VERIFIED CONTENTAuthor: Dominika Wilk

The scar is not just an aesthetic problem. Its occurrence is also associated with pain, itching or the formation of adhesions. Therefore, in order to prevent the negative effects of scar formation, it is worth increasing its mobility as soon as possible and detaching it from other tissues. All kinds of manual techniques performed by a physiotherapist and self-mobilization at home will be helpful in achieving this goal.

Manual treatment of postoperative scarsinvolves, inter alia, on gently massaging or rolling the scar in order to increase its mobility and detach it from other tissues. As a result, the scars become softer and more elastic. Scar therapy also avoids the formation of keloids or hypertrophic scars.

What is a scar?

A scar is a fibrous tissue that forms where a large amount of the basement membrane has been damaged. The deeper the wound, the greater the destruction of the basal membrane and therefore the greater the risk of scarring.

The process of scar formation is divided into stages that we can recognize, among others by the appearance of the scar. Fresh is red in color, which is due to the formation of capillaries at the site of the injury. Later it becomes brighter and turns pink to finally turn white. At the last stage, the structure of the scar tissue changes - it stiffens and becomes less and less elastic.

It is worth emphasizing that the fragment of the skin covered by the scar does not have any glands. So there are no hair follicles or cells where the dye usually accumulates. For this reason, the scar does not grow hair, and the scar itself does not change color under the influence of the sun.

The formation of a scar is not only an aesthetic problem. Many of them cause fascia tension, which can cause dysfunction of nearby areas of the body, not only related to the skin, but also to organs that are located, for example, under the abdominal integuments. Some of them may also limit the mobility of the joints, cause itching or pain.

How to take care of a scar so that it heals well?

The most important issue in the proper process of scar healing is to ensure that the injured tissue is properly cleaned. You shouldclean according to doctor's instructions, e.g. with disinfectants.

Another important issue is skin hydration. The scar cannot be dry, so you should use special lubricating scar ointments or creams to ensure its proper level of hydration.

The mobilization of the scar also plays an important role in caring for the scar. If we leave the scar on its own, the fascia may stick together, as well as the formation of adhesions that will affect nearby organs, causing pain not only in the surrounding areas, but also the tissues located much further, e.g. a scar near the liver may cause pain in the right shoulder.

How to care for a caesarean section scar?

In addition to the above-mentioned tips: taking care of skin hygiene, oiling and quick mobilization of the scar, in women after a CC, it is also important to take care of proper movements, getting up or sitting down immediately after giving birth. A caesarean section is a cut through multiple layers of skin.

Stapling them is associated with a high risk of fascial gluing or adhesions. Therefore, in the first days after the operation, remember to treat the scar properly and not to strain it in everyday functioning by inappropriate movements. When getting out of bed, you should, for example, remember not to get up with your stomach, because this will result in the later dilatation of the rectus abdominis muscle.

The correct lifting pattern for women in post-cc puerperium is to roll over, lean on your hand, and then get out of bed. The position of taking during breastfeeding is also extremely important, because too much forward bend will put pressure on the abdominal wall, and thus on the scar itself.

When feeding your toddler, it is best to sit upright, with a high pillow over your knees, on which you can place the newborn so that it can easily reach the breast.

Manual therapy - why is it so important?

The mentioned mobility of the scar is extremely important for the later functioning of the patient and his he alth. First of all, it allows you to avoid pain or itching.

In addition, it increases the elasticity of the tissue, and also makes it possible to avoid unpleasant consequences in the form of tension of the surrounding tissues, organ dysfunction, and malfunction of the body. A complication of a poorly healing scar may also include sensory disturbances, postural defects or muscle contractures, so it is worth mobilizing the scar as soon as possible and detaching it from other tissues.

Types of manual therapies

Skin rolling

Very beneficial effect onthe scar is skin rolling. This procedure is usually performed by a physical therapist. He rolls a fold of skin with his hand as if he were rolling a dough. It does this sensitively, of course, allowing the body time to unwind the skin. Only then does he continue the treatment.

