In the second part of a series of blogs about the different therapies that I use here in clinic – this looks at scars and ScarWork. Claire from Restoring Balance is one of a few hundred practitioners in the UK that work with scars, and one of handful that combine ScarWork and Functional Neurology together.

 

What is ScarWork?

The benefits of treatment for scars is becoming more widely known –  this is great, however it takes great skill to work on a scar in a safe and effective way that allows your nervous system to feel safe.  It is very different to conventional massage. It can be one of the final steps in the healing process.

Scars are one of the body’s ways of repairing itself. If skin is damaged, your body works to form fibrous structures to mend the wound. Scar tissue contains more fibrous tissue and collagen deposits than normal skin, making it structurally and functionally different from the surrounding skin.  Scars can feel tight, numb, red or raised. Sometimes they may feel sore.

Scars are like icebergs.  We only see the small part of the scar that is on the surface.  Whilst your scar my look neat and tidy to the naked eye, often underneath the skin is a story of disorder and chaos.  Scars have a profound effect on the body – especially the fascia. Scars are often the missing piece in the pain puzzle, clients often present with a pain, restricted movement, numbness and tingling. There is often a pain pattern that links to a scar elsewhere. 

Iceberg1 Fascial Pull

 

Why is my nervous system important when working on my scar?

Each time we gain a scar our body stores it in our nervous system as another layer of trauma that we need to process.  Quite often we don’t always get a chance to rationally process our emotions particularly if the scar came through an accident or an emergency surgery. 

When this happens your body goes into hyper vigilance – it thinks it’s being chased by a sabre tooth tiger all the time.  It doesn’t matter whether you’re in the gym or doing the shopping, your body is in a state of alert all the time. 

Sometimes this is so strong it makes feel that we are unsafe if touch our scars.  You may feel disconnected from the area of the body that has been operated on, and that is ok – working together I can help you re-connect with your body in a safe and supportive way.

All of the clinical practice here at Restoring Balance is built upon your nervous system feeling safe – it can be a journey of acceptance and re-connection, where I’ll hold space for you to do this. 

 

What are adhesions?

The body is amazing, everything is connected by something called fascia.  As skin heals after an operation or accident, sometimes the different layers under the skin get stuck together (adhered) as the body tries close and heal the wound.

Internally scar tissue can be far reaching, adhesions and fibrosis can leave your body having to work harder to perform movements.  The functional muscles, ligaments and fascia get exhausted and tired, pain and inflammation is also a common factor. Irritation and fatigue in the healthy structures of the body, which trying to make up for the lack of mobility as a result of the scar.

The power of the scar is that they don’t just cause issues locally near the scar.  Scars also cause a break in the electrical circuits that sends messages around the body, this can change how messages from our brain through our nerves to muscles to generate movement. This break can cause issues elsewhere in your body, – particularly with your breathing mechanics & pelvic floor; or make your shoulder hurt for no real reason.  That’s before we even get to visual and emotional impact of your scar.

ScarWork stimulates the area and the movements used encourage further natural healing to take place. Helping to release the stuck layers to allow for better function and movement in the scar and surrounding tissues.

ScarWork is used to improve feeling and functionality in the scar and surrounding tissues, creating better movement between the layers of the skin, connective tissue and muscle.

Tightness in surrounding tissues can be reduced, helping restore normal muscle function. Knots and tight, ropey scars are often softened and loosened and ridges and holes may be minimised.

Visually scars often appear smaller, flatter, lighter and less prominent but the emphasis is on the underlying tissue changes. Dense scar tissue can reduce, nerve impairment such as numbness, pain, itching, irritation or extreme sensitivity may improve.

Knots Ropes

 

Is there a psychological impact of scarring on a person?

Scars affect everyone differently, so it’s impossible to give a one size fits all answer.  There is often an emotional connection to a how a scar was gained; for others there is a greater attachment to how the scar looks visually.

I understand this is from my own miss-adventures leading a series of nasty cuts to my face.  It’s really difficult to hide scars on your face.  Initially I was convinced that everyone was staring at my scars as they were quite red and they affected how I spoke, it really damaged my confidence. Now they’re barely noticeable. Read more about how my scars affected me here.

 

Can you change how my scar looks?

Your scar will always be there, it will never disappear, but it may be possible to change some of the visual impacts of your scar – making it flatter, softer, less lumpy and even less sensitive.

 

How can ScarWork help me?

