique to get a good feel of what it is supposed to feel like are the skin over your hands, knees (outstretched is better) and feet.

If you are not a massage therapist and are working on your own scar tissue, please reach out with any questions for clarification.  Above all, the most important thing to remember is that this should not hurt!  I know I have said that a few times, but that is how important it is.  If something hurts, feels sore or tender, or is just uncomfortable, stop.  Ask for clarification if you need it, or wait for a little while and come back to that technique in a day or two.  If you do not feel comfortable doing this on yourself, seek out a massage therapist to work with.