Scars serve as reminders of past injury. Sometimes they also cause problems long after the initial trauma, even when we don’t realize it. Pain from scar tissue is often missed because the scar itself might not hurt. Instead, scars can cause pain by distorting the sheet-like connective tissue in our bodies, known as fascia. This can cause muscle imbalance and joint instability, resulting in pain felt in nearby muscles and joints.  Fortunately, releasing internal restrictions in scars can offer pain relief and restore normal movement to affected fascia.  

New Scar, New Pain 

A patient, whom I will refer to as Terry, is a cellist. She asked me to help alleviate new pain and tension in her right shoulder blade. The pain began after she healed from a skin biopsy in the right shoulder blade area, and was constantly intensified by the shoulder movement with her bow while playing cello. Terry was sure this new scar was the source of her pain and tension, but massages on the scar tissue and pain-relieving lotions had not relieved the pain at all. Her discomfort was increasing each week, limiting her ability to continue playing. 

Upon examining Terry’s scar, I noticed a hard, restricted feeling, compared to the skin around it. Some of the muscles between her spine and shoulder blade were abnormally tight and weak. Pressing on them caused Terry to feel a sharp discomfort. When I stimulated the scar with precise, targeted pressure, those tight muscles relaxed and were much less tender to pressure.  This confirmed the scar was a source of both her pain and tension. 

After about five minutes of precise manual therapy to soften the scar, Terry’s muscle tension melted.  Retesting the weak muscles showed improvements to solid, normal strength.  Terry practiced bowing movements as if playing the cello and was excited to feel her shoulder restored to free, easy motion. She now plays her instrument pain-free.  

Old Scar, New Pain 

Samantha came into my office for assistance with hip pain after using her thighs to lift a heavy box. She thought the pain could be from a subsequent muscle strain, but weeks later, she still experienced weakness and some difficulty walking.  My practice focuses on finding restrictions in connective tissue (especially fascia), which cause muscular imbalance and joint misalignment that result in pain, so I examined her thoroughly for fascia restrictions.  Although she presented with mild inflammation in the hip area, there were no significant restrictions. 

However, Samantha exhibited a loss of muscle tone and weakness in her left abdominal muscles. Searching for the source of this weakness, I found a line of fascia tension in her left rib cage, which she informed me was actually the line of a surgical scar. At age two, she had an enormous incision made in the left side of her chest to allow for heart surgery.   

This scar remained painful throughout her entire life, and was exquisitely tender to even light pressure. Upon examining the scar, I stimulated it with gentle pressure while retesting her abdominal muscle strength. They were much stronger, and movement at her left hip became less painful. The scar was large and, therefore, could not be completely released in just one treatment. However, that partial release during the first treatment offered enormous relief from her left hip pain. Further treatments resolved her pain entirely.  

It never occurred to Samantha that a scar from her early childhood might still affect her decades later. Unbeknownst to her, the scar had been creating a weakness in her abdominal muscles that made it difficult for her to recover from a minor injury. She had, in fact, strained some muscles due to heavy lifting, but the restricted fascia from her old scar caused continual stress in the affected area, which inhibited its healing.  

Referred Pain 

Samantha’s story illustrates another potential facet of pain that can be caused by scars. The pain can “refer” to somewhere distant from the scar, so it’s often hard to know where the pain comes from. I see many cases where scars from abdominal surgeries, such as C-sections or appendectomies, cause distortions in the body’s web of fascia, causing hip muscle weakness.  This can lead to sciatica or knee pain, interfering with basic mobility.  

Sometimes scars could even cause pain to cross over to the other side of the body. One example of this is an abdominal scar on one side of the body that causes weakness and twisting of the pelvis. This can lead to misalignment or binding of the joints on the opposite side, resulting in low back pain or sciatica. That’s why I evaluate all patients, from head to toe, and take a thorough history of their past injuries and surgeries. It is entirely possible and even common for restrictions in fascia to have absolutely no pain of their own, while causing pain and dysfunction somewhere else in the body.   

Easy Does It  

Restriction in scar tissue is often painful to pressure, but effective fascia release can be gentle. Stiffened scars often respond to just ounces of hands-on pressure, restoring the normal softness and pliability to a tissue that allows for restored muscle tone, balance, and joint stability. Scars that have felt hard or dense for years can often be softened in one treatment and completely restored to near-normal pliability in just two or three visits.  

Some types of scars that are most likely to activate pain (even when the scar itself is not painful) are those from the following surgeries: hysterectomy, c-section, hernia repair, hip or knee replacement, spinal fusion, or the implantation of hardware. I highly recommend an evaluation for scar tissue restrictions in any case of unexplained chronic pain where there is significant scar tissue not far from the pain area. For many folks, releasing scar tissue offers the sustainable relief they were unable to find anywhere else.   

Eric Winder D.C. uses gentle manual therapy and rehab techniques to assist patients with a wide range of pain issues and injury problems. For more information, call 941-957-8390 or visit https://gentlebay.com/