In this blog I explore what scar tissue is, how massage can benefit scar tissue, why and how I know scar tissue hurts, how this helps me as a Clinical Canine Massage Therapist and subsequently how this helps your canine companion.
‘Scar tissue’, is not just the visible area after a wound or an incision has healed. Scarring can occur below the surface of the skin, in the deeper tissues of the muscles, tendons and ligaments that hold the body together!.
When soft tissue is damaged a process of repair starts immediately to protect us from further harm. This repair tissue, aka scar tissue, is made up of haphazardly built collagen fibres instead of neat rows found in original tissue. Scar tissue is less flexible as it does not contain as much collagen, it shrinks as it matures and can cause tightness in the tissues – literally strangling blood vessels, the nerve supply and the lymphatic system. A lack of nutrients and increase in waste, toxins & chemicals cause additional pain and the body enters into the ‘cycle of pain’. Yes scar tissue really does hurt!
The physical act of massage can break down these haphazardly attached cross linked collagen fibres. It helps remodel & reorientate scar tissue to lie in the correct direction! Massage also increases the temperature within the tissues – this assists break down and re-alignment; increases elasticity & flexibility, thus relieving restriction and tightness. I.e. When more blood enters the tissues, it brings more nutrients; the lymphatic system is no longer impeded – so waste is drained efficiently; nerves are reporting & responding correctly; fibres are no longer stuck to surrounding structures and the myofascial network is fluid once again! Subsequently pain is reduced or even eliminated. Wow!
Timing of massage after injury is vital: Too soon and massage may cause further injury but too late – may mean restrictions have already formed, which are then harder to remodel & realign.
Case Study – Me!:
My experience with ‘pain associated with scar tissue’, started in early September 2019. Whilst on holiday in Croatia, I had a ‘minor’ mishap on a moped. I was going round a bend, the bike slid from under me and crushed my left leg – resulting in the visible wounds to my shin & knee seen in the photo above!
I also had a small puncture wound and incredible pain on the inside of my shin / calf muscle. However, I got on with life as I was convinced it was all superficial and just bruising – sound familiar?
Fortunately, I regularly see a physio – shout out to Rebecca Simpson Physiotherapy (https://www.rsimpsonphysio.co.uk) – not only to maintain & manage the health of the muscles in my body but to retune my empathy levels when working as a massage therapist.
I visited her 2 weeks after the ‘mishap’. The superficial stuff was healing nicely but my calf was sore, ached & was still tender to touch. So I asked my physio for a 2nd opinion and she referred me to my GP – as my calf muscle wasn’t healing as expected. Diagnosis – I had a deep tissue infection around the area of the tiny puncture wound!
After 2 weeks of antibiotics, a bruise appeared and started to clear up nicely but this then highlighted another problem within my calf. The surface of my skin looked pale in comparison to adjacent areas, it felt hard, lumpy and cold but numb to touch & painful on pressure. In other words, I was ‘feeling’ the consequence of the blood & nerve supply being hindered and waste removal not occurring all because of the scar tissue that had developed. Photo below.
Another trip to my wonderful physio was required. The area of scar tissue measured an area of 9cm by 4cm and we judged roughly 2cm in depth.
The weight & impact of the moped had crushed my calf muscle to such an extent that I had sustained an equivalent of a grade 2 (moderate) to a grade 3 (severe) strain in my calf. This means the muscle fibres in my calf had received sufficient trauma to cause between 50% to 100% of them to be severed ……..Ouch!!!!!!
Could I just treat myself and utilise my training in scar tissue remodelling techniques?
As a massage therapist my hands/fingers are finely honed AND very perceptive. They are trained to detect whats happening in the tissues of a body and report this information back to my brain for interpretation.
In addition to this my leg was feeling pain on light touch, let alone any form of manipulation!
The outcome meant my brain was receiving 2 sets of information – as a Therapist and then as a client but they were contradicting one another. Scar tissue hurts and to heal effectively, I had to allow my brain to process data it was receiving as a client not as a therapist.
Various Swedish, deep tissue and scar tissue remodelling massage techniques were used on this area over the next 6 months.
By February 2020, the scar tissue had reduced to a point that it could no longer be measured – Awesome!!!!!
I can now work on my leg myself. After extended periods of exercise (I am a professional dog walker and currently training to walk the Camino) – my calf aches and feels like its ‘pulling’. I have minimal scar tissue, where my calf muscle overcompensated for the injury but the blood, nerve and lymphatic systems in the muscle still need stimulating as the area congests quicker than before.
Scar tissue hurts – I can testify to that!
Initially, any massage over the scar tissue area caused immediate intense, deep pain and nausea. Afterwards, my calf was very sore for at least 48hours – it felt as if it had been bruised all over again! I could barely tolerate light touch not just from pain perspective but because it was numb on the surface. I struggled to keep still and the urge to pull away was overwhelming, as I tried to protect my leg. I however could speak to my physio and tell her when I had had enough. I also understood why I needed it, so persevered in each treatment as I knew it would help.
After 6 months, massaging over the area can still be sore and uncomfortable rather than the intense sickening pain, but mostly it brings relief.
Lets summarise :
- Scar tissue hurts!. I can personally vouch for that!!!
- Scar tissue occurs in response to any type of tissue damage – generally through injury, trauma, surgery or disease.
- Scar tissue is not always visible.
- Scar tissue is restrictive – less flexible & elastic. It affects the muscle fibres, myofascial network, blood vessels, lymphatic system and nerve supply. It also causes functional impairment via splinting & overcompensation on adjacent muscles and joints.
- Scar tissue is not as strong as original tissue and therefore there is a high chance of re-injury.
- Massage is good at reducing scar tissue.
- Massage is good at re-aligning scar tissue.
- Massage is good at improving health & condition of the tissue. Restores blood & nerve supply, stimulates the lymphatic system and fluidity of the myofascial network.
- Massage improves the flexibility and elasticity of scar tissue.
- Massage breaks the strain/restrain cycle and the pain cycle.
Why this is important to you as a dog guardian?
As a ‘client’ – my calf muscle and brain appreciate what it feels like to have scar tissue painfully massaged! As a Clinical Canine Massage Therapist – my fingers, hands and brain can identify dense scar tissue and the effect it has on the muscle.
This means, my empathy radar is finely tuned to appreciate another dimension of pain perception and therefore, I am able to utilise this experience in the treatments I provide for your dog.
Our canine companions communicate pain through their body language but even then they are very good at hiding it! They love being with us and want to please us with every woof and wag. Subsequently, signs of muscular pain can be sometimes be mistaken as signs of ageing or ‘just something they do’. The reality is however, that muscular pain can be caused by numerous things from normal repetitive activities of daily living (think RSI in humans) to chronic orthopaedic conditions such as arthritis – all which in many different ways create scar tissue. Remember Scar tissue hurts!
I can support you, your dog and your dogs vet, in developing a suitable health care/rehabilitation/pain management plan according to their individual needs. Scar tissue treatment requires time, patience & understanding.
For more information on what Clinical Canine Massage is – check out this page on my website: https://momentumcaninemassage.co.uk/what-is-clinical-canine-massage/
‘My aim at Momentum Clinical Canine Massage is to help your dog enjoy being a dog for as long as they can – whatever that means to them.’
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