Be Prepared: Scar Management
Simple Tools and Steps for Scar Care
Let’s talk about scars. Not the metaphorical kind from your teenage years, but the ones left behind after surgery or injury. Whether it’s from an ACL reconstruction, hip replacement, C-section, or something else, scar tissue can leave more than just a mark.
I've noticed that a lot of people don’t realise scar management is a real and important part of recovery. Once the skin heals, many assume that’s the end of it. In reality, it’s often just the beginning of what that scar could be doing beneath the surface.
So, What Exactly Is Scar Tissue?
When your body repairs itself, it lays down collagen fibres to close the wound, but it doesn’t do this in a neat, organised way. Instead, it throws down a random web of fibres, forming a dense, sometimes stiff patch of tissue that can behave very differently from the surrounding area.
And remember, that visible line on the surface is just the tip of the iceberg. Scar tissue can extend deep into the layers beneath: through fat, fascia, muscle, and sometimes even to internal organs. That can affect how you move, stretch, and function, sometimes for years after the scar forms.
I want to walk you through a few practical tools that can help manage scar tissue more effectively. Scar tissue doesn’t have to be something you just live with. Whether your scar is a few weeks or a few years old, there are simple things that can be done to try and improve mobility, reduce tightness, and support better movement.
Here are a few techniques I often recommend to patients:
Self-Massage: Get Hands-On
Massage is one of the easiest and most effective things you can do at home, especially when it’s done with the right technique.
If you’re further along in your healing - a few months post-surgery, for example - and the scar is fully closed and stable, then it’s okay to work deeper into the tissue, as long as you stay within your comfort levels. We’re aiming to influence the deeper layers of scar tissue, not just the skin.
How to massage your scar effectively:
Start around the scar using deep circular motions to warm up the surrounding tissue.
Work along the scar, following its direction.
Try cross-friction massage, moving the tissue side-to-side using both hands in opposite directions.
Don’t be afraid to work deeper into the scar over time. If it’s well-healed, deeper work may help mobilise stuck layers.
You can also use rubber gloves to add more grip and friction. This helps create better movement through the skin and fascia.
Finally, try lifting and moving the scar in all directions: widthways, lengthways, diagonally. Think of it as trying to unstick the scar from the layers underneath.
Reminder: Always wait until the scar is fully healed and cleared by your healthcare provider before starting deeper work. And if you're unsure, ask for guidance.
Myofascial Release (MFR): The Deep Stuff
Fascia is a thin layer of connective tissue that wraps around your muscles and organs, a bit like the silvery film you sometimes see on raw meat (sorry veggies/vegans). It can become sticky and tight around scar tissue, limiting your range of motion.
Myofascial release (MFR) uses gentle, sustained pressure to help hydrate and soften the fascia. This process is called thixotropy, where the fluid inside the fascia becomes more mobile in response to gentle pressure.
Visual aid: Imagine standing on wet sand. At first, it's solid underfoot. But stand there a while, and you'll see a little puddle forming around your feet. That’s thixotropy, and it’s similar to what happens when we hold gentle pressure over stiff fascia. The fluid slowly moves in, and the tissue begins to soften.
MFR isn’t about pressing hard. It’s about feeling for resistance, gently waiting at those tension points, and letting the body do the work. Subtle, but powerful. This technique is usually done by a trained professional whose fingers can detect and encourage these subtle releases; it can be quite tricky to replicate this effectively on yourself.
Taping Techniques: The Long-Short Method
Kinesiology taping can be a helpful way to support scar tissue and the surrounding areas. It’s gentle, low-risk, and can be used alongside other treatments.
The long-short taping method involves applying strips of tape with different levels of stretch. The longer section is stretched to encourage movement, while the shorter anchor points are left unstretched to hold the tape in place.
This approach may:
Lift the skin and fascia to allow more movement
Help reduce tension or tightness around the scar
Encourage better blood and lymphatic flow
Support collagen reorganisation and improve tissue pliability over time
While not a fix-all, it’s a useful tool that can complement other scar treatments. Just be sure to get guidance on the correct application from a trained professional, as the placement and stretch make all the difference.
Ultrasound (US) Therapy: No, We’re Not Looking for a Heartbeat
Therapeutic ultrasound (not to be confused with diagnostic ultrasound scans) can be a helpful tool in the early stages of healing. It may assist in reducing swelling and supporting tissue repair. However, its benefits tend to lessen after about three months, unless there is ongoing inflammation or swelling.
It's important to mention that the research around therapeutic ultrasound is still evolving. While some studies question its effectiveness, others, including my own clinical experience, have shown positive results. I would almost always use ultrasound alongside a structured rehabilitation programme, so it’s difficult to credit progress to ultrasound alone. It’s just one piece of the puzzle in a comprehensive recovery plan.
Final Thoughts: Your Scar Is Still Part of the Story
Scars don’t have to be problems, but they can become one if left unmanaged. If you're dealing with stiffness, pulling, or reduced mobility, it might be time to take a second look at an old scar and give it some attention.
From hands-on massage to fascia release and supportive taping, there are plenty of options to help you move more freely and comfortably.
Not sure where to start? Book in for a session and we’ll take a look at how your scar may be impacting your movement and build a plan that works for you.
If you have any other questions or queries, please feel free to contact me!
Thank you for reading,
Yasmin Spence
Call for Comments
Based on this newsletter, here are a couple questions to think about:
Have you ever had an old scar surprise you with new issues or affecting how you move?
What are your stories about scar management aiding your rehab?
If you have been reading along consistently, thank you. In the meantime, if you’re keen for more performance insights from our previous editions - all here on Substack.
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