This content was updated for accuracy and relevance on 1/3/24.
Long after the short term effects of surgery have subsided, many people are left with scar tissue. Scar tissue forms as a mass of cells and collagen that forms under the skin. This can cause pain, limited range of motion, and unsightly marks on the skin. The good news is that scar tissue treatment can be modified in a variety of ways with skilled therapy. Each method of rehabilitation physical therapy is designed to reduce or eliminate the tissue restriction that is causing pain. It can also even out a cosmetic imperfection that may be caused by underlying tissue.
What is Scar tissue?
When you undergo a surgical procedure, injure a muscle or tendon, or cut your skin open, your body’s inflammatory system will take over to begin the tissue healing process. This process involves creating new cells to replace the ones that were damaged. Some of the new cells that are created are formed with collagen. Under normal circumstances, this would promote strength within those tissues.
However, when the body undergoes trauma, such as surgery, skin wound, or significant injury, those collagen cells can clump together in an abnormal way, and scar tissue forms. Scar tissue has a different composition from “normal” connective tissue. It can harden, shrink, and interfere with normal tissue mobility.
Does that mean you have to live with damaged tissue for the rest of your life? Not exactly. While some scar tissue will never go away, oftentimes, if treated properly, the injured tissue can be remolded to resemble normal, healthy tissue. This can restore normal tissue behavior and provide pain relief in any area of the body, even pelvic muscles following the birth of a baby.
Scar Tissue Treatment & Management Tips Post Surgery
Post surgical scarring is a natural part of the body’s ability to heal itself. However, excess scar tissue can limit movement and cause pain. By focusing on the things you have control over you’ll be giving your body the best chance for successful surgical scar healing.
Taping the scar area
Taping the scar area after surgery could minimize the risk of the scar growing in size. Using tape to aid in surgical scar and wound healing will make the biggest difference when done right after surgery and continued for the first few weeks. This is something you’ll want to go over with your doctor to make sure you are applying the tape correctly and not causing any additional irritation to the affected area. Physical and occupational therapists can guide you in the correct technique and type of therapeutic tape to use.
Use silicone sheets or rolls
Silicone sheets or rolls, often found in the first aid department of your local drug store, can be cut to fit right over the affected area. Be sure to remove the silicone before washing or getting it wet.
Don’t smoke
Smoking can actually slow down the wound healing process while increasing your risk of scar tissue formation because nicotine restricts blood flow to the incision. This will prevent the cells from getting to the area to begin the healing process.
Get enough Sleep
Get enough sleep so your body can take it’sits time to heal and repair. Having enough sleep also plays a crucial role in minimizing inflammation and promoting collagen formation.
Be mindful of your diet
Diet can play a factor, so experts suggest limiting alcohol (as it causes dehydration) and increasing protein-rich foods which can help your skin heal.
Limit sun exposure
Limit sunlight exposure because a sunburn may darken your scar. Shielding your scar from harmful UV rays helps prevent discoloration and promotes a healthier and less noticeable healing process.
Bathing
Your surgeon will give you detailed instructions. However, you should avoid soaking or putting soap on your wound until your incisions or adhesions have healed.
Movement
Follow your physician’s advice on any restrictions. If there are none, be sure to slowly stretch through full movement when you have the green light to do so.
Massage
Another method to prevent stiffness around the scar tissue is to massage the skin following the direction of the scar. To see the best results, it is recommended to have a scar tissue massage for ten minutes twice a day.
Vibration Devices
The most common form of vibration therapy can be conducted by using an electronic massager for scar tissue pain relief caused by overactive nerves. These devices work to desensitize nerves that could be contributing to muscle tension and stress.
What are the best methods for scar tissue removal?
Scar tissue can be painful, limit your range of motion, and leave long-lasting and unsightly marks. But, there are a variety of scar treatment methods that can help reduce or eliminate surgical scar tissue. Here are a few options:
1. Manual Therapy
Manual therapy – Applying the right force in the right direction can prevent tissue restriction. it can also re-organize the collagen fibers before they are mature and unchangeable. Timing is important!
2. Topical Solutions
Topical solutions – Depending on the severity of the scar, it may respond positively to a topical solution. This is a viable option for many people who have minor scarring.
3. Laser Therapy
Laser therapy – Laser therapy is less invasive than surgery, however, it requires multiple laser treatment sessions over a period of time.
4. Surgery
Surgery – It might sound unusual to have scar revision surgery to remove the effects of a previous surgery, but scar tissue on the skin could be reduced or eliminated through a cosmetic procedure. Scar tissue removal is a more common choice among people who have suffered severe burns or intense accidents. Of course, with any surgical procedure, there is a risk for additional scar formation. You should always consult with a trusted healthcare provider before proceeding with scar tissue removal surgery.
