"Look How Cool My Scar Is!"

By: Katie Burnham, DPT

Ever wonder what a scar actually is… Why some people scar more than others? 

Scarring is the body’s natural response to damage of the tissues. It is the process of repairing and is the final result of a wound’s healing. Apart from being less than desirable in appearance, scars are a necessary process. The result is an area of more fibrous tissue which does not move and stretch like normal healthy tissue. We do have some influence on how well we heal however.

There is a time frame for wound healing and scar formation. Without being too “nerdy” I will say there are 3 phases of healing: inflammation, proliferation and remodeling. Various types of cells come into play throughout the steps of healing. Fast forward 2 to 3 weeks after an injury, the wound is replaced by granulation tissue (new connective tissue) and has been covered by new epithelial cells (skin tissue). Collagen fibers enter the scene and these are initially arranged in a disorganized way. Over time they rearrange and as a result the scar becomes less thick and noticeable. A significant difference between healthy tissue and a scar is the increased amount of collagen present in scar tissue. 

Now that we know more about what scars actually are, let’s talk about how people can scar differently. Factors such as mechanical stress to the tissue, environmental conditions, location of a wound on/in the body and even nutritional health can impact wound healing. So if you aren’t taking in an adequate and diverse type of vitamins, minerals, healthy fats and even protein you may heal more slowly.

Let’s go back to that collagen for a moment. Knowing that scar tissue has an increased amount of collagen in comparison to healthy tissues we can say there is a reduction in the elasticity of the tissues. Reduced elasticity means restriction!  So rehabbing after a surgery is crucial to promote organized formation collagen fibers. This is why we instruct patients on scar tissue mobilization!  Massage promotes improved pliability which is important for optimal healing. The timeframe for this is usually just a couple weeks from the injury or surgery. So don’t be afraid to mobilize that scar!

*The pictures above show a scar on Karyssa's dads thoracic spine post surgical fusion of his vertebrae (T2-T7). The picture on the left (staples still in place) was taken a week after surgery and the one on the right was taken 2 months post surgery (staples removed).