Scar Tissue Release and Soft Tissue Therapy – What You Need To Know.
Hi, I am Dr. Josh Jagoda, Chiropractor, and soft tissue specialist, and today what I wanted to do was talk to you a bit about Scar Tissue how it forms, and potentially how it can impact you and your pain. After working in the field for more than 10 years as a Chiropractor and therapist, one of the greatest ways to help get someone out of pain and improve their function is through working the muscles, ligaments, tendons, and soft tissue!
What is scar tissue?
Believe it or not but scar tissue actually has a purpose and a function in the body. After you have a new injury that initiates the inflammatory phase of care. This is great in that it starts the healing process. In the first week and even longer, you will not develop scar tissue, but as the body starts to piece together different types of soft tissue, layers of tissue or fibers within the tissue may not line up. In addition, scar tissue is actually a different type of tissue in that the soft tissue may heal in a haphazard or cross-linkage type of pattern. Just for a second, visualize a mesh or checkered pattern. This scar tissue or irregular pattern can adhere to or create adhesions that stick to the muscle. These adhesions are three dimensional and penetrate all parts of the tissue which can prevent muscles from gliding and sliding. Think a muscle or group of muscles that are next to each other or that are layered on top of each other. If there is adhesion and scar tissue, this can cause one muscle to stick or become stuck to another. In some cases, you can get this sticking to nerves which can also cause nerve pain. This sticking can create friction, irritation, pain, and can even cause more dysfunction because scar tissue tends to not have good blood flow (avascular). Since there is less blood supply to that area, it can make healing even harder, and now if you have an injury, reduced motion, scar tissue, and reduced blood flow, it makes healing a lot more difficult. This is one reason many people choose to have there tight muscles, scars, or adhesions worked out.
Is Scar Tissue Bad or Good?
You would think that scar tissue is completely bad but there are some instances where scar tissue can actually be beneficial. First, remember that when you are healing scar tissue can be laid down and serve as the framework, scaffolding, or foundation for new tissue to come in later. Just because it is scarred now, does not mean that it cannot be manipulated or changed later.
Scar tissue can become problematic when it starts to stick to different structures like nerves or arteries or veins that’s where we can see nerve pain or impingements. This is often seen in peripheral nerve entrapments and often times you will see tender, tight, or scared areas that are bound up and can stick to these sensitive structures. Since nerves run down the arm, hands, feet, legs, etc, it can shoot pain into other areas of the body and make this difficult to treat at times.
Scar tissue can have some benefits as we mentioned before as it can serve as the foundation for new tissue to come in. For example, if you injure a ligament it can also be good when we have “functional scar tissue.” Ligaments can be a lot harder to heal since they are a lot deeper structures and there are a lot less vascular. Ligaments hold bone to bone and are necessary for stability for a joint. If you injure one, or even partially tear one, the body can lay down scar tissue and other soft tissue to help bridge the repair. In this case, it can help the healing process and if the tissue works well with the existing ligament, then the scar tissue poses no problem to the person.
Scar Tissue Research
So what does the research say about scar tissue? Well, even with treatment you may not be able to totally get rid of it but you should really care about it is painful and/or function. In addition, right now its really important to note the glide and slide of a muscle. Essentially, do they move well past each other? Muscles and joints that move well past each other have less resistance, flow well, and increase lubrication to the joint. All which is normal and healthy! It is really important to get muscles and tissues to slide well past each other so that you can keep good mobility within the joint, prevent pain, and arthritic like conditions.
What are some treatments to help scar tissue?
The most common name for the treatment of scar tissue is called myofascial release. In our office, we use Active Release Technique or Active Release Therapy as well as the Graston Technique and a lot of people also refer to that as scraping. After more than 10 yrs doing muscle work, I believe that these are very important types of modalities/treatment because Active Release helps to promote soft tissue mobility by pinning down a muscle and actively going through a range of motion. Graston or scraping, on the other hand, helps with a lot of friction, blood flow, and soft tissue manipulation using a tool. We also know this as Instrument Assisted Soft Tissue Mobilization (IASTM).
In addition to myofascial release, a lot of people neglect other modalities such as rehab or mobility training. This is a HUGE mistake! So we prescribe a lot of exercises that help increase your mobility and is very important because this helps to mobilize the joints, soft tissue, and keeps the whole body strong. When you complete exercises and rehabilitation, you’re going to strengthen the tissues in a better state to you’re going to help that irregular scar pattern.
As you continue to exercise, you add better healing capabilities and you slowly start completing your own scar tissue releasing. This eventually helps to heal the body faster as it helps change the alignment of the fibers and smooths out the scar tissue. When you complete Chiropractic adjustments, mobility training, rehab, and work on restoring the normal joint motion, you really are giving your body the best chances to heal.
What you can expect about soft tissue work?
Using soft tissue therapy like myofascial release, Graston, Active Release, etc can really help expedite your recovery because it mobilizes the entire soft tissue and joint complex. When done correctly, you can expect to have 1-2 sessions per week for 10-20 minutes each session. Typically you will go for about 4-8 weeks and after about 3-4 weeks you should notice a considerable difference in how you feel. Many ask if it’s painful… A good session or therapist will not put you in pain to release the structures as this can increase your risk for further injury. You may feel some discomfort but NOT PAIN. The most common side effect is really just general soreness which fades within a few days to one week.
If you are someone interested in getting out of pain, improving your mobility, fixing an injury, or reducing scar tissue, I encourage you to schedule an appointment today by clicking here.
If you are not in San Diego, we can still help you with some of our online programs. Click here to check out Dr. Josh Jagoda’s other website
See you soon,
Dr. Josh Jagoda
Your San Diego Chiropractor