Table of ContentsView AllTable of ContentsWhat Is Scar Tissue?Is Scar Tissue Permanent?Management TechniquesManagement After a FractureResearchFAQ
Table of ContentsView All
View All
Table of Contents
What Is Scar Tissue?
Is Scar Tissue Permanent?
Management Techniques
Management After a Fracture
Research
FAQ
Physical therapists commonly use scar tissue massage to help remodelscar tissuethat has developed in injured tissue. You might have this type ofphysical therapyafter you experience an injury that results in a buildup of scar tissue, including:
Also CalledScar massageScar mobilizationScar tissue mobilization
Also Called
Scar massageScar mobilizationScar tissue mobilization
This article explains how scar tissue develops and the techniques involved in managing it.
Jan-Otto / Getty Images
Collagen(a protein found in muscles, bones, and other tissues) forms scar tissue. After an injury, your body lays down collagen that will become normal healthy tissue.
Collagen that develops under typical, healthy circumstances aligns to give your tissue strength. However, the collagen cells that form in response to an injury do so randomly. This sporadic layering leads to the buildup of scar tissue.
Scar tissue can develop almost anywhere in the body. Some examples of how scar tissue appears include:
1:36Click Play to Learn How to Break Up Scar Tissue
1:36
Click Play to Learn How to Break Up Scar Tissue
Scar tissue is not a permanent fixture in the body. After it forms and heals, the scar mustremodel.
Remodeling is a natural part of the healing process. During remodeling, your body rebuilds the scar so that it becomes stronger and more similar to the tissue that was there before the injury.This adjustment is necessary so the new tissue can tolerate the stress and forces that the body typically experiences in a day.
RemodelingStretching and pulling the area helps the remodeling process. This stretching allows the collagen to align and return to normal.
Remodeling
Stretching and pulling the area helps the remodeling process. This stretching allows the collagen to align and return to normal.
Remodeling is essential to ensure that your injured tissue regains normalrange of motion,strength, and mobility. When scar tissue doesn’t remodel correctly, it can lead to mobility loss andjoint contractures(a shortening and tightening of fibers that make movement difficult). If contractures form, they are permanent.
How Long Does Remodeling Take?Everyone is different and heals at different rates. In general, it takes about six to eight weeks for injured tissue to remodel entirely. If the wound does not heal within eight weeks, contact your healthcare provider.
How Long Does Remodeling Take?
Everyone is different and heals at different rates. In general, it takes about six to eight weeks for injured tissue to remodel entirely. If the wound does not heal within eight weeks, contact your healthcare provider.
Keloids and Hypertrophic Scars
Sometimes chronic inflammation can cause extra collagen to be produced at the site of a wound, resulting in a raised scar. This can lead to akeloid scarorhypertrophic scar.Keloids grow to be larger than the wound that caused the scar and can be painful, itchy, and disfiguring.
Unlike keloid scars, hypertrophic scars don’t extend beyond the boundary of the the original wound.
Scar Tissue Management Techniques
If you have developed scar tissue after an injury or surgery, yourphysical therapist(PT) may perform a scar massage on the injured tissue to help with the remodeling process. They may also instruct you or a family member how to massage scar tissue properly.
Talk to Your Healthcare ProviderCheck with your healthcare provider or physical therapist to ensure that your scar is properly healed before having a scar tissue massage. Massaging a scar that is not fully healed can damage the developing scar tissue, which can delay healing.
Talk to Your Healthcare Provider
Check with your healthcare provider or physical therapist to ensure that your scar is properly healed before having a scar tissue massage. Massaging a scar that is not fully healed can damage the developing scar tissue, which can delay healing.
In addition, massaging an unhealed scar may open it and lead to bacteria and infection in your body, something that could lead to serious complications.
Lubrication
Do not use lubricants if you have any open sores or incisions, as it could lead to an infection.
Cross Friction Massage
One effective method of scar massage is calledcross-friction or transverse friction massage. This technique involves using one or two fingers to massage the scar in a direction that is perpendicular to the scar line.
This technique helps to remodel the scar. It also ensures that the collagen fibers of the scar are correctly aligned.
PTs commonly use cross-friction massage to treat the following:
The technique is performed for five to 10 minutes. If instructed to do so, you may be able to perform scar tissue massage on yourself two to three times per day.
