Scar tissue. Adhesion. Fibrosis. The words are different, but the concepts are the same. This dense, fibrous tissue affects us all and is an underlying factor in many injuries. Scar tissue binds up and ties down tissues that need to move freely. As scar tissue builds up, muscles become shorter and weaker. Tension on tendons causes tendinosis. Nerves can become trapped. All these problems can cause reduced range of motion, loss of strength, and pain as well as tingling, numbness, and weakness.
Scar tissue forms two different ways. First, if a muscle, tendon, or ligament is torn or crushed, the body creates scar tissue to ‘glue’ the torn pieces together. This is a necessary part of the healing process.
The second, more common way for scar tissue to form is by soft tissue in the body not receiving enough oxygen (hypoxia). Hypoxia is more common than one may think. Poor posture, athletic pursuits, repeated use, and sustained pressure (as in sitting) all increase muscle tension and result in hypoxic conditions. When muscle tension is increased, blood supply to the area is reduced. A healthy blood flow is so important because blood carries oxygen to muscles. A reduced blood flow means less oxygen and that means hypoxia.
Hypoxia leads to free radical accumulation in muscles. Unfortunately free radicals attract cells that produce scar tissue. These cells begin lying down scar tissue and over time, scar tissue begins affecting surrounding muscles, tendons, ligaments, fascia, and nerves. The following are some of the common effects of scar tissue:
Decreased Muscle Length
Scar tissue does not have the same flexibility and elasticity as healthy muscle. Since it doesn’t lengthen like normal muscle, areas with scar tissue may have limited range of motion and an altered joint axis of rotation.
Delayed Lengthening Speed
A muscle with scar tissue may still reach full length, but the time needed to achieve this may increase. Since muscles need to work together with precise contraction times, big problems result. For example, you kick a soccer ball. The quadriceps (front of your thigh) must shorten and the hamstrings (back of your thigh) must lengthen. If the quadriceps shorten at their normal speed, but scar tissue in the hamstrings slows down their lengthening time, a tear can result.
Scar tissue acts like glue binding up muscles. Bound muscles have less functional muscle available to work. Fewer muscle fibers working simply mean less strength can be produced. Pain or a malpositioned joint can also limit strength.
Nociceptors (pain nerve endings) have been found in scar tissue, so the scar tissue itself can be painful. Pain also can be felt in the involved tendon attachment or in a structure compensating for functional changes due to scar tissue.
Nerves are supposed to slide through and around muscles, not stick to them. If a nerve happens to lie next to scar tissue, it can become entrapped. The scar tissue “glues” the nerve to the muscle. Then when you move, the nerve becomes tugged on or tensioned instead of sliding as it is supposed to. Nerve symptoms are weakness, numbness, tingling, burning, aching, and pins and needles.
These are a few of the most notable implications of scar tissue.
Unfortunately the body doesn’t have a natural mechanism to remove scar tissue. Active Release Techniques and Sound Assisted Soft Tissue Mobilization are two highly effective methods for reducing scar tissue. After reducing scar tissue, preventing its return and further formation can help prevent injuries in the future.