Scars are visible reminders of past injuries, but they can also cause problems long after the initial trauma, even when we don’t realize it. Pain from scar tissue is often missed because the scar itself might not hurt. Instead, scars cause pain by distorting the sheet-like connective tissue in our bodies called fascia. This can lead to muscle imbalance and joint instability, which often results in chronic pain. Fortunately, releasing internal restrictions in scars can provide relief by restoring normal movement to the affected fascia.  

New Scar, New Pain 

A patient, whom I will refer to as Terry, is a cellist. She came to my office for treatment of pain and tension near her right shoulder blade.  The pain started after healing from a skin biopsy in the right shoulder, then subsequently intensified due to the shoulder movement of playing her cello. Terry believed that a scar was the source of her pain and tension, but nothing she tried offered any relief. Finally, the discomfort began to inhibit her playing. 

Upon examining Terry’s scar, I found noticeable restrictions, compared to the other skin around it.  Some of the muscles between her spine and shoulder blade were abnormally tight, and pressing on them gave Terry sharp discomfort. When I tested the muscles for strength, they were quite weak. After stimulating the scar with precise pressure, those muscles relaxed and became less tender to pressure.  This confirmed the scar was a source of pain and tension. 

After about five minutes of precise manual therapy to soften the scar, her muscle tension melted away. Retesting the weak muscles showed strength improvements as well. Terry has since resumed playing the cello with free, easy motions and no pain in her shoulder.   

Old Scar, New Pain 

Samantha came to my office with hip discomfort after lifting a heavy box. She thought the pain could be from a resulting muscle strain, but weeks later, she still experienced weakness and difficulty walking.  My practice is focused on finding restrictions in connective tissue (especially fascia) that cause muscular imbalance and joint misalignment so I examined her thoroughly for fascia restrictions. Although she exhibited some mild inflammation in the hip area, I could not locate any significant restrictions. 

However, Samantha had visible loss of muscle tone and weakness in her left abdominal muscles. Searching for the source of this weakness, I found a line of fascia tension in her left rib cage, which she informed me was the line of a surgical scar.  At age two, she had an enormous incision in the left side of her chest to allow for heart surgery.   

The scar had remained painful her entire life, and was exquisitely tender to even light pressure. After testing the scar, I stimulated it with light pressure, then retested the strength of her abdominal muscles. They were much stronger, and movement at her left hip became less painful. The scar was large and, therefore, could not be completely released in just one treatment. However, partial release of the first treatment offered her enormous relief, and further treatments resolved her pain altogether.  

It had never occurred to Samantha that a scar from her early childhood might still affect her in adulthood. Unbeknownst to her, the scar created weakness in her abdominal muscles that made it difficult for her to recover from a minor injury. She had, in fact, strained some muscles due to heavy lifting—but the restricted fascia from her old scar was the cause of continual stress and lack of healing in the strained area.  

Referred Pain 

Samantha’s story illustrates another potential element of pain that can be caused by scars.  The pain can “refer” to somewhere distant from the scar, which makes it hard to know exactly where the pain is coming from. I see many cases where scars from abdominal surgeries, such as C-sections or appendectomies, cause distortions in the body’s web of fascia, which leads to hip muscle weakness.  This can cause sciatica or knee pain, interfering with daily tasks.  

Sometimes scars can even cause pain on the other side of the body. For example, an abdominal scar can cause weakness in the pelvis, which leads to misalignment in joints on the opposite side, resulting in low back pain or sciatica. This is why I examine all patients, from head to toe, and take a thorough history of their past injuries and surgeries. It is entirely possible for restrictions in fascia to have absolutely no pain of their own, while causing pain and dysfunction somewhere else in the body.   

Easy Does It  

Restriction in scar tissue is often painful to pressure, but effective fascia release can be gentle. Stiffness from a scar often responds to just ounces of hands-on pressure, restoring normal softness and pliability to the tissue. This improves both muscle tone joint stability. Scars that have felt dense for years can often be softened in just one treatment and completely restored to near-normal pliability in just two or three visits.  

Types of scars most likely to activate pain (even when the scar itself is not painful) are those from the following surgeries: hysterectomy, C-section, hernia repair, hip or knee replacement, spinal fusion, or surgeries that implant hardware. I highly recommend an evaluation for scar tissue restrictions in any case of unexplained chronic pain where there is significant scar tissue not far from the pain area. For many, releasing scar tissue offers the kind of lasting relief they could not find anywhere else.   

Dr. Eric Winder has been practicing chiropractic for 27 years, with a focus on fascial treatment and soft tissue therapies for the past 24 years. Dr. Winder’s practice focuses on relieving pain and restoring alignment and motion through gentle soft tissue therapies. For more information, call 941-957-8390 or visit https://gentlebay.com/