5. Compression
Compression – Compression wraps (found at any drug store) can help decrease the inflammation around the affected tissues, while also reducing pain. Again, you should be sure to consult with your healthcare provider before applying any kind of pressure to the affected area so you don’t cause any additional irritation. Other types of therapeutic compression include prescriptive garments with symmetrical pressure. This can be used for a deep burn, or as compression to assist circulation around a healing wound bed.
6. Steroid Injection
Steroids are injected into the keloid scars which can help decrease the scar tissue pain. Steroids are a powerful anti-inflammatory, but injections could also damage the surrounding skin which may slow down the healing process.
Can you massage away scar tissue?
Under the right conditions, scar massage and manual therapy techniques can significantly impact scar tissue release. It is important to note that your scar must be fully healed before you begin any type of scar tissue massage therapy. If you begin too soon you could cause the wound to reopen or tear, which could cause chronic pain or lead to an infection.
Using scar massage techniques will be most effective in the first 2 years, while the scar is still forming. During this timeframe, you may notice significant benefits to massaging scar tissue, including:
- Improved blood flow to promote scar healing progression
- Increased range of motion, making the scarred area not feel so tight
- Reduced swelling by draining excess fluid
- Less scar tissue build up, which can reduce muscle stiffness and weakness
- Reduced sensation of numbness and tingling
Massage can reorganize scar tissue, helping your body heal faster, and potentially reduce the appearance of your scar. After consulting with your healthcare provider, you may want to try massaging your scar at home. Here are a few tips to ensure it is done properly:
- Gently apply a lotion or oil that contains vitamin E. This has been known to build collagen fibers. Essential oils like rosehip and frankincense can also be used. However, be sure to double-check with your healthcare provider.
- With your thumb or index finger, begin massaging in a circular motion. Press firmly, but never to the point where it’s painful.
- Slowly maintain a circular motion around your scar, then switch and rub in the other direction. This alternating motion will help to drain excess fluid from the area.
- Repeat the process several times throughout the day.
Does internal scar tissue go away?
Scar tissue can build up over time for a variety of reasons. These include injuries such as sprains, strains, overuse, or trauma, surgery, or simply by prolonged daily movement. Most commonly found in joints, tendons, muscles, and soft tissues, scar formation begins to cause stiffness, aching, and pain. You’ll notice the stiffness and chronic pain you once felt will subside once the scar tissue congestion is removed. This will allow for more freedom of movement.
There are certain stretches and exercises that can be performed to help aid in this soft tissue therapy process. This is where a physical therapist can really help. Physical therapists will create a personalized manual therapy, exercise, and stretching routine that you can do at home.
How do you dissolve scar tissue naturally?
If you have tried all other options or are just looking for a safe and natural method to reduce or eliminate your scarred tissue, you can try a few non-invasive treatment methods at home like:
- Get moving as soon as your doctor gives you the green light. This can help prevent stiffness from occurring.
- Stretching will help restore your natural tissue length.
- Massage techniques mentioned above can help with scar management.
- Using natural remedies to remove scars
How can physical therapy help with scar tissue?
Severe injuries and excessive scar tissue can directly affect your muscles and joints by reducing your range of motion in those areas. This is where physical therapy can have a huge impact.
A physical therapist will develop a plan that includes specific exercises designed to strengthen your muscles and joints so that you can move more freely and without pain. These custom plans are especially helpful if your scar tissue affects your back, abdominals, and limbs. These are all areas that require frequent movement.
Once your scar tissue has fully healed, your physical therapist can begin administering manual techniques. Hands or instruments are used to help encourage the injured tissue to stretch out.
Depending on the location and severity, your physical therapist might recommend a scar tissue treatment on your joints called the IASTM (Instrument Aided Soft Tissue Manipulation), also referred to as ASTYM or Graston. With the pressure of the tools used in these techniques, mechanical changes at the cellular level can and do occur in order to normalize scar tissue as much as possible.
Physical therapy can be a safe and effective option for treating scar tissue. If you have concerns regarding chronic pain in your joints or muscles, an upcoming surgery, or questions about how to get rid of scar tissue, give us a call or request an appointment to discuss your options.
Article by: Holly Lookabaugh-Deur, PT, DSc, GCS, CEEAA
Ivy Rehab
Holly is a practicing physical therapist, partner and Director of Clinical Services at Ivy Rehab Network. She has more than 40 years of experience in sports management with young athletes, and is board certified as a geriatric clinical specialist and certified exercise expert for aging adults. Deuer is certified as an aquatic and oncology rehabilitation specialist and serves as adjunct faculty at Central Michigan University and Grand Valley State University.
