Massage Tutorial: Mature scar tissue (myofascial release)

Working with a client who has substantial scar tissue that has fully healed? Here are some strategies for working with that scar, and with that whole human, to reduce pain and dysfunction.

While I demonstrate on a friend who has scarring of her low leg, this can apply to any long-standing scar tissue: An old shoulder reconstruction, scarring from broken bones, or even a hip or knee replacement. See this as an opportunity to remind the body of its own capabilities, assisting your client in using the area to its fullest.

As I discuss in the video, there isn't any "scar release" that we can do. Collagen, especially in mature scar tissue, isn't just glue that we can break down with our hands. It's one of the strongest substances that our body produces, and it infiltrates and joins with all the surrounding structures. If two sliding surfaces are adhesed, they are, for all intents and purposes, now one single structure.

So what can we do? We can communicate with the local nervous system to reduce pain and spasm. We can use movement to prove to the body that it is capable of contracting nearby muscles, and of achieving a useful range of motion. Over time, the client should see an improvement in symptoms, even though we've created very limited change on a histological level.

Is that to say that we make no changes in the tissue? Not necessarily. It's likely that we create some local inflammation and cause an increase in fibroblast and fibroclast activity. It is plausible that, over time, there may be some subtle changes to the scar. This is especially likely if we introduce the client to a gentle self-massage protocol that they can do between sessions.

Do you have any tips for working with scar tissue? I'd love to hear about them in the comments!

[sophabreela]

Whenever I feel like i'm needing a brush up on massage routines. Just a few of your videos does the trick. Keep up the brilliant work Ian

[Giovanni.QuintonValentine]

I'm not a therapist but you inspire me to become one. Thank you for your richly informative videos!

[goddesignd]

Thank you for using a real person with real problems like us! 👍👏👏😎

[AMYBIERHAUS]

OMG! An awesome therapist AND video, Ian! (I love the calm, soothing voice!)

[bhehhbg]

I like to watch your videos. I am a massage therapist from Ukraine. Your videos are very informative for me. Thanks a lot!

[christelcolson]

Great video! I really enjoyed watching you work from the heart, talking to the CNS. Wonderfull! Thanks

[emilyelizabethbrack]

Excellent Scar “Release” video. Very informative. Thanks 🙏🏽!

[carriefix]

This is the best explanation and direction I've seen ever! Thank you!

[dominikamaciejasz]

Wow. Working with you would be such an honor.
I genuinely love your passion for massage.
Huge thank you for all your videos!

[eme]

Thank you so much for your videos! You have so much knowledge and you're techniques are great. Your tutorials have helped me to grow in my massage skills. You rock Massage Sloth!

[andrewsilva]

Thanks for the time you take to share your knowledge and try to help people this info can be life changing. To people who catch it in time.

[wooders]

Really enjoyed your video - informative with some nice specifics included. Like so many things in life, contact be it verbal or physical, with areas that are damaged can make such a difference - sometimes it can be hard but go gently and the progress and benefits for both can be huge. Trainee therapist so many thanks

[pensadoraapocaliptica]

Love it, treateing currently a client with a huge scar after accident, this video helps a lot!!! thanks

[xzwzdbk]

This probably felt so good. I rember when my wound on my foot was healed enough to touch it felt amazing 😂 is it weird I miss the feeling now that I’m fully healed 😢haha

[NatAnnSch]

Really nice! Would have liked to hear how Ashley felt after your wonderful massage.

[somebody]

He meant *Fibroblast not Osteoclast activity just incase you're taking notes easy to mix up, great vid Ian!!

[Phripheoniks]

Great video! Please increase your usage of the term "That's just gravy". Thanks.

[dylansantiago]

awesome video ! big respect, would you like to make a video about golfers elbow ? how to treat the flexors and extensors of the forearms :), greetings from Colombia

[elpisfocho]

Wow been looking for something like this, thank you for making a video with real person I also have this disturbing scar for more than 7years now on same spot as the lady so how long do I need to massage it to mk it softer

[stardresser]

Really good! As a student of massage AND having had recent foot surgery, I used thus as a guide to do my own feet now that I can just begin to walk in a boot again. I'll be doing it nightly, to bring flexibility and proprioception back to my foot. You're a great teacher, thank you!!!