Understanding Scar Tissue: Can It Be Remodeled? by Kathy Klich, RMT
- Kathy Klich, RMT
- May 26
- 3 min read
Updated: Jun 6
Scar tissue forms during the healing process after an injury—whether from surgery, trauma, inflammation, or repetitive strain. It's composed of collagen, but unlike the original tissue, the collagen fibers in scar tissue are less organized. This disorganized structure can lead to:
Reduced elasticity
Decreased mobility
Pain or adhesions
Can Scar Tissue Be Broken Down or Remodeled?
While scar tissue can't be "broken down" in the sense of being eliminated, it can be remodeled to become more functional and less symptomatic.
Research indicates that: Collagen remodeling occurs over time, spanning months to years.
Controlled mechanical loading—through manual therapy, stretching, and movement—can influence the alignment and behavior of collagen fibers. Scar tissue doesn't disappear but can become more pliable and functionally integrated with surrounding tissues.
Evidence-Based Techniques to Remodel or Reduce Scar Tissue
1. Massage Therapy
Massage therapy is a cornerstone in scar tissue management. Techniques include:
Cross-fiber friction (Cyriax technique): Encourages realignment of collagen fibers by applying pressure perpendicular to the scar.
Myofascial release: Targets the fascia to reduce adhesions and restore tissue glide.
Deep tissue techniques: Focus on deeper restrictions around the scar to improve mobility.
Instrument-assisted soft tissue mobilization (IASTM): The Graston Technique is a form of manual therapy known as soft-tissue instrument-assisted mobilization. It is a manual therapy approach that uses instruments with a specialized form of massage or scraping the skin gently that applies controlled pressure, promoting collagen realignment and functional improvement.
Studies have shown that IASTM can stimulate fibroblast activity, leading to increased collagen production and improved tissue healing.
2. Stretching and Movement
Incorporating stretching and movement into rehabilitation programs can aid in scar tissue remodeling:
Gentle, progressive stretching: Helps promote collagen fiber alignment and increases tissue flexibility.
Active and passive range-of-motion exercises: Assist in maintaining joint mobility and preventing stiffness.
Regular movement encourages the body to adapt, reducing the risk of adhesions and improving overall function.
3. Cupping Therapy
Cupping therapy involves placing suction cups on the skin to create negative pressure. This technique may:
Lift and mobilize fascial layers
Improve circulation
Potentially reduce adhesions
While more research is needed, some studies suggest that cupping can alleviate musculoskeletal pain and enhance healing.
4. Heat Therapy
Applying heat to scar tissue can increase tissue pliability, making manual therapy or stretching more effective. Heat therapy may:
Enhance blood flow
Reduce muscle tension
Prepare tissues for further therapeutic interventions
Utilizing heat packs or warm baths before therapy sessions can optimize treatment outcomes.
5. Kinesiology Taping
Kinesiology tape can be applied around scars to:
Reduce tension
Improve lymphatic flow
Support tissue alignment
This non-invasive method provides continuous support between therapy sessions, aiding in the remodeling process.
6. Laser Therapy & Ultrasound
Advanced modalities like laser therapy and therapeutic ultrasound have shown promise in scar management:
Laser therapy: Stimulates fibroblast activity, promoting collagen production and improving scar appearance.
Ultrasound therapy: Enhances tissue healing by increasing blood flow and reducing inflammation.
These treatments can be particularly effective for hypertrophic scars and keloids.
7. Manual Lymphatic Drainage (MLD)
MLD is a gentle massage technique that encourages lymph flow, helping to:
Reduce swelling
Alleviate congestion around scars
Promote healing
Incorporating MLD into a comprehensive scar management plan can enhance overall outcomes.
Clinical Studies Supporting Scar Tissue Management
A systematic review found that IASTM can reduce patient-reported pain and improve function in individuals with musculoskeletal disorders. Research indicates that stretching can increase tendon elasticity, which has important clinical implications for the treatment and prevention of tendon injuries. A pilot study demonstrated that soft tissue mobilization of chronic C-section scars reduced pain and improved flexibility and function.
Conclusion
Scar tissue remodeling is a gradual process influenced by various therapeutic interventions. While it may not be possible to completely eliminate scar tissue, evidence-based techniques such as manual therapy, stretching, and other modalities can enhance tissue function and reduce discomfort. Consulting with healthcare professionals to develop a personalized treatment plan is essential for optimal outcomes.
