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Scar Therapy and Myofascial Release
submitted by Chava Quist
Kamwo Staff Contributor
Fascia is a connective tissue network that wraps all of the structures within our bodies. This thin tissue sheath covers muscles, nerves, blood vessels, and organs. Every inch of our bodies is connected by this uninterrupted fascia envelope, including large sheaths over the surfaces of the feet, palms and scalp. Fascia helps some structures to move smoothly against each other, thereby reducing friction. Fascia also suspends structures in place, keeping organs on a proper axis and facilitating muscle group synergy. While fascia is pervasive in the body tissues, it is often overlooked until there is pathology.
This connective network creates a tensegrity structure, coming under the forces of mechanical pull from postural alignment and muscle movement. While fascia has largely been thought of as an inert structure, some research points to evidence of independent contraction of the tissue that could contribute to muscle dynamics. With soft tissue injury, scarring or mechanical misalignment, the torque on the fascia sheath can become unbalanced or extreme in one or more directions, creating pain syndromes from impinged muscle groups or nerve tissue.
As a scar forms, fascia can become strained when pulled together by the healing wound as the edges contract together. This type of strain can affect the skin, subcutaneous fat layer, and muscle tissue only, or in the case of surgical scars, can apply torque to the axis of the organs as well. The effects of this can result in decreased or loss of normal range of motion, pain syndromes, nerve entrapment, and parasthesia. The fascial sheath is a collagen structure, the nature of which is thixotropic, meaning that alone it is an elastic, gel-like substance, but in response to heat and pressure, it will soften. This gives manual therapists an avenue to break down fascial adhesions, and reshape the tissue to allow more normative function and improve scar appearance.
Scar therapy with acupuncture can usually begin four weeks after injury. Needling into the area of scar tissue on its own will increase local circulation, but often lift and thrust manipulation is used break up adhesions. Infrared heat lamp therapy, along with topical herbal liniments may be used to further improve circulation and malleability of fascial tissue. Massage therapists often use a combination of manual friction, compression and external heat sources such as warm compresses to the same affect. As the tissue soften, pliability increases, and the therapist may stretch or roll the tissue gradually to reshape it.
Structural misalignments or pain syndromes from scars and fascial adhesions can be corrected in this manner over a series of treatments. Between sessions, a client may be instructed on certain homecare practices, including heat therapy, stretching or the application of herbal solutions to the affected area.
While surgical intervention certainly has a necessary place in our healthcare system, rehabilitation post injury is often lacking due to economic concerns or inaccessibility. Movement restriction and adhesions can be common postoperative without consistent follow up care and client education. TCM and massage therapy excel in this area, offering sufferers a solution to chronic pain or restriction. Whether clients are looking to be pain free, or simply to improve the cosmetic appearance of scar tissue, TCM practitioners and body workers have much to offer in the management of these chronic conditions.