First… What is scar tissue?
Scar tissue forms as a result of the healing process after an injury to any tissue in the body. Scar tissue forms commonly after biopsies, surgeries such as mastectomies, as well as during radiotherapy related to breast cancer diagnosis and treatment. The healing time of scars and formation of scar tissue will be different in everyone, however the management and care of scar tissue is similar in many ways.
Complications from scar tissue
Scar tissue can result in sensations of pain, burning or numbness on and around the scar itself. Additionally, nerve-type pain (feelings of burning, tingling, numbness, prickling, zinging/shooting), into the arms can also result from scar tissue formation and irritation of surrounding structures. Tightness in the fascia (tissue coverings around muscles and organs) is another consequence of a surgery or biopsy, leading to limitations in mobility.
Scar tissue massage
Scar tissue can sometimes “adhere” or stick to the tissue underneath, causing limitations and pain of the incisional area. This adherence of tissue may result in limitations of movement, pulling sensations and pain. Scar tissue massage is a good method of relieving symptoms of pain, improving mobility and overall aesthetics of scars post surgery or biopsy.
Wait until sutures are removed and the scar has healed, which can take about 2 weeks. You will be able to know when the scar is healed by observing the area around the scar. If the edges are pinkish, with no “gaps” or scabbing, then you are ready to perform scar massages.
Care of scar tissue
When beginning a scar tissue massage, allow for the area around the scar to be free (I.e. no tight clothing).
Allow your scar to be well exposed; move parts of your body in order to allow exposure (I.e open up your arm in order to expose the scar in the area of the armpit, or move your breast in order to expose the entirety of your mastectomy scar).
Start by slowly touching your scar with one or two fingers (index or index and middle finger) and slowly apply pressure and move the pads of your fingers against the scar in circular motions (clockwise and counterclockwise). Try to feel for the movement of the scar – is it free to move along with the skin around it? Does it stay rigid? It is likely that certain areas of the scar will move less, remain rigid and will be more sensitive to the touch. These areas need to be worked on with gradual massage in order to loosen the scar tissue. You can also move in vertical and/or horizontal directions onto the scar to see the movement of the scar.
Image adapted from: Gilbert, S. (2011). Managing your scar. Retrieved from https://moffitt.org/media/1086/managing_your_scar.pdf
The pressure applied during a scar massage should be tolerable. Do not apply heavy pressure causing pain, which can also irritate the tissue underneath.
Depending on the ease and comfort of doing your massage, try to aim for 5 minute massages on each scar. Performing this 2-3 times per day will allow you to show improvements. Scar massage should be continued 6 months to a year after the initial surgery.
In conjunction with scar massage, mobility exercises can be useful to maintain the effects from scar massage, as well as improve mobility of joints close to areas of surgery; especially for the shoulder joint after axillary lymph node biopsies and mastectomies. Such exercises are discussed and reviewed in the article « Mobility exercises post mastectomy ».
** Please note that if you are undergoing other forms of treatment, such as radiation therapy, you may be advised by your attending physician to stop massages, as the skin may be irritated and highly sensitive. In this case, you may stop scar massages and begin again, once your treatments are finished.
If you are wondering if scar tissue massage will be helpful for your specific case, or to ensure it is performed correctly, you can consult a physiotherapist through our service of virtual physiotherapy. This service is practical and convenient, as it allows for a rehabilitation experience from the privacy of your own home. A physiotherapist will be available to discuss and teach you how to properly perform your scar massage, as well as guide you through other management techniques and exercises to facilitate your rehabilitation.