What is scar tissue?
Scar tissue is connective tissue — mostly collagen — that forms when the body tries to repair damage to the skin or internal tissue, for example after an injury or surgery. Whenever an object goes through the skin, a scar is formed. But scar tissue can also form under intact skin, for example from a muscle strain. The visible scar after surgery is just the tip of the iceberg. Almost all scar tissue caused by keyhole surgery (e.g. laparoscopy or arthroscopy) lies under the skin. The scars in the skin are sometimes not even visible after a few years, but they can always be felt with the fingers. In most surgical procedures in the abdominal region (including caesarean sections), the surgeon has to cut through five layers of muscles and membranes in addition to the skin. A scar develops in each layer. The picture above shows scars from two common surgeries in the lower abdomen: caesarean section and appendix removal. The formation of scar tissue typically continues for up to 2 years after tissue damage.
What does scar tissue do?
Scar tissue is always less elastic than the original undamaged tissue. It can also stick together muscles or membranes, which normally slide freely past each other. Scar tissue can therefore restrict the mobility of structures in the body, such as joints, organs, membranes, nerves, and lymph and blood vessels. Since everything in the body is connected by fascia (membranes), a scar can disturb the balance in the body even at a great distance. Scar tissue pulls the surrounding tissue towards it, but usually you are not aware of this. Your brain tries to prevent the pulling of the scar from causing you pain or discomfort by adjusting your posture or by tightening muscles or fascia. In this way, a scar can cause many ‘inexplicable’ symptoms. This is why I always ask my clients about injuries and operations and check whether scar tissue could be a cause of the symptoms. Even a surgery in the first year of life can cause symptoms in adulthood, which can be remedied or reduced with scar massage.
Massage of scar tissue
Massage of scar tissue is not aimed at destroying the tissue. With fresh scars, this would counteract the healing process. Old scars cannot be ‘broken’ with massage, as collagen is as strong as steel. However, it is possible to use massage to make and keep scar tissue supple. Furthermore, scar massage can also promote the gliding of adjacent layers of tissue, which can, for example, easily stick together after surgery. Skilled scar massage supports the healing of fresh scar tissue and reduces the risk of adhesions. In case of old scar tissue, massage restores its mobility and elasticity and can also reduce adhesions. I have successfully massaged fresh scars, even before the stitches had been removed, as well as scars that were dozens of years old. What amazed me the most was how the massage of scar tissue, caused by an operation undergone as a baby, made long-term symptoms disappear in one of my adult clients. Moreover, it is amazing how a gentle, painless massage can effect big changes in tough scar tissue.