Scars contribute to chronic pain
Scars have depth, texture, density, form and pull. To say what we see on the surface is the tip of the iceberg is a huge understatement in many cases. I have become obsessed with scars since fall of 2018 and my obsession continues. I have so many clients with large scars that interfere with their motor control and cause chronic pain issues. A motor control issue means that the muscles and joints aren’t coordinating well to create smooth, easy and functional movements. When muscles become uncoordinated they start to ache, get tight and painful, and they can impinge on nerves. This creates problems like sciatica or numbness. Tight muscles can also change blood flow, causing versicose veins, issues with the skin like rashes or hairloss, and temperature control issues like really cold feet and hands. Both over active and underactive muscles can be painful.
How do scars interfere with motor control?
There are several different ways that scars interfere with motor control and contribute to chronic pain as well as other issues. I have organized these into three categories:
1) Mechanical
through the mechanical pull of the scar itself which may be sticking many layers of tissue that should be able to move independently to each other, or reducing the movement in single layer of a joint capsule, ligament, or muscle tissue, or the fascial pull of the adhesions they form with the tissues around them
2) Sensory/Motor (Somatic)
through the increase or decrease of sensory afferents (scar tissue has more nerve endings laid down around it) that can overwhelm or confuse the motor control center of the brain
3) Emotional (Autonomic)
through emotional trauma that can interfere with motor control through the limbic system.
Scar rehab work will address all three of these issues to some degree. While Integrative movement therapy is a trauma informed practice, it focuses on mechanical and sensory/motor issues. Clients who have a lot of unresolved emotional issues connected to their scars should also be seeking therapies intended to address these from other angles, such as somatic therapy and talk therapy. Referrals are availalbe.
Types of Scars
I have many clients who have problem caused by scars –incontinence, joint pain, digestive issues, lack of mobility, posture issues, headaches, migraines, TMJ issues, diastis recti, back pain, knee pain, plantar fasciitis, hip pain and low back pain.
Some of these scars are recent, just healed and less than 2 months old. Many more of these scars are years and even decades old. Scars from early childhood can have particularly global effects, causing multiple problems through the body. And old scars are almost more likely than new ones to be actively causing problems. It’s never too late to get a scar worked on. Some of the types of scars I have worked on include crush and spiral fractures that are hidden below the surface; surgical scars including those from infant, childhood and adult surgeries, extensive and multiple or overlapping abdominal surgurical scars; c-sections; laproscopic scars; scars from deep cuts made by jagged edges; radiation scars and burn scars; scarring caused by blunt force trauma and bruises; scarring from internal infections, scars from choking, fascial scars, birth trauma scars (especially from forcep use); and self-inflicted scars.
Surgical Scars
Scars from surgeries, or scars made by sharp objects are very different from the scars created by internal fractures, infections, bruises, or burns. These scars will have a direction of pull created by the direction of the cut and the adhesions that are regulated by the skill of the surgeon as well as by the post-operative rehab or lack of rehab.
Each scar has to be treated differently, but there are techniques that can be applied to the different types of scars in different areas. This is especially true for surgical scars that follow more regular and predictable patterns..
If you have scars and pain — there is a good chance there is a connection between the two.
