By Sharron Wass
Thousands of surgeries are performed yearly, but very few people pay attention to the scar that results. With every surgery scar tissue is going to form. This can occur for up to a year afterwards. Scarring is good in that it closes wounds, but heavy binding scar can prevent normal function and potentially cause pain. Scar management improves the healing of a scar. It reduces infection, aids skin and tissue motion, and stretches fully healed scar tissue. Scar massage can help to reduce the amount of scar tissue, soften the scar, and discourage the scar from “sticking” to your pelvic organs and/or the muscles.
The Early Stages
After the staples or sutures have been removed, and there is no seepage from the scar you can start with desensitization techniques and mobilizing the tissue around the scar.
1-2 Weeks Post Surgery
- Some men and women experience sensitive skin in the surgical area. After surgery, even clothing may be painful if it touches the incision. The nerves are sometimes oversensitive. Desensitization techniques on a daily basis can decrease the pain and tenderness.
- Desensitization Techniques (Rub for 5-10 minutes 3 times per day)
Massage the sensitive area of skin in circles with gradually increasing pressure. Until the scar is closed and the scabs have fallen off stay 2 inches away from the scar itself. Gently rub and tap the sensitive area starting with soft material and gradually working up to rough materials. Some materials to try: cotton balls, silk, cotton fabric, towel, paper towel, soft velcro, curduroy.
When the Scar Heals
Scar massage should not be started until the incision is fully healed. This is usually 4 to 6 weeks post surgery. Make sure your hands are clean before beginning. You may also want to rub your hands together to warm them up. Below are some suggestions of different ways to move your scar.
When The Scar Heals
- Push & Pull: Imagine that you have divided the scar into sections 2 finger widths apart. Place 2 fingers in the left most section and move it in all directions of a “clock” (12, 3, 6, and 9 o’clock). Where ever the scar feels “stuck” hold this position for 60 seconds. You will feel a strong pulling or light burning. Then move to the next section until you have massaged the whole length of the scar. When the top layers of skin move more freely try to press a little deeper to get to a deeper layer of the scar.
- Skin Rolling: Pinch the skin on either side of the scar, lifting the skin up. Start at either end and move forward and backward, rolling and raising the skin as you move. A free scar bulges upward, a stuck scar will dimple.
- Stroking along the Scar:Massage the scar tissue by working it with a rubbing motion along the grain. You can move your fingers apart along the length of the scar as if you are trying to make the scar longer.
- Plucking: Put your index finger on one side and thumb on the other side of the scar. Try and lift scar up, separating it from the underlying tissues. If the skin slips out of your hands, you may not be ready for this stage.
Massage Tips
The sensation you feel when you massage your scar is one of strong pulling or light burning, NOT sharp pain. Sharp pain is as if you cut your fingers with a knife. Scar massage should NOT feel like that.
When The Scar Heals
- Do not use any lotion as you massage because this will make your fingers slide and massage will not be effective.
- Massage 1 to 2 times per day for 5-10 minutes while watching TV, reading, or even in the shower. The more it is massaged, the more pliable, soft and thin it will become.
- You may use vitamin E oil, cocoa butter, or aloe after the massage. Cool wash cloths may also help to soothe the skin.
If you are concerned about how to perform scar massage or are having pain that you think is related to your scar, you should contact your healthcare provider. If you have scar tissues that is adhered and painful you may be a good candidate to work with a physical therapist to help break up the scar tissue and return to normal pain free function.
The X10 Meta-Blog
We call it a “Meta-Blog” because we step back and give you a broad perspective on all aspects of knee health, surgery and recovery.
In this one-of-a-kind blog we gather together great thinkers, doers, writers related to Knee Surgery, Recovery, Preparation, Care, Success and Failure. Meet physical therapists, coaches, surgeons, patients, and as many smart people as we can gather to create useful articles for you. Whether you have a surgery upcoming, in the rear-view mirror, or just want to take care of your knees to avoid surgery, you should find some value here.