How to Get Rid of Scar Tissue in Muscles
The First 72 Hours
While most people are aware of the importance of applying the R.I.C.E. regimen to a sprain or strain in the first 48 to 72 hours, it's after this that most people get stuck. Let's start by having a look at what happens during those first 72 hours and then move onto what's needed for a full recovery.
Without a doubt, the most effective, initial treatment for soft tissue injuries like muscle pulls, strains and tears is the R.I.C.E.R. regimen. This involves the application of:
- (R) rest;
- (I) ice;
- (C) compression;
- (E) elevation; and obtaining a
- (R) referral for appropriate medical treatment.
Where the R.I.C.E.R. regimen has been used immediately after the occurrence of a pulled muscle, it has been shown to significantly reduce recovery time. R.I.C.E.R. forms the first, and perhaps most important stage of injury rehabilitation, providing the early base for the complete recovery of injury.
The diagram below is a comparison of the same injury treated with the R.I.C.E.R. regimen and without. The top row of pictures show the effects of a muscle tear when the R.I.C.E.R. regimen is not used. While the bottom row of pictures show the effects of a muscle tear when the R.I.C.E.R. regimen is used.
The first diagram in the series shows a rupture in the soft tissue immediately following a muscle tear. 24 hours later, when R.I.C.E.R. has not been used, there is a large amount of uncontrolled bleeding and swelling. However, in the bottom diagram, the application of rest, ice, compression and elevation has significantly reduced the amount of bleeding and swelling, and most importantly, scar tissue formation.
Picture courtesy of Dr. Barry Oakes, MB, BS, MD, F.A.S.M.F.
Senior lecturer in the department of Anatomy, Monash University, Victoria, Australia
How to apply ice
Crushed ice in a plastic bag is usually best. However, blocks of ice, commercial cold packs and bags of frozen peas will all do fine. Even cold water from a tap is better than nothing at all.
When using ice, be careful not to apply it directly to the skin. This can cause "ice burns" and further skin damage. Wrapping the ice in a damp towel generally provides the best protection for the skin.
How long, how often? This is the point where few people agree. Let me give you some figures to use, as a rough guide, and then I will give you some advice from personal experience. The most common recommendation is to apply ice for 20 minutes every 2 hours for the first 48 to 72 hours.
These figures are a good starting point, but remember they are only a guide. You must take into account that some people are more sensitive to cold than others. Please be aware that:
- Children and elderly people have a lower tolerance to ice; and
- People with circulatory problems are also more sensitive to ice.
Personally, I recommend that people use their own judgment when applying ice to themselves. For some people, 20 minutes is too much. For others, especially well conditioned athletes, they can leave ice on for up to an hour at a time. The individual should make the decision as to how long the ice should stay on.
My personal recommendation is that people should apply ice for as long as it is comfortable. Obviously, there will be a slight discomfort from the cold, but as soon as pain or excessive discomfort is experienced, it is time to remove the ice. It is much better to apply ice for 3 to 5 minutes a couple of time an hour, than not at all.
Avoid: During the first 72 hours after an injury, be sure to avoid any form of heat at the injury site. This includes heat lamps, heat creams, spas, Jacuzzi's and saunas. Avoid all movement and massage of the injured area. Also, avoid excessive alcohol. All these things will increase the bleeding, swelling and pain of your injury. Avoid them at all costs.
How to get rid of scar tissue
Firstly, you must keep active! Don't listen to anyone who tells you to do nothing. Most of the swelling and inflammation will have subsided after the first 48 to 72 hours and you are now ready to start light activity.
Light activity promotes blood circulation and also activates the lymphatic system. The lymphatic system is vital in clearing the body of waste products, which can accumulate in the body following a pulled muscle or muscle strain. Activity is the only way to activate the lymphatic system.
To complete your recovery and remove most of the unwanted scar tissue, you now need to start two vital treatments. The first is commonly used by physical therapists (or physiotherapists), and it primarily involves increasing the blood supply to the injured area. The aim is to increase the amount of oxygen and nutrients to the damaged tissues.
Physical Therapists accomplish this aim by using a number of treatments to stimulate the injured area. The most common methods used are ultrasound, TENS and heat.
Ultrasound uses high frequency sound waves to stimulate the affected area, while TENS (or Transcutaneous Electrical Nerve Stimulation) uses a light electrical pulse to stimulate the injured area. And heat, in the form of a ray lamp or hot water bottle, is also very effective in stimulating blood flow to the damaged tissues.
Secondly, to remove the unwanted scar tissue it is vital that you start a course of deep tissue sports massage. While ultrasound and heat will help the injured area, they will not remove the scar tissue. Only massage will be able to do that.
Either find someone who can massage the affected area for you, or if the injury is accessible, massage the damaged tissues yourself. Self massage has the advantage of knowing just how hard and deep you need to massage.
