Written by Daan Lansdorp<\/a>, physiotherapist and owner of FysioGrow. Trained in scar therapy and fascia massage.<\/em><\/p>\n\n Did you know that scars can cause physical problems as well as cosmetic ones? That adhesions can lead to pain and limit your movement?<\/strong><\/p>\n\n At FysioGrow in Rijswijk, near The Hague, I treat people with problems caused by scar tissue. On this page I explain how a scar forms, what effects it can have and how scar therapy works.<\/p>\n\n A scar is the repair tissue the body makes after damage to the skin and the tissue underneath. Think of surgery, a cut, a burn, or even a deep graze. You can see the scar itself on the outside, but under the skin the tissue can also stick to deeper structures such as muscles, fascia (connective tissue) and nerves.<\/p>\n\n These adhesions can cause various problems:<\/p>\n You may notice these problems right after a scar forms, but they can also flare up months or even years later.<\/p>\n\n Scar tissue directly affects how well the connective tissue, also called fascia, can move. Fascia holds muscles, bones, nerves and other tissues in the body together. It makes movement possible, moves fluid around and spreads the forces that act on the body.<\/p>\n\n Fascia runs through your body in chains, like a kind of spider’s web. So an adhesion or stiffness in the fascia in one place can cause problems somewhere completely different. A scar in the calf can affect neck pain, for example, and a scar after a caesarean section can cause back pain.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t When the body repairs damage, we can roughly distinguish three phases:<\/p>\n\n In this phase the body starts an inflammatory response to begin healing the wound. You’ll see signs such as pain, redness, warmth and swelling. The surrounding skin stiffens and becomes more sensitive to pressure. This phase lasts a few days.<\/p>\n\n This phase starts about 1 to 3 days after the wound appeared. The body produces healing substances that stimulate the growth of new cells. New tissue forms to close the gap.<\/p>\n\n In this phase the new cells are arranged more neatly in place. The connective tissue takes shape according to the pattern and direction in which the tissue needs to be used. The scar becomes less red, softer and thinner. The surrounding skin becomes more elastic. This phase can go on for a year or longer.<\/p>\n\n Once the healing process is complete, a scar is left behind. What it looks like depends on the cause and the type of tissue.<\/p>\n\n Important: drinking enough water plays a role in healthy connective tissue. Fascia is full of water. With chronic dehydration, fascia dries out and can’t function as well.<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t Not every scar is the same. At FysioGrow we recognise the following five types:<\/p>\n\n A scar that is red or pink and slightly raised. It can itch and be painful. This is a normal phase that often passes by itself.<\/p>\n\n An older scar, usually pale, flat, thin and light in colour. This is the end stage of a healthy healing process.<\/p>\n\n More common in young people, especially after burns, and in people with reddish or dark skin. This scar tissue is usually red and thickened and can cause itching or pain. A hypertrophic scar doesn’t grow bigger than the original wound and can develop within a few weeks of the injury. It can heal by itself, but that can take a long time.<\/p>\n\n An abnormally thickened, irregularly shaped scar. It is red to dark in colour and bigger than the original wound. A keloid can occur at any age, but develops more often in younger people and people with dark skin. It can develop after any kind of skin damage: a surgical wound, burn, vaccination, tattoo, piercing or acne scar. Sometimes a keloid even develops without a clear cause, for example from an inflamed hair follicle.<\/p>\n\n A small scar that sits slightly sunken in the skin. It looks like a little pit in the skin. Well-known examples are scars from acne and chickenpox.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t Scar therapy is a targeted physiotherapy treatment to reduce or prevent problems caused by scar tissue. Scars can come from surgery or cancer treatment, among other things, and they affect the fascia. This can lead to adhesions, thickening and hardening, which in turn cause restricted movement, pain, fluid build-up, muscle weakness and loss of strength.<\/p>\n\n With scar therapy we tackle these adhesions and thickenings. In practice we often see that scar tissue is overlooked as a cause or contributing cause of pain. By treating the scar and loosening it, we can get good results, even with problems that at first sight seem to have nothing to do with the scar.<\/p>\n\n Do you have a scar after surgery, an accident or giving birth, and do you recognise one or more of the problems in the list above? Then scar therapy may help. Book an appointment<\/a> to discuss what we can do for you.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\tWhat are scars and what problems can they cause?<\/h2>\n\n
\n
The role of fascia<\/h3>\n\n
How does a scar form?<\/h2>\n\n
1. The inflammatory phase<\/h3>\n
2. The proliferation phase<\/h3>\n
3. The remodelling phase<\/h3>\n
![\"fascia\"](\"https:\/\/www.fysiogrow.nl\/wp-content\/uploads\/2021\/06\/fasciamicroscoop.jpg\")
\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\tTypes of scars<\/h2>\n\n
Immature scar<\/h3>\n
Mature scar<\/h3>\n
Hypertrophic scar<\/h3>\n
Keloid scar<\/h3>\n
Atrophic scar<\/h3>\n
![\"superficial](\"https:\/\/www.fysiogrow.nl\/wp-content\/uploads\/2021\/06\/20190614_101500-601x1024.jpg\")
\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\tWhat is scar therapy?<\/h2>\n\n
Goals of the treatment<\/h3>\n
\n
![\"littekenweefsel](\"https:\/\/www.fysiogrow.nl\/wp-content\/uploads\/2021\/06\/Scar-tissue-2-scaled-1-1024x768.jpg\")
\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t