Scar Tissue
One of the most common and frustrating soft tissue problems are those re-occurring injuries and the main reason for that is scar tissue. Pulled muscles, sprains, strains and tears commonly come about through lack of conditioning , and limited warm up and stretching and often when the muscle is under load in the stretched position. So these things need to be considered in the rehabilitation phase.
The way you rehab the soft tissue will have an affect on the likelihood of a re-injury. Everyone is aware of RICE as the initial treatment: ( R ) rest, ( I ) ice, ( C ) compression, ( E ) elevation. But adding another ( R ) for Referral to appropriate medical treatment. Is essential. The first 24 to 72 hours are crucial to your recovery and the formation of scar tissue. As you can see from the diagram below, the difference RICER makes to a soft tissue injury.
Diagram courtesy of Dr Barry Oakes, Monash University, Victoria Australia
The problem with scar tissue is that it is made from brittle, inflexible fibrous material that binds to the soft tissue in an effort to draw the tissue back together. It also develops in a cross-hatched way to add strength not in a smooth one directional way as the muscle tissue might be, therefore it loses that flexibility that the muscle has. This injury site is now a weak spot in the muscle tissue and when loaded up as in exercise it has a tendency to re-injure. It also compromises the performance of the muscle (strength and power), because it isn’t as strong or flexible as before.
What to do??
The first step to reducing scar tissue is the above treatment of RICER within the first 72 hours, after that it’s massage time!! Deep tissue massage can help break down the already formed scar tissue but it can also help realign new scar tissue in an attempt to create a more uniform scar and therefore the scar will have less impact on the performance of the muscle in the future.
Obviously the first few massages will be lighter as the injury site will still be tender, but as your tolerance builds the massage needs to be firmer and following the direction of the muscle fibre.
If you can get to the injury site yourself, some self massage will be beneficial as the more regular the better (eg: once a day with lighter pressure, every second day with firmer pressure).
The use of heat first to warm the muscle tissue can help as well as the use of an anti-flamme crème or arnica can assist healing. Drink plenty of water to help flush out the waste products produced by the massage.
For older scar tissue your therapist will probably do some cross-fibre friction across the scar tissue to help break down the cross-hatch of tissue and then smooth out with with-fibre strokes.
Finally, getting back into your sport, exercise or recreation should be done at an easy pace with lots of stretching, strengthening and conditioning and recovery time (and of course massage).
So don’t delay when you have a strain, sprain, tear or pulled muscle get to your massage therapist within a week of your injury for best results!
Welcome Viv Butler!!
Viv is our newest member of the Balance Team.
Viv has a Diploma in Therapeutic Massage (2008). She recognises the importance of regular massage and enjoys working alongside her clients with a whole body approach to relieve pain and muscular tension
Viv is also interested in injury prevention & general wellness massage.
Viv is available on a Monday, Tuesday and Saturday
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