Scar work is beneficial for nearly all scars; here are the things that I look at when assessing your scars

  • How close the scar is to a tendon or muscle: A scar may get stuck or adhered to the surrounding tissue such as tendons and/or muscles. As tissues heal, scar adhesion can make movement more difficult.
  • Closure of the wound: Different types of wound closures have subtle differences in how the wound heals due to tension and torque.
  • Shape of the scar: If your scar is from a surgery, it is usually a thin line. If scar is from an accident, it may be irregularly shaped and/or vary in depth which can make healing challenging and you feel the scare is unpleasant for to look at.
  • Type of scar: As skin heals, it shrinks slightly and can cause pain and interfere with motion.  Hypertrophic scarring can occur causing scar tissue to form outside the normal borders of the wound.  Keloid scarring can also occur which causes a large, raised scar.
  • Sensitivity of the scar: Skin is used to being touched by different textures during the day such as clothes, jewellery, and resting surfaces. After an injury or surgery, the wound area is covered for a short amount of time to keep it clean and protected.  During this time, the skin can become hypersensitive.  This can be very painful, cause you to protect your scar during use, and may also affect your sleep.
  • Effect of the scar: how the scar has affected you both emotionally and physically. Working together we’ll check that your breathing mechanics are working fully, as they are the foundations of good health, and without them working well we’ll struggle to achieve changes, from there we’ll look at movement and movement patterns.

Types of wound closures

Treatments are gentle, making them ideal for children or anyone with extremely sensitive scars. A scar can take up to two years to reach maturity and fully heal.

All kinds of scars from very old to newly healed (once you have been discharged by your doctor) can be treated using ScarWork. The scars could be the result of an accident, operation or scars from:

  • Abdominal surgery
  • Achilles tendon surgery
  • Amputations
  • Appendix or gall bladder removal
  • Breast surgery
  • Caesarean section
  • Childhood injury
  • Facial scarring
  • Foot Surgery
  • Hysterectomy
  • Joint replacements
  • Orthopedic reconstruction – pins and plates, tissue grafts
  • Piercings
  • Scars from life misadventures
  • Spinal surgery
  • Tattoos
  • Tube/drain sites
  • Tummy tuck surgery
Thigh scar Abdo scar Hand Scar Knee Replacement Scar

 

Is this something I can do myself?

Absolutely yes, but first work with a skilled therapist who can identify the correct techniques for your scars and coach you how to use them appropriately. Depending on how your wound was closed, will depend on the techniques used as they each create their own areas of tension and torque during healing.

ScarWork isn’t available on the NHS currently as it is viewed as a cosmetic rather than a medical problem, although many NHS trusts are starting to recognise the many benefits of this type of work.

 

Wrist Scar

 

How can I help?

Claire is a Health, Wellbeing and Rehabilitation Specialist at Restoring Balance; a sports scientist who is also a multi-disciplined therapist specialising in person-centered care.   Claire is trained specifically trained Sharon Wheeler’s ScarWork (and specialist training for MSK scars), Functional Neurology and Neuro Muscular Testing.

Claire has a refreshingly different approach to health, wellbeing & rehabilitation using a unique combination of movement, nutrition & mind to help you with your recovery by:

  • Understanding the changes your body has been through
  • Increasing mobility
  • Improving balance & stability
  • Improving co-ordination
  • Calming your stress & anxiety
  • Improving your digestive health
  • Balancing your hormones
  • Changing your mind set and emotional health
  • coaching you to breathe effectively again
  • supporting your recovery with nutritious & nourishing foods
  • Changing your relationship with your scar

 

References:

https://www.britishskinfoundation.org.uk/blog/the-benefits-of-scar-massage?fbclid=IwAR2ZfN7MzY4n4CdDu6UvtSftblie_WIjRoeAeg4t09bunE1kXuNccy4FP7o

https://pubmed.ncbi.nlm.nih.gov/24630820/

https://pubmed.ncbi.nlm.nih.gov/17435407/

https://pubmed.ncbi.nlm.nih.gov/10850898/

https://pubmed.ncbi.nlm.nih.gov/8736373/

https://www.assh.org/handcare/blog/advice-from-a-certified-hand-therapist-scar-management

https://www.assh.org/handcare/condition/scar-treatment

https://www.eurekalert.org/pub_releases/2018-02/uops-pad012518.php?fbclid=IwAR3MDSrMYYvek0KSszki9QJnBBnfPt8heHhCen57Hjh3rUBc3oN1EhPXoCQ#.Xe6qlzM0KZk.facebook

http://www.fascialfitness.net.au/articles/effect-of-scar-tissue-massage-after-thyroidectomy-on-neck-discomfort-and-voice-changes/?fbclid=IwAR0MQdcHz4I705RD2-u07Ykq14vW0qp9JRqpFQuIxzJe8hxGjBvPNkxVhn4

https://www.theguardian.com/lifeandstyle/2019/aug/18/how-to-minimise-scars-caused-by-acne-or-injury?CMP=Share_AndroidApp_Copy_to_clipboard&fbclid=IwAR2KrdVDPtZD0KkM2hRG91LYuA_HReRqDeatPBp6KfoxlMEQ-mj7foN_Ly4

https://www.sciencedirect.com/science/article/abs/pii/S0140673619326364?fbclid=IwAR2qqyj-gY-VAVVqQz0xhprZs010S-ilirwQeNlxzNMqB9SXX4mjOQl6R3U

https://www.jingmassage.com/blog/scar-tissue-release-for-emotional-and-physical-healing-by-rachel-fairweather-published-by-massage-world-magazine/?fbclid=IwAR10I54-4C9VQWIWAKZ-Yj6aQ5kLCMkFkUAyElswrm0XNOyLKk_DpJ5igcY