Issue link: https://www.massageandbodyworkdigital.com/i/1509769
A B M P m e m b e r s ea r n F R E E C E h o u r s by rea d i n g t h i s i s s u e ! 71 (elastic fibers). It's the combination of fiber types and their specific organization that determines a tissue's mechanical properties and contributes to the overall tissue integrity. The repair process happens through the following overlapping series of highly regulated physiological events. Phase 1: Stop the Bleeding and Call in the Troops Phase one begins immediately upon injury. The body's healing mechanisms mobilize to first stop any bleeding (hemostasis) through clotting and vasoconstriction and to restore the integrity of the skin's barrier to the outside world. The injured region is f looded with a series of immune cells and protein "instigators" with accompanying inf lammation and swelling that trigger the next phase to begin. Phase 2: Clean Up and Rough Draft Patching the wound with new tissue happens next during the proliferation phase. Starting around day three, fibroblast cells migrate into the region and do what they do best: make fibers. Creating a disorganized meshwork of webby collagen type III fibers, they make an initial scar "rough draft" that will go through robust editing and revision. Phase 3: Edit and Rewrite As early as day eight and lasting up to three years, the body begins remodeling the scar. During this period, the initial collagen type III fibers of the provisional scar are replaced with tougher collagen type I fibers in a more organized fashion, forming a mature scar. Scars can run deep, affecting multiple tissues at once and influencing their texture, function, and relationship with each other. Scar tissue from a C-section. In this superior to inferior view of the lower abdomen, the subcutaneous adipose tissue has been dissected and reflected from the rectus sheath beneath. Fibrotic scarring at the incision site has caused adhesion between the two layers, creating a significant change in their relationship. For a more detailed look at this image, go to abmp.com/anatomy for our companion digital extras. Image courtesy of AnatomySCAPES.com. 2 GOOD AS NEW? The formation of scar tissue allows the body to heal but creates a new normal. Scar tissue is never identical to the original pre-injury tissue; the local tissue architecture has changed down to the level of protein fibers. While hopefully the tissue retains functionality, it sometimes doesn't. Changes in stiffness and tissue relationships can create pain, impact movement, and have ramifications distant from the original injury. This is often when clients seek treatment. Which brings us to the million-dollar massage question: Can you get rid of scar tissue? The answer is far more complex than a simple yes or no and depends in part on when you first meet the scar and where it is in its healing process. Simply put, scar tissue never goes away (and at the level of tissue integrity, that's a good thing!), but how well it integrates can vary greatly. Though bodyworkers can't prevent or eliminate scar tissue, our skillful touch can aim to inf luence its development, remodeling process, and long-term integration into the surrounding tissue. And that's a big deal.