Scar Tissue: Where and how?
Why do I have scar tissue?
Scar tissue is simply a body response. Our bodies are constantly busy breaking down or regenerating itself, even during our normal daily activities.
Can you believe that the epidermis regenerates itself every 28-30 days! This is vital for the growth processes of your body.
Every small action causes micro-tears in muscle and connective tissue, after which the body rushes the needed chemicals and cells to the area to
do the repair job! Our bodies are so vibrant, clever and adaptable, what an amazing work of artful engineering...
If we take care of our bodies, they function in ways that engineers can scarcely imagine. Enough exercise, healthful eating, good clean air and
growing our minds will keep the regeneration going, as also in the case of healing scar tissue.
A Case Study
This time, exactly a year ago, I had a very big operation on my leg. I broke the top of the femur bone, right under the knee cap,
shattering it into little pieces. My leg got caught and was twisted, after slipping on a flight of stairs, between two open ended steel steps.
Major surgery followed, and then a very long and painful rehabilitation process, being left with a knee that cannot bend more than 55 degrees and lots
of...guess what? Inner scar tissue.
The busy bees in the body
Millions of tiny, tiny cells in the body are constantly working to help the body to grow and develop. Other cells are the
“supervisors”, creating the systems for the millions to do their work. All of these work on scar tissues to heal trauma to the body.
What exactly is scar tissue?
According to Merriam-Webster, (the online version), scar tissue is:
the connective tissue forming a scar, and composed chiefly of
fibroblasts in recent scars and largely of dense collagenous fibers
in old scars.
Brittanica.com defines a scar as:
A mark left on the skin after a wound heals. Cells called
fibroblasts produce collagen fibers, which form bundles that make
up the bulk of scar tissue. Scars have a blood supply but no oil
glands or elastic tissue, so they can be slightly painful or itchy.
Hypertrophic scars grow overly thick and fibrous but remain within
the original wound site. Scars can also develop into tumor-like
growths called keloids, which extend beyond the wound's limits.
Both can inhibit movement when they result from serious burns over
large areas, especially around a joint. Scars, especially those
from unaided healing of third-degree burns, can become malignant...
As part of the healing process, specialized cells called
fibroblasts, in adjacent areas of skin, produce a fibrous
connective tissue made up of collagen. The bundles formed by these
whitish, rather inelastic fibers make up the bulk of the scar
Let’s talk about Fibroblasts
These cells let out proteins, mostly collagen. Collagen builds connections, particularly over the scar, which helps
connective tissue to grow. When the scar has healed, it will have regular nerve pathways, blood flow and elasticity and movement.
The importance of fibroblasts is, well, very important.
They're involved in normal growth, healing, wound repair, and the
day-to-day activities of every tissue and organ in the body. The
fibroblast does everything.
Interference with their activities causes a vast array of clinical
problems. The deficiency affects a specific pathway in collagen
creation, with consequences like skin sores, anemia, edema,
ulcerated gums, loosened teeth, and hemorrhage of mucous membranes.
Restoration of the vitamin allows the fibroblasts to work normally
and cures the problem.
Let’s talk about Collagen
Collagen is the structural protein of bones, tendons, ligaments,
and skin. About one quarter of all of the protein in your body is collagen.
Collagen is a major structural protein. It forms cables
that strengthen the tendons. It also forms large, resilient sheets that support
the skin and internal organs. Bones and teeth are made by adding
mineral crystals to collagen. Collagen provides structure to our
bodies, protecting and supporting the softer tissues and connecting
them with the skeleton.
Vitamin C assists with oxygen in the process of modifying some amino acids into
hydroxyproline, which is critical for collagen stability. Vitamin C deficiency slows the
production of hydroxyproline and stops the construction of new
collagen, ultimately causing scurvy (Loss of teeth and easy bruising are some of the symptoms).
When the body needs to go into healing mode, and builds any new cellular structure, collagen is most important.
It controls all sorts of tasks undertaken by cells, and causes broken bones and wounds to heal.
The collagen mesh provides the plan for what the tissue will look
like, the road map for the cells to find where they need to
regenerate and grown, and the way for the body to be able to
re-grow damaged or broken tissue.
REMEMBER: Scar tissue is what we need for the body to regrow itself.
Let’s talk about MUSCLES
We tend to say "Push your arms together." This is a totally
inaccurate statement. Muscles never push, they only pull. In
other words, you don't get any force from your body when your
muscles relax, you only get force from your body when muscles
contract. This is the only movement they can do – strange but true...
And they can also relax.
Skeletal muscles are usually attached to bone by tendons composed
of connective tissue. This connective tissue also covers the entire
muscle & is called epimisium.
Skeletal muscles consist of numerous bundles, called fascicles.