Rolling is performed on the areas of the skin located on the side of the scar, perpendicular to it or parallel to it. After this type of massage, the tissues should be visibly relaxed.

Lymphatic drainage

Lymphatic drainage consists in manual work of a physiotherapist in the area of ​​the scar in order to improve lymph flow and reduce swelling. This treatment includes stroking, pressure, and various types of rubbing the skin and tissues, e.g. circular rubbing. They are performed according to the patient's breathing movement, in a specific sequence and rhythm.

Tapping

Tapping, or tapping, is another method that helps mobilize the scar. It allows you to release the fascial and skin systems and does not require much effort on the part of the physiotherapist or the patient. The duration of the treatment varies, as it is performed until the skin and tissues subjected to tapping become soft.

The tapping does not take place directly on the scar, but along its side. It helps to reduce skin tension and increase its elasticity.

Cyrjax's cross massage

James Cyrjax was a British orthopedist who paid a lot of attention to the patient's subjective feelings and individual pain assessment.

He believed that thanks to a properly collected interview, observation, functional and tactile tests, it is possible to choose the technique that will bring the best results in his case.

In the case of scars, the best solution is a transverse massage, which involves massaging the tissues along the damaged tissues. This allows for the removal of pain and relaxation of excessively contracted areas of the body.

Automobilization of the scar

A very important element in restoring the mobility of the scar is self-mobilization, which the patient can and should do alone at home. It mainly concerns postoperative scars. This type of manual procedures can be started immediately after removing the stitches. In the first stage, however, you do not work directly on the scar itself, but on the surrounding tissues. The idea is to make the surrounding tissues as mobile as possible, so that it would be easier to mobilize the scar later.

First, when the patient works on a fresh scar, he performs astringent movements towards the scar. He does them slowly, without too much pressure. Later (stage 2), when the scar is healed, it may start making diagonal movements.which consist in pressing the scar and the skin around it as if you wanted to twist it.

So she grabs the skin at the scar at two opposite ends and gently twists it. In step 3, he may add rubbing to these movements, which tears the scar up and delicately detaches it from the subcutaneous tissues. This allows for good mobility of the scar and prevents or reduces the risk of possible adhesions.

What other techniques may be helpful in scar therapy?

Cupping

The manual techniques used on scars include vacuum cupping. A cup made of glass, plastic or bamboo can be placed directly on the scar and surrounding tissues or on the skin areas on the side.

Thanks to the bubbles, additional blood circulation is obtained, and therefore oxygenation of the skin, which helps to remove toxins. The lymph flow also increases and the resulting swelling is reduced. We shouldn't put the bubbles on our own, but always with the help of a specialist.

Kinesiotaping

Kinesiotaping is a technique that covers the scar with special tapes that resemble the structure of the skin. You can start sticking the scar only after the wound has healed.

It consists in alternately sticking strips of tape directly on the scar, sticking its ends outside its area. Bonding starts at the bottom of the scar, where a strip, e.g. 5 cm long and 1 cm wide, is stuck under the scar, applying a tension of the strip 50-100%.

Another tape is placed on the strip, which is slightly stretched along the scar, "crosswise". And so, crossing the stripes, we glue them alternately until the end of the scar. The tape strips are very comfortable, they can be washed in them, so you can wear them freely for a few days or longer.

Dry needling

Dry needling can also be beneficial in relieving the pain associated with the occurrence of a scar, as it allows you to relax overly tense areas of muscle tissue. Usually, it is too much tension around the scar and pulling on the surrounding fascia that makes us feel pain.

When these structures relax, we feel relieved. Dry needling mainly involves inserting sterile needles into the area associated with the scar. Unlike acupuncture, which stimulates the flow of energy in the meridians, needles used by a physiotherapist are designed to influence the myofascial points.

Category:

Dermatology