WHAT IS SCAR TISSUE?
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.
WHAT ARE THE 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.
Decreased Strength – 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.
Pain – 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.
Nerve Entrapment – 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.
SHOULDER SCAR TISSUE
Although scar tissue can occur throughout the body, shoulder scar tissue can lead to unique symptoms such as bursitis, rotator cuff injuries and even shoulder impingement syndrome. Scar tissue is many times a secondary symptom of other conditions such as a sprain/strain injury. Another symptom of scar tissue is the formation of Trigger Points and faster Degenerative changes to the surrounding bone. Trigger points are defined as a “sensitive area of the body, stimulation or irritation which causes generalized musculoskeletal pain when overstimulated.” Both of these ailments can be very annoying and often times linger for years if left untreated.
Unfortunately, the body Does Not have a great natural mechanism to remove scar tissue quickly. This is why therapies such as Graston Technique, Rapid Release and Sound Assisted Soft Tissue Mobilization are some of the highly effective methods for reducing scar tissue. After reducing scar tissue, preventing its return and further formation can help prevent injuries in the future. Chiropractic adjustment are used to decrease the strain of the muscle itself by loosening the joint so that the muscles do not have to work as hard.