Scar tissue gets such bad press. It is seen as a bad thing. Something to be avoided at all costs. But is that the whole story? Definitely not! Scar tissue is amazing and here’s why you will love it…
Super scar tissue?
Did you know that very few of our tissues can regenerate themselves when they get injured or damaged? Most of our tissues heal by replacing damaged tissue with new, fresh scar tissue. This is one stage of the inflammatory process that follows any injury. But we are getting ahead of ourselves – scar tissue is only half of the story.
Now you’ve torn it…
As soon as tissues are injured, the body springs into action to control the damage. Immediately blood vessels in the area become narrower to reduce blood flow. Within 5-10 mins of injury, those same blood vessels will dilate and get bigger. If any of them have been torn then blood will pass into the surrounding tissues, which is why you get bruising in some injuries. Bruising is simply blood that has leaked into the tissues. But this isn’t the only thing that happens to blood vessels…
Also within a few minutes of injury, the walls of the blood vessels become leaky. They become specifically leaky to the chemicals needed to drive the healing process and they ooze a clear fluid into surrounding tissues. This fluid is what causes swelling in some injuries.
Recovery starts immediately
Next, cells that are always present in our tissues (monocytes) transform into voracious scavengers (macrophages). These macrophages are awesome – they actually engulf and absorb any damaged tissue in the area. This cleanup job prepares the way for the next stage of the process when scar tissue is laid down.
At the same time as the rubbish is being cleared away, the body is laying down a kind of glue that holds the injured tissue together with a blood clot. This allows scar tissue fibres to grow into the clot and bridge the gap. Blood vessels also grow into the clot from about 12 hours after injury to supply nourishment and oxygen to the new scar tissue.
So, over a few days the injury is cleaned up and filled with fresh new scar tissue. This takes a few days for mild injuries and weeks for severe injuries.
The magic of movement
At about 3 weeks after injury, the scar tissue starts to change from standard scar tissue into something much more like the damaged tissue it has replaced. It does this best if it is being moved and stressed just enough to encourage the fibers to get sorted into the strongest and most mobile arrangement they can. But it is a balancing act – too much resting in one position and the scar becomes stiff and sticky; too much movement and the tissues will pull apart and start the whole injury process again. So how much movement is the right amount? Read on!
Get the best healing you can
Here is where a few basic principles can help you to get it right.
- Control swelling – Use ice packs and elevate the limb (if possible) to help the body reabsorb the swelling as fast as possible.
- Move a little – as soon as you can, start moving the injured part gently. Only move in a range that causes you no extra pain. Move in as many directions as you can. Gradually aim to increase the range of these movements until you have full range but never push into pain unless you have been told to by a healthcare professional.
- Move as often as you can – as a physiotherapist I advise people to move an injured part for about 5 minutes every hour throughout the waking day. Little and often is definitely best.
- Do not stretch – it is tempting to stretch an injured part but if you do you are just going to damage the fresh scar tissue and prolong the healing process. Do not stretch an injury until you can work the muscles in the area really hard with no pain or discomfort.
- Mindful return to practice – even with an injury there are likely to be poses that don’t hurt you – these are fine to keep doing in the first few days after an injury. As your pain starts to settle, gradually reintroduce poses or modified poses that cause you no pain. If you have no pain you are not overstressing the scar tissue. Listen to your body and slowly return to your normal practice. It is far better to be too cautious at this stage than rush ahead and re-injure yourself.
When to seek help
Happy, healthy scar tissue is mobile, flexible and strong. Follow these basic principles and you give yourself the best possible chance of a high-quality recovery from an injury. But what if the injury is severe? In this case, you may benefit from the guidance of a rehabilitation professional to get the best results. In the UK your GP or a hospital doctor can refer you to an NHS Physiotherapy Department or you can go directly to a Private Physiotherapist without needing to see a Doctor first.
If an injury is old and continuing to be troublesome you may need to seek professional help. Physiotherapists are also skilled in treating old scar tissue and advising on appropriate rehabilitation to get back to optimum fitness.
And finally
Scar tissue is truly amazing stuff. I love it! I hope you now have a healthy respect for this incredible, natural repair facility that the body has. Here’s to scar tissue and all that it can achieve.