Fascicles are also surrounded by connective tissue
(called the perimysium) and each fascicle is composed of numerous
muscle cells). Muscle cells, which are wrapped by
endomysium, consist of many myofibrils, and these
myofibrils are made up of long protein molecules called
The cell membrane of a muscle cell is called the sarcolemma.
So, impulses travel along muscle cell membranes just as
they do along nerve cell membranes. However, the 'function' of
impulses in muscle cells is to cause the muscle to contract.
In the human body, the muscle fibers are
made up of muscle cells.
That means that inside each muscle fiber
are muscle cells. Each muscle cell needs fresh blood (with new clean oxygen), needs to have waste
carried away, and needs to be able to receive and transmit electric impulses. Each of the muscle fibers
also has to be able to carry materials
and messages in both directions.
Trauma can prevent the movement of blood through the
the muscle fibers. It can be a cut, bruise, or any other trauma that causes the flow of blood to be
slowed or stopped. If the fibroblasts cannot create the necessary pathways (due to distance or lack of movement),
these tissues harden and turn into scar tissue.
Lets talk about your SKIN
Skin is an amazing organ in the human body.
It is made up of two main layers: the
epidermis on the outside and the dermis on the inside. The
epidermis is the barrier, while the dermis is the layer containing
all the nerve endings, sweat glands and hair follicles.
In the subcutaneous layer you can see the blood vessels.
The epidermis is your contact with the world: It has two main layers, the inner of which is
living and the outer of which is dead. The dead skin cells of the
outer layer are what we can actually see, and they are constantly
flaking off and being replaced by new cells being pushed outward.
This happens every 30 days or so.
The living, inner layer is called the malpighian layer. The
malpighian layer creates the dead cells that we can see. It is in
direct contact with the dermis, which feeds and supports it.
Next up is something called the stratum corneum. This is the outer layer of dead cells - the
cells that we see as our skin. The cells in this layer are filled
with a protein called keratin. Keratin is a very strong and solid protein. Horns, hair, hoofs,
fingernails and feathers all gain their strength from keratin. The
same stuff that your fingernails are made of actually forms your
How is scar tissue formed?
Pathcurve.com explains the forming of scar tissue in the following way:
"When a nerve is severed, provided that the schwann cells are able
to reconnect (they can grow over small distances) then regeneration
and complete healing takes place. But when the wound or cut or
damage is quite bad and no electrical conductivity can be
re-established between the cut nerve and the neuroepidermal cell
into which it "plugs", then regeneration cannot take place and the
rapid build up of collagen is necessary to plug the hole.
"Because collagen is produced in abundance by fibroblasts, it
invariably forms a domed layer over the wound and this domed layer
is the scar which is often disfiguring and large.
"There are few, if any, neuroepidermal junctions in scar tissue so
it has very little touch sensation. Because of this, the mind,
which perceives the body as a hologram of nerve endings, doesn't
send much blood to the area of scar tissue, so it doesn't stay very
supple and doesn't grow. This means that it doesn't regenerate
like the rest of the skin, otherwise it would fall off and renew
like the rest of the skin."
In the body, often the cut or damaged nerves re-route to the nearest area of normal
skin and connect to the healthy skin cells there.
This can make the skin around any scar more sensitive and often
quite painful for longer periods of time. This is also what leads
to the strange feeling that often accompanies scars when
you touch them.
How can I help heal the scar tissue?
The forming of serious scar tissue, as with whiplash and surgery, can take more than
normal stretching and activity to heal. It does not go away with time, but has to be
1. Scar tissue on the skin:
Because people don't normally use or touch a part of the body which had some kind of
trauma, the tissue doesn't receive any stimulation. The nerve endings and connections
develop less, it therefore has less feeling, and gets touched less, and so it goes on and on.
Eventually a thick mass of non-sensory tissue develop, most of it scar tissue.
Touch the scar, on a daily basis, with an object with a small point (pencil, nail file, needle, etc.) on several
spots on and around the scar to stimulate the nerve endings. In time feeling will return.
2. Scar tissue in muscles:
Scar tissue in muscles can either be worked on through direct massage, or become areas that are deeper and more
difficult to work on directly.
Remember that the muscles around the scarred area will tighten up in protection of the injury. A trained therapist
will be able to work on these muscles, and they can be rubbed by yourself as well.
The best way to work on your own muscles is through a technique called cross-fibering.
Say for instance, like me, you had surgery on your upper leg and knee. You would use your hand to
go up and down the muscles vertically when standing. Use the second knuckle, closest to the hand, on the ring and middle
fingers, to get into the muscle fibres, while the second and pinky fingers glide across the leg. Finish by doing
a gentle massage on the area to calm it down.
Remember also that the breaking up of scar tissue does not happpen overnight! Give the tissue as long to break up,
working on it daily, as the time it took to form initially. Bottom line: be patient and persistent...
And finally:Jonathan Kraft, CMT, has written a book about this issue. This article has been researched from his book. Find the info here.
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