Scar tissue is fibrous tissue which the body produces to replace normal tissue after injury. Scarring results naturally and is a key element during the process of wound repair in the skin and other tissues of the body. Unless very slight, every injury or lesion will result in some degree of scarring.
If a wound heals quickly within two weeks with new formation of tissue, minimal collagen will be deposited and no heavy scarring will form. Generally, if a wound takes longer than three to four weeks to heal, a more problematic scar will form. This is often the case in repetitive strain injuries or conditions such as plantar fasciitis whereby continued use of an injured are hinders healing through re-injury and as such the healing process is prolonged and more scar tissue is laid down.
Scar tissue is composed of the same protein (collagen) as the tissue the original tissue destroyed or torn during injury. However, the composition of the tissue is different. Instead of a random linear formation of the collagen fibres found in normal tissue, Scar tissue rebuilds tissue using the collagen cross-links. This means that scar tissue is usually of weaker, less elastic and less functional in comparison to the original tissue which it replaces. In addition, scar tissue can also become adherent to surrounding tissue causing pain on and limitation of movement.
If for example and athlete tears fibres of their hamstring, their body will commence the healing process and begin to knit the tissue back together using scar tissue. As we know, scar tissue is weaker and less elastic than the springy muscle tissue it is replacing. We also know that scar tissue as it is forming will tighten. This is because the body is trying to pull the torn tissue together to heal (a little like stitching). The end result of this is that the scar tissue formed does not have the same functional capacity as the surrounding hamstring muscle tissue within which it is situated. But, the body still expects this level of function. This is where problems can arise. We have all heard of footballers who come back from injury and only get through half a season before their hamstring goes again? Well, this is why scar tissue management is so important.
Due to the difference in composition, the scar tissue will not contract and relax in the same fashion as the original tissue and surrounding muscle tissue and, as such, as the person goes through normal movement the tight inflexible scar tissue can shear and tear due to the pressure of movement. This will happen on a normal basis and eventually the scar tissue will lengthen out and be remodelled to a length so that these imperfections no longer have an impact.
Unfortunately, in some cases where the demands on the area are constant and no period of adjustment or rest is afforded. This can cause a cycle of scar tissue breakdown as the scar tissue is not given time to settle causing tearing of the scar tissue. This kick-starts inflammation and the body must restart scar tissue composition to replace the damaged scar tissue. Unless this pattern is addressed this cycle can role on for long periods as the body battles to heal against a continuous breakdown of tissue.
Here at the Buckingham Clinic we are happy to house one of the few available Shockwave machines in Glasgow. Shockwave sends pulses into the body directed at the scarred area and causes breakdown of the excess scar tissue and allowing for new tissue to be lain down in its place, thus reducing pain and returning the tissue to normal function. For more information just give us a call.