Myofascial Release
Myofascialrelease(MFR) manages scar tissue and the adhesions that may accompany it. The technique involves using the hands to massage the skin and underlying tissues around the scar.
Motions are slow, and the amount of force is usually light. Your PT can feel for tissue restrictions, calledfascia, in various directions. They can then work to improve movement in those restricted directions.
Instrument Assisted Scar Tissue Massage
However, research to date hasn’t made a compelling case for the effectiveness of IASTM.
Stretching
Another standard method to help remodel scar tissue is stretching and flexibility exercises. Stretching can help lengthen the injured tissues and improve their overall movement.
If you have had an injury or surgery, your physical therapist is likely to incorporate both scar massage and stretching into your rehabilitation program.
Stretching scar tissue may be an essential component of your recovery. Most PTs agree that prolonged, low-load stretching (slow, moderate stretching held for a long time) is necessary to help you fully remodel scar tissue.
Scar Management After Fracture
The scar tissue in the bone is called acallus.It is present for four to 12 weeks after a fracture.
If you have broken a bone and have started physical therapy, your therapist may massage the overlying tissue near the callus. This technique helps restore normal mobility. If you have had surgery to repair the broken bone, scar massage over your incision may also help.
Does Science Support Scar Tissue Massage?
Although more research is needed, some evidence suggests that massages may provide moderate-to-strong pain relief for burn scars. A 2020 meta-analysis examined massage as a type of physical scar tissue management. Specifically, it looked at its effect on:
One study included in the meta-analysis found that massage may significantly improve the pliability ofburn scars. The meta-analysis also concluded that massage therapy may have a moderate effect on pruritus.
Two studies in the meta-analysis found that massage could help reduce the thickness of scars, but two other studies found no such benefit. The authors noted that the length of the massage treatment (30 minutes versus five) may account for the differences in the findings.
Can I Self-Massage a Scar?
Yes, you can self-massage a scar. Self-massage is safe and can be particularly effective given that you can easily adjust the pressure and location of the massage according to the sensations you feel.
You can start self-massaging a scar as soon as the wound is healed and any stitches you may have had are removed. All you need is a water-based cream or skin-safe plant oil to lubricate the skin. Olive oil, grape seed oil, coconut oil, and jojoba oil are all great options due to their wound-healing properties.
How to Massage a Scar
Your healthcare provider may have specific directions for how often you should massage the scar and how long each massage session should last.
Do Massage Guns Break Up Scar Tissue?
Summary
Scar tissue massage is a form of rehabilitation that uses pulling and stretching to remodel scar tissue. Scar massage helps you regain mobility and strength in your damaged tissue.
PTs use a variety of techniques in scar massage. Additionally, they may instruct you how to do the exercises on your own at home.
Frequently Asked QuestionsIt may worsen it if the tissue is fresh and inflamed, as very new scars tend to be for the first two weeks. It’s best not to manipulate such tissue too aggressively as this could increase inflammation and slow routine healing and scar formation.Learn MoreWhat to Know About Skin InflammationMassage is unlikely to improve the appearance of a scar, increase mobility, or soften the tissue after two years.Treatments that are used instead of or in addition to massage for hypertrophic and keloid scars include:Extracorporeal shockwave therapy (ESWT)Silicone gelCreams containingprotease enzymesLaser therapy
Frequently Asked Questions
It may worsen it if the tissue is fresh and inflamed, as very new scars tend to be for the first two weeks. It’s best not to manipulate such tissue too aggressively as this could increase inflammation and slow routine healing and scar formation.Learn MoreWhat to Know About Skin Inflammation
It may worsen it if the tissue is fresh and inflamed, as very new scars tend to be for the first two weeks. It’s best not to manipulate such tissue too aggressively as this could increase inflammation and slow routine healing and scar formation.
Learn MoreWhat to Know About Skin Inflammation
Massage is unlikely to improve the appearance of a scar, increase mobility, or soften the tissue after two years.
