Scar Management

What's the difference between undamaged tissue and a scar?

This explanation is about external scars that are visible, even if sometimes hard-to-see. When surgery has been performed, or other damage has occurred, scar tissue forms not only on the skin but on all the internal wounds as well.

Undamaged tissue

There are many layers to our tissues. First, the skin, which is relatively thin; then superficial fascia, a fluffy fat-filled connective tissue; then deep fascia, a tough fibrous membrane; then muscle, and deeper still, depending on where on the body we are, bone and/or organs. All of these are connected by, enveloped and interwoven with connective tissue. Without damage or surgery, all these of layers are able to move freely, sliding over each other in whatever movement our body makes.

undamaged tissue illustration

Smoothly gliding layers of normal tissue.

Damaged or scarred

Collagen is the main component of that provides strength to healing wounds. Collagen is very strong, but not elastic. When not manipulated, a scar will typically be denser and less moveable than normal tissue.

The illustration shows the binding effect of a scar. Instead of sliding smoothly and easily over each other, the fascial layers are stuck down through the layers. This binding effect can restrict motion both nearby and in distant structures in sometimes subtle ways.

damaged tissue illustration

Scar tissue binds layers, inhibiting movement

"Wound contraction is a normal part of healing and involves migration of wound margins toward the center. Some wounds continue to contract after closure, and a disfiguring scar or disability results. The ability of a wound to close depend in part on the flexibility of the surrounding skin. ... Contractures may interfere with joint mobility or with other body movements, such as breathing and head movement. They can occur in any area, in skin, and in subcutaneous tissue as well as after bone fractures and tendon, muscle, or nerve injuries."¹

Self-Care for Scars

Without good mobilization, the tissue layers can stick together, restricting the movement of the fascia layers, and consequently can affect movement of nearby joints and underlying or even distant structures. Once your wound has fully healed, it can be manipulated, even if it is painful at first. Gradually, with manipulation, the area will become less sensitive and more flexible.

Ways to improve a scar naturally

Even mature scars that are decades old can benefit and improve with regular manipulation. If you work with your scar daily, it will change rapidly in both appearance and comfort.

Although the scars illustrated are linear incision-based scars, these techniques will also work with large matted scars such as those from third degree burns or radiation therapy.

1. Movement of tissue in a circular direction over underlying tissue or bone. You must use enough pressure to move the scar tissue. "Putting on lotion" pressure is not enough. All of these techniques will work better if NO lotion or lubricant is used, as the movement itself is what accomplishes your goal.

scar pressure illustration

1. firm circular pressure

2. Sideways pressure. Be sure to go in both directions.

scar pressure illustration

2. Sideways pressure

3. S-Shaped pressure. Do this in both directions, the whole length of the scar.

scar pressure illustration

3. S-Shaped pressure

4. Skin Rolling. This also works very well for puncture wounds such as those for arthroscopic surgery. Pick up the loose layer of skin around the scar, and roll in all directions so that you're also picking up the scar itself.

scar pressure illustration

4. Skin Rolling

scar pressure illustration

4. Skin Rolling

What Mechanical Link does for scars

Having highly developed sensitivity in the hands, an ML practitioner can determine if a scar is causing a problem, and which part of the scar is contributing most to a dysfunction. Sometimes, it is not the scar itself, but the skin nearby which has been affected by the tensions created by the scar.

ML treatment of scars and skin is much faster, gentler, and less painful than the techniques shown above.

After treatment by recoil, the scar will gradually improve in appearance and rapidly improve in comfort. While the skin will never regain normal pigmentation, angry red scars will fade and although still visible and unpigmented, will move and feel like the rest of the body.

In the practice of ML the following correlations are frequently found: urinary tract dysfunction and chronic pelvic pain related to gynecological scars or appendectomy; neck pain related to face lift scars; frozen shoulder and other upper extremity problems related to heart or breast surgery right hip and/or knee pain related to appendectomy.

scar before

Mature scar after liver surgery. Healing by second intention.

scar after

The same scar, after 4 treatments, spaced months apart.

scar before

Hysterectomy scar 2 years after surgery and 24 Visceral Manipulation treatments, spread over 3 months.

scar after

The same scar 2 years later after 6 Mechanical Link treatments. After the first Mechanical Link treatment, patient reported that her "bladder holds more, and empties more completely."

¹Pathophysiology:Adaptations and Alterations in Function, Barbara Bullock, R.N., M.S.N., Philadelphia: Lippincott 1996 p. 309