The Commonality of Scars
Do you have any scars? Perhaps from an injury or surgery? According to the Cleavland Clinic, almost everyone has a scar. They can range from mild and barely noticeable to quite obvious on the surface, but they may connect to many structures underneath the skin. There are various creams and techniques to address the appearance of scars, but since their connections in the body run deep, you can still experience discomfort after the surface marks on the skin have faded. Keep reading to find out how we at Mayer Wellness are implementing new, fascia-informed™ techniques to heal even the oldest scars and how you can start treating them at home.
How do Scars Form?
I’ve often wondered, if the body has such incredible healing properties, why are scars often so noticeable and disorganized? Here’s what you may not know. One of the biggest threats to the body is having the skin open, exposing us to the outside world. When this happens, the body’s number one concern is to close that opening as soon as possible.
First, the body acts quickly to clean the area, rushing fluids and cells from the immune system to the site of the injury. Second, the opening is closed to protect the body from outside germs or bacteria. Which system is rushing to close our wounds? The fascial system, of course!
Fascia to the Rescue
The fascial system is more than a web of connective tissue; it contains important cells that have many responsibilities within the body: fibroblasts and myofibroblasts.
Fibroblasts rush to the area of open skin and begin to lay down collagen as quickly as possible. The fibroblasts do not care about organization or how pretty the body looks. They only care about closing the gap and saving your life. Imagine an old zombie movie. The main characters run for their lives into a run-down home. With the zombies close behind, they begin to haphazardly nail boards over the windows and doors. Does it look nice? Do we consider it fine craftsmanship? No, but the humans are safe and will live to fight another day. Fibroblasts close an injury in the same way. Lots and lots of collagen is laid down often in a very disorganized manner in an attempt to close the gap quickly. It does not matter how pretty it looks when your life is at risk.
Another cell that is part of the fascial system is the myofibroblast. “Myo” means muscle. These tough little cells come in and begin to act as winches, pulling on the dense collagen the fibroblasts laid down to close that gap. Here, I often evoke the imagery of soldiers behind a castle door trying to push the door closed before the dragon has an opportunity to get in. Again, there is no organization or order in this process; the soldiers only want the door closed, and they push on the door and each other to make it happen.
Scars Run Deep
In the imagery above, the processes are two-dimensional. We must remember that the body is three-dimensional. Much like an iceberg, what we see above the water is quite small compared to what is beneath the water. Even though a scar may look benign, there may be a lot going on underneath. The fibroblasts do not lay down just one layer of collagen. There are many, many layers of disorganized collagen. The myofibroblasts do not just pull the layers toward the scar. They grab onto whatever they can underneath the surface to create safety and stability, including many structures located underneath the skin and deeper as necessary to create stability. As the myofibroblasts grab and pull, the tension they create can pull into other areas of the body, including the rest of the fascial system. Let’s explore that idea.
Strain Lines in the Fascia
In healthy fascia, there are lines of strain. Strain lines exist where we move our bodies the most. For example, we have a strain line in the abdominal area from the upper legs into the chest. The fascia contracts when we sit and stretches when we stand up, creating a line of strain in the fascia. In a line of strain, the collagen of the fascia is very organized to support movement. The more we repeat a movement, the stronger and more organized the strain pattern becomes.
Now, imagine a scar over this line of strain. The part of the scar underneath the surface of the skin may reach down and grab into that strain line, disrupting its flow and function. This disruption could possibly result in additional tension in the strain line, causing asymmetry in the body. This asymmetry can result in changes in movement patterns that may continue to alter the tension in the fascia and the movement of the joints far away from the scar itself! One small scar in the abdomen could affect the entire body.
In the picture above, I laid out a thin towel. This represents the fascia. I used a hair tie to hold the bunched-up fascia in place. This represents the scar. You can clearly see how the scar has created lines of pull in the towel. A scar in the body can create similar lines of pull but in every direction into the three-dimensional body.
Traditional Approaches to Healing Scars
In many traditional approaches to managing scars, the goal is to reduce or eliminate connections or adhesions created by a scar to structures below the surface of the skin. The goal is to create a scenario where the skin can freely glide over the structures below. That may sound like a good goal; however, we need to organize the unorganized collagen formed by the scar and reintegrate it back into the fascial system as a whole.
A New, Fascia-Informed™ Approach to Scars
Reorganizing scar tissue back into the greater fascial system is a completely new idea. Sharon Wheller, a therapist in Washington state created this process, which is slowly catching on among practitioners who are paying attention to the developments in fascia. Fascial scientists are also supporting this new approach. What is truly unique about this method is that it’s very, very gentle.
In our culture, “no pain, no gain” is the norm, but where fascia is involved, gentle is better. Fascia protects us, so creating change in this system requires gentle consistency rather than intensity. The imagery that comes up for me here is sending a kindergartener to school for the very first time. Initially, the child clings to their parent, not wanting to integrate into the classroom with the rest of the children. Gentle coaching from the teacher slowly, over time, begins to soften the child’s fear of leaving the parent. They stop clinging so tightly, which allows them to begin integrating into the classroom. The child learns that they can still stay connected to the parent and integrate with the greater whole of the class.
At Mayer Fascia Wellness, we have begun integrating this new approach to scar management with incredible results. This new approach, along with other myofascial approaches, has yielded results that even we did not expect. Even scars that are many years old can be affected positively through this approach. Scars that are very sensitive can become less sensitive. Scars that pull and pucker can become smoother. Scars that pull deep underneath the surface, causing a variety of problems, can be tamed.
The Gentle Scar Work Approach
Scar Work, as Sharon Wheeler has coined it, is a multi-step process. It is unique because there is very little pressure on the scar itself, and there is no attempt to release or break adhesions. Using this technique, the therapist works around the scar, directing their strokes toward the scar rather than on top of it. The initial strokes are very light. You may be thinking that this can hardly do anything underneath the skin, but not so! There are many studies demonstrating how tensioning the skin pulls on the fascia below. This light stroking stimulates the fibroblasts to help organize the fascia.
Other phases of scar work involve slightly more firm stroking and pressure on the skin but always toward the scar. Another phase involves pressure into the most restricted area of the scar. What is unique is that the pressure is gentle and straight down into the tissue. The therapist then follows the softening as their finger sinks into the tissues, which feels very much like the myofascial techniques we currently use in our practice. Finally, the therapist “integrates” the stimulated tissues by gently tensioning them in the line of strain where the scar is located.
Treating Your Fascia and Scars at Home
This approach to scar management can be difficult to perform on yourself, especially if your scar is in a hard-to-reach area. However, we have taught people to use the technique on their own. If you can’t reach or don’t feel comfortable using the technique, what you can do is move. Moving in ways that gently pull into the strain lines can help teach the scar to reorganize itself back into your fascial strain lines. Traditional approaches to exercise, like running, do not always do this. They are often too aggressive and too linear.
Gentle forms of yoga are better options. Check out my YouTube channel for several different yoga routines. If you’re unsure which style of yoga is best for you, check out my on-demand course, Yoga for Your Health, which will guide you to the yoga style that best fits your needs.
Even better, let us guide you in developing an individualized approach to stretching, moving, and exercising better to heal your body. Make an appointment (we now offer virtual appointments!) or join us for a workshop.