Treatments that are used instead of or in addition to massage for hypertrophic and keloid scars include:Extracorporeal shockwave therapy (ESWT)Silicone gelCreams containingprotease enzymesLaser therapy
Treatments that are used instead of or in addition to massage for hypertrophic and keloid scars include:
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mathew-Steiner S, Roy S, Sen C.Collagen in wound healing.Bioengineering (Basel). 2021 May;8(5):63. doi:10.3390/bioengineering8050063Gardner T, Kenter K, Li Y.Fibrosis following acute skeletal muscle injury: Mitigation and reversal potential in clinic.J Sports Med (Hindawi Publ Corp). 2020 Sep;2020(1):7059057. doi:10.1155/2020/7059057Gonzalez AC, Costa TF, Andrade ZA, Medrado AR.Wound healing - a literature review.An Bras Dermatol. 2016;91(5):614-620. doi:10.1590/abd1806-4841.20164741Summerlin Hospital.Wound care & treatment.Ogawa R.Keloids and hypertrophic scars.UpToDate.Ault P, Plaza A, Paratz J.Scar massage for hypertrophic burns scarring—a systematic review.Burns. 2018;44(1):24-38. doi:10.1016/j.burns.2017.05.006Kim J, Sung DJ, Lee J.Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application.J Exerc Rehabil. 2017;13(1):12-22. doi:10.12965/jer.1732824.412.Cheatham SW, Lee M, Cain M, Baker R.The efficacy of instrument assisted soft tissue mobilization: a systematic review.J Can Chiropr Assoc. 2016;60(3):200-211.Kohata K, Itoh S, Horiuchi N, Yoshioka T, Yamashita K.Influences of osteoarthritis and osteoporosis on the electrical properties of human bones asin vivoelectrets produced due to Wolff’s law.Biomed Mater Eng. 2017;28(1):65-74. doi:10.3233/BME-171657Deflorin C, Hohenauer E, Stoop R, van Daele U, Clijsen R, Taeymans J.Physical management of scar tissue: a systematic review and meta-analysis.J Altern Complement Med. 2020;26(10):854-65. doi:10.1089/acm.2020.0109Lin TK, Zhong L, Santiago J.Anti-inflammatory and skin barrier repair effects of topical application of some plant oils.Int J Mol Sci. 2018 Jan;19(1):70. doi:10.3390/ijms19010070British Skin Foundation.The benefits of scar massage.Moffitt Cancer Center.Managing your scar.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mathew-Steiner S, Roy S, Sen C.Collagen in wound healing.Bioengineering (Basel). 2021 May;8(5):63. doi:10.3390/bioengineering8050063Gardner T, Kenter K, Li Y.Fibrosis following acute skeletal muscle injury: Mitigation and reversal potential in clinic.J Sports Med (Hindawi Publ Corp). 2020 Sep;2020(1):7059057. doi:10.1155/2020/7059057Gonzalez AC, Costa TF, Andrade ZA, Medrado AR.Wound healing - a literature review.An Bras Dermatol. 2016;91(5):614-620. doi:10.1590/abd1806-4841.20164741Summerlin Hospital.Wound care & treatment.Ogawa R.Keloids and hypertrophic scars.UpToDate.Ault P, Plaza A, Paratz J.Scar massage for hypertrophic burns scarring—a systematic review.Burns. 2018;44(1):24-38. doi:10.1016/j.burns.2017.05.006Kim J, Sung DJ, Lee J.Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application.J Exerc Rehabil. 2017;13(1):12-22. doi:10.12965/jer.1732824.412.Cheatham SW, Lee M, Cain M, Baker R.The efficacy of instrument assisted soft tissue mobilization: a systematic review.J Can Chiropr Assoc. 2016;60(3):200-211.Kohata K, Itoh S, Horiuchi N, Yoshioka T, Yamashita K.Influences of osteoarthritis and osteoporosis on the electrical properties of human bones asin vivoelectrets produced due to Wolff’s law.Biomed Mater Eng. 2017;28(1):65-74. doi:10.3233/BME-171657Deflorin C, Hohenauer E, Stoop R, van Daele U, Clijsen R, Taeymans J.Physical management of scar tissue: a systematic review and meta-analysis.J Altern Complement Med. 2020;26(10):854-65. doi:10.1089/acm.2020.0109Lin TK, Zhong L, Santiago J.Anti-inflammatory and skin barrier repair effects of topical application of some plant oils.Int J Mol Sci. 2018 Jan;19(1):70. doi:10.3390/ijms19010070British Skin Foundation.The benefits of scar massage.Moffitt Cancer Center.Managing your scar.