The Fault in our Scars

Shoulder ScarScars have the potential to cause trouble somewhere down the road. Not always but sometimes. To better understand how this might be, consider the function of our skin. What is it’s primary purpose? It is the largest organ of the body and plays a critical role in our survival. It is part of our immune system. Simply put, it keeps out bad things from getting into our bloodstream.

            What happens when you get cut? Your insides are exposed to the outside. Depending on the depth of the cut determines how much flesh and how many nerve endings get severed. The automatic response is to close down in that open area to keep anything from getting in (and keep your blood from getting out). It is a very primitive response to maintain our survival.

            What is it that helps close down the area? Clotting occurs to seal the wound. Also, staples, sutures, and super glue are additional modern medical ways to seal the opening. Eventually, the cut heals over. However, when the scar forms the severed nerve endings remain severed, and it will take a very long time for sensation across the scar to occur if it ever does. During this time of limited nerve, sensation imagine what the brain is going through. As far as it is concerned there is still a hole because it can not feel the connection across severed nerve endings.

            Your skin and muscles tighten around it, and your posture may change to accommodate the continued protective response. It takes only a short amount of time before this protective response normalizes into your everyday posture. If you have ever undergone surgery, you have probably experienced how scar tissue limits movement. It has become a common approach in the world of physical therapy to try and break up scar tissue to allow the body more freedom of movement. But what if the scar tissue did not break up or if the nerves never repaired? What if you were able to bring attention and awareness to the scar area so the brain could get feedback that it is, in fact, healed? Simply touching the scar and getting the body to move can potentially have amazing results.

            We had a client some time back who was suffering from low back pain. We went through a health history and learned that he sustained a head injury when he was a child, and it required major surgery which left a sizable scar across his forehead. We checked his range of motion at various joints. We found he had significant restrictions which needed to be removed. We guided him through some movements, but the restrictions did not change. Fault In ScarsThen we had him place his palm over the scar on his forehead and his range of motion at all of the joints significantly improved. We were able to guide him again through some movements while he held his scar and the result was no more low back pain. It may seem pretty far-fetched but it happened nonetheless. His whole posture had reorganized itself around the injury and eventually created an environment for low back pain to occur.

            Is it out of the question to think that a person who underwent a hysterectomy or hernia repair or mastectomy may develop low back pain, elbow tendinitis or other joint pain because of being restricted elsewhere in their body? The protective tension surrounding a hysterectomy or hernia repair may lead to a shifted and rotated pelvis and forward tilted rib cage which would compromise the spine’s position and ask other areas to work harder to overcome the restricted joint mechanics. A mastectomy might draw the same side shoulder forward and inward and cause limited shoulder function and ask the elbow to overwork.     

            Unfortunately, there is very little research about scars and their effect on movement and chronic pain. Equally unfortunate is the majority of conventional therapeutic approaches are more symptom-based and will only focus attention on the pain site without considering the larger picture and asking one simple question: why? Why is there pain there and what is the cause? Just one question could lead to a much more comprehensive answer and understanding. Often scars are easily discounted, and no importance is placed upon them. They are thought to be old news with no relevance in the present. If we refuse to consider their potential role in changing structure and causing pain then the fault, dear Brutus, is not in our scars but in ourselves.

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