Scarred for life? (Alain Michelotti DC MCSP)
Scars, also called adhesions when situated deep in our body, are an inevitable fact of life. They are the results of the body’s healing process. The tissue involved in the process of scarring is called the connective tissue. “Connective” because it connects, supports, binds and separates other tissues or organs.
When we injure ourselves, the repair process has to happen quickly. Because of the emergency of the response, the tissue produced is not of the same quality as the original one. Instead of a good, strong “patch” of well-aligned fibres, we end up with a lower quality tissue, looking more like a game of pick-up sticks. The poor quality of this new tissue results in poorer functionality. For example, somebody with a poorly healed ankle sprain or a pulled muscle will be more likely to have a recurrence of the same injury.
As living creatures we are very exposed to traumatic events such as sprains and strains, pulled muscles and torn tendons. These injuries will heal with the inevitable scar tissue. In addition, the healing process resulting from any inflammation and infection will also result in the formation of some scar tissue.
Surgery, particularly abdominal and pelvic surgery, is also a cause of internal scarring, called adhesions. The problem is that these adhesions can squeeze organs, diminish the blood flow, trap nerves and reduce or impede the mobility of organs. The end result usually involves discomfort, pain and reduced mobility.
If we imagine our body as a structure delicately balanced between ‘elasticity’ (the skin, the muscles, the connective tissue) and ‘rigidity’ (the bones), we have a very smart design allowing stress to be distributed equally throughout the structure. The end result is flexibility and stability. As soon as there is scarring or adhesions anywhere in the body, this delicate balance is compromised. This in turn results in us ‘cheating’ and compensating e.g. if we cannot turn our head, we will turn our body.
When scar tissue is formed it often traps other important structures in the area such as small nerve endings and blood vessels. Trapped pain receptors can cause a scar to remain painful long after the injury has healed. This is often the case with coccyx pain (pain in the tail bone after a fall on the buttocks). During the healing process other receptors may be disturbed by the surrounding scar tissue and this may prevent the brain from receiving the correct feedback allowing it to control properly how we stand and move.
Fortunately, there are ways to mitigate the damage and to redress the balance. The most important thing to remember is that although it is important to give an injury time to heal, it is just as important to start the rehabilitation process as early as possible. We are designed to move and lengthening the period of immobility is not helpful. This is why in the case of a mild whiplash injury, for example, neck collars are only advisable in a very limited number of cases and for as short a period as possible.
Physical therapists, including chiropractors, can help by monitoring any healing process whether of an internal wound, the skin, a muscle, a tendon, or a ligament and will progressively introduce soft tissue work (superficial or deep massage) and gentle passive, active and resisted exercises. This will improve the quality of the scar tissue and restore functionality by increasing mobility, flexibility and strength.
Scarred for life? Not necessarily, if you take the right steps at the right time.