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Mathew-Steiner S, Roy S, Sen C.Collagen in wound healing.Bioengineering (Basel). 2021 May;8(5):63. doi:10.3390/bioengineering8050063Gardner T, Kenter K, Li Y.Fibrosis following acute skeletal muscle injury: Mitigation and reversal potential in clinic.J Sports Med (Hindawi Publ Corp). 2020 Sep;2020(1):7059057. doi:10.1155/2020/7059057Gonzalez AC, Costa TF, Andrade ZA, Medrado AR.Wound healing - a literature review.An Bras Dermatol. 2016;91(5):614-620. doi:10.1590/abd1806-4841.20164741Summerlin Hospital.Wound care & treatment.Ogawa R.Keloids and hypertrophic scars.UpToDate.Ault P, Plaza A, Paratz J.Scar massage for hypertrophic burns scarring—a systematic review.Burns. 2018;44(1):24-38. doi:10.1016/j.burns.2017.05.006Kim J, Sung DJ, Lee J.Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application.J Exerc Rehabil. 2017;13(1):12-22. doi:10.12965/jer.1732824.412.Cheatham SW, Lee M, Cain M, Baker R.The efficacy of instrument assisted soft tissue mobilization: a systematic review.J Can Chiropr Assoc. 2016;60(3):200-211.Kohata K, Itoh S, Horiuchi N, Yoshioka T, Yamashita K.Influences of osteoarthritis and osteoporosis on the electrical properties of human bones asin vivoelectrets produced due to Wolff’s law.Biomed Mater Eng. 2017;28(1):65-74. doi:10.3233/BME-171657Deflorin C, Hohenauer E, Stoop R, van Daele U, Clijsen R, Taeymans J.Physical management of scar tissue: a systematic review and meta-analysis.J Altern Complement Med. 2020;26(10):854-65. doi:10.1089/acm.2020.0109Lin TK, Zhong L, Santiago J.Anti-inflammatory and skin barrier repair effects of topical application of some plant oils.Int J Mol Sci. 2018 Jan;19(1):70. doi:10.3390/ijms19010070British Skin Foundation.The benefits of scar massage.Moffitt Cancer Center.Managing your scar.
Mathew-Steiner S, Roy S, Sen C.Collagen in wound healing.Bioengineering (Basel). 2021 May;8(5):63. doi:10.3390/bioengineering8050063
Gardner T, Kenter K, Li Y.Fibrosis following acute skeletal muscle injury: Mitigation and reversal potential in clinic.J Sports Med (Hindawi Publ Corp). 2020 Sep;2020(1):7059057. doi:10.1155/2020/7059057
Gonzalez AC, Costa TF, Andrade ZA, Medrado AR.Wound healing - a literature review.An Bras Dermatol. 2016;91(5):614-620. doi:10.1590/abd1806-4841.20164741
Summerlin Hospital.Wound care & treatment.
Ogawa R.Keloids and hypertrophic scars.UpToDate.
Ault P, Plaza A, Paratz J.Scar massage for hypertrophic burns scarring—a systematic review.Burns. 2018;44(1):24-38. doi:10.1016/j.burns.2017.05.006
Kim J, Sung DJ, Lee J.Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application.J Exerc Rehabil. 2017;13(1):12-22. doi:10.12965/jer.1732824.412.
Cheatham SW, Lee M, Cain M, Baker R.The efficacy of instrument assisted soft tissue mobilization: a systematic review.J Can Chiropr Assoc. 2016;60(3):200-211.
Kohata K, Itoh S, Horiuchi N, Yoshioka T, Yamashita K.Influences of osteoarthritis and osteoporosis on the electrical properties of human bones asin vivoelectrets produced due to Wolff’s law.Biomed Mater Eng. 2017;28(1):65-74. doi:10.3233/BME-171657
Deflorin C, Hohenauer E, Stoop R, van Daele U, Clijsen R, Taeymans J.Physical management of scar tissue: a systematic review and meta-analysis.J Altern Complement Med. 2020;26(10):854-65. doi:10.1089/acm.2020.0109
Lin TK, Zhong L, Santiago J.Anti-inflammatory and skin barrier repair effects of topical application of some plant oils.Int J Mol Sci. 2018 Jan;19(1):70. doi:10.3390/ijms19010070
British Skin Foundation.The benefits of scar massage.
Moffitt Cancer Center.Managing your scar.
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