Our bodies are formed of interlacing structures designed to slide and glide. As a surgical scar forms, the slide and glide of the area is disrupted, and can be permanently compromised. ‘Adhesions’ are a common complication where sticking of two internal structures occurs. Adhesions reduce the integrity of the area and often cause a feeling of pulling, tightness or pain.
Internally, scar tissue can be far reaching. Adhesions and fibrosis can leave your body having to work harder to perform movements. The healthy, unscarred muscles, ligaments and fascia get exhausted and tired, whilst pain and inflammation are also common factors. Irritation and fatigue occur in the healthy structures of the body, which are trying to make up for the lack of mobility as a result of the scar.
Lymphatic flow can be interrupted where surface tissues have been damaged and lymph nodes have been removed. Lymphoedema is a common complication, often because scarring interrupts the lymphatic pathways. Breath, which is used to move lymphatic flow, may be shallower after surgery as tightness in the ribs or diaphragm alter our breathing patterns.
Women undergoing breast cancer surgery are more likely to suffer complications with scar healing due to the necessity of radiotherapy which causes localised tissue damage, contracture and thickening.
ScarWork and scar massage can help after surgery or an accident causes damage to tissue. The ScarWork techniques were developed over a lifetime by American Structural Integration therapist, Sharon Wheeler. Taught by Ida Rolf (founder of Rolfing) in 1973, Sharon started working on scar tissue and developed a unique approach to promote change in scar tissue, old or new. Training only started a few years ago in the UK and I travel to cancer centres and therapy schools teaching therapists these skills with Restore Therapy Training, an accredited provider.
Tightness, discomfort and pain in the surgery site is common and can persist for years after the operation. Some women I see for treatment are a couple of months after their mastectomy or reconstruction surgery, others are years into their recovery and looking to move forward. It is wonderful to be able to bring relief and improvements for the patients, with either new or older scars and help them move on.
“There is strong evidence that scar massage therapy can help resolve both pain and hardness quickly and effectively. After a couple of scar therapy sessions with ScarWork, I was impressed to see that many of my patients’ breast pain had resolved”Comments Kelvin Chong, oncoplastic breast surgeon
Women are often left with mobility problems and many dislike the appearance of their mastectomy or breast reconstruction. With altered or no sensation around the scar, the area may feel like it is disconnected. Massage over the scar and surrounding area, together with stimulation using ScarWork techniques can promote tissue health and sensitivity may improve. Gentle touch helps create a therapeutic space for emotional healing after the stress and trauma of the whole experience.
Stimulation with ScarWork treatment helps to bring nutrients into the scar area and encourage blood and lymphatic flow which can initiate further healing by gently working to encourage the scar tissue to become loose and mobile. Treatment is always within the comfort level of the client and so treatment always progresses at a pace that’s right for them. Usually a series of treatments lasting around 30-60 minutes per session are given over a few months.
Incremental changes should occur leaving the whole area and arm feeling looser and more comfortable. After a reconstruction such as a DIEP, LAT, TRAM flap or similar, the donor site will also be treated. The scar line is only an access point, so the entire area traumatised by surgery is included in the treatment. Scars often improve visually as well as improvements in the deeper tissues.
“There was an obvious improvement in the cosmetic appearance and texture to the breast (after ScarWork) which at least partially reversed the effects of surgery and radiotherapy. I would recommend that this treatment should be available to all breast cancer patients.”Says Kelvin Chong, oncoplastic breast surgeon.
“Having had 5 breast cancer surgeries in 15 months, a double mastectomy, direct to implant, infections & cellulitis, rejection and removal of implants, capsular contracture and further sinus and leaking complications, along with previous radiotherapy, I thought the scarring was beyond repair. I was traumatised and unable to accept how I had been left from surgery. The taut, tissue-thin blue skin had little movement or blood flow to it. The scars were dense, hard and painful to touch. It felt like they were stuck to my rib cage. I was in a mess physically and emotionally.
I contacted Emma at Restore Therapy. No one had seen my scars, and I hadn’t even been able to touch them myself. After just the first session I noticed a change in my skin colour and after just 3 x 45min sessions, I had movement and motion I could never have imagined. My confidence is returning with each treatment. Emma is one of those beautiful people that you meet and changes your world around. She is so passionate about ScarWork and I would highly recommend her. I think all surgeons specifically in Breast Cancer Units, should be made aware of this treatment and the huge benefit and impact it has on patients.”
Emma’s background is as a massage therapist, but she has found her specialism in ScarWork and scar massage and now teach these techniques to therapists as well as running a busy private clinic. Scar tissue complications have been largely ignored with little research into possible treatments, but she is working hard to increase awareness within UK. She is fortunate to have open minded surgeons working in the hospitals near her, who have been supportive of the benefits of treatment. Research is ongoing into ScarWork treatment and why these techniques are so effective. Recent studies* are showing encouraging research that massage and mobility of the scar reduce the formation of adhesions.
For more information on ScarWork and scar massage and how to find a local therapist, please contact: Emma Holly firstname.lastname@example.org
*Research paper ‘Attenuation of postoperative adhesions using a modelled manual therapy’ June 2017 Geoffrey M Bove et al
The information and content provided in all guest blogs is intended for information and educational purposes only and is not intended to substitute for professional medical advice. Please seek professional advice or speak to your medical team if you have any questions about the issues raised in this guest blog.
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