To start with, the area will be quite tender. Start with a light stroke and gradually increase the pressure until you're able to use deep, firm strokes. The more you massage the affected area the harder and deeper you will be able to push.
Use deep, firm strokes, moving in the direction of the muscle fibers. Concentrate your effort at the direct point of the tear or strain, and use your thumbs to get in as deep as possible to break down and realign the scar tissue.
A few final points before finishing up. Be sure to drink plenty of fluid during your injury rehabilitation. The extra fluid will help to flush a lot of the waste products from your body.
Also, I recommend you purchase a special ointment to use for your massage called FEELGOOD Natural Pain Cream. This special ointment is extremely effective in treating soft tissue injuries, like sprains, strains and tears. It includes all-natural ingredients, has zero side effects and best of all, it's quite cheap. You can purchase this ointment from the link above.
What is Active Rehabilitation?
Most people refer to this phase of the recovery process as the active rehabilitation phase, because during this phase you will be responsible for the rehabilitation process. You will be doing the exercises and activities required to speed up your full recovery.
This phase of the injury rehabilitation process should only be implemented after the initial healing process has been completed.
The aim of this phase of your rehabilitation will be to regain all the fitness components that were lost during the injury process. Regaining your flexibility, strength, power, muscular endurance, balance, and co-ordination will be the primary focus.
Without this phase of the rehabilitation, there is no hope of completely and permanently making a full recovery from your pulled muscle. A quote from a great book called "Sporting injuries" by Peter Dornan & Richard Dunn will help to reinforce the value of active rehabilitation.
"The injury symptoms will permanently disappear only after the patient has undergone a very specific exercise program, deliberately designed to stretch and strengthen and regain all parameters of fitness of the damaged structure or structures. Further, it is suggested that when a specific stretching program is followed, thus more permanently reorganizing the scar fibers and allowing the circulation to become normal, the painful symptoms will disappear permanently."
The first point to make is how important it is to keep active. Often, the advice from doctors and similar medical personnel will simply be; rest. This can be one of the worst things you can do. Without some form of activity the injured area will not receive the blood flow it requires for recovery. An active circulation will provide both the oxygen and nutrients needed for the injured muscle to heal.
Any form of gentle activity not only promotes blood circulation, but it also activates the lymphatic system. The lymphatic system is vital in clearing the body of waste products that accumulate in the body following a serious injury. Activity is the only way to activate the lymphatic system.
Warning: Never do any activity that hurts the injured area. Of course you may feel some discomfort, but never push yourself to the point where you're feeling pain. You've come a long way from first being injured; don't take a step backwards now. Be very careful with any activity you do. Pain is the warning sign; don't ignore it.
Now it's time to make that injured area strong again. The main areas you're going to be working on are your range of motion, stretching & strengthening, and co-ordination. Depending on your background, and what sport you're involved in, these elements should be your first priority. As you start to regain your strength, flexibility and co-ordination, you can then start to work on the more specific areas of your chosen sport. Let's start with range of motion.
1. Range of Motion Exercises
Regaining a full range of motion is the first priority in this phase of the rehabilitation process. A full range of motion is extremely important, as it lays the foundation for more intense and challenging exercises later in the active rehabilitation process.
As you work through the initial stages of recovery and your pulled muscle begins to heal, start to introduce some very gentle movements. First bending and straightening the injured area, then as you get more comfortable with this simple movement, start to incorporate some rotation exercises. Turn the injured area from side to side, and rotate clockwise and anti-clockwise.
When you feel comfortable with these range of motion exercises and can perform them relatively pain free, it's time to move onto the next phase of the active rehabilitation process.
2. Strength Exercises
Now it's time to add some intensity to the range of motion exercises. The aim here is to gradually re-introduce some strength back into the injured muscles, ligaments and tendons.
When attempting to increase the strength of the injured area, be sure to approach this in a gradual, systematic way of lightly over-loading the muscles and tendons. Be careful not to over-do this type of training. Patience is required.
The use of machine weights can be very effective here, as they provide a certain amount of stability to the joints and muscles as you perform your rehabilitation exercises.
Another effective and relatively safe way to start is to begin with isometric exercises. These are exercise where the injured area does not move, yet force is applied and the muscles and tendons are contracted.
For example: imagine sitting in a chair while facing a wall and then placing the ball of your foot against the wall. In this position you can push against the wall with your foot and at the same time keep your ankle joint from moving. The muscles contract but the ankle joint does not move. This is an isometric exercise.
3. Stretching Exercises
It's also important at this stage to introduce some gentle static and passive stretching exercises. These will help to further increase your range of motion and prepare your injury for more strenuous activity to come.
Remember, while working on increasing the flexibility of the injured area, it's also important to increase the flexibility of the muscle groups around the injured area. In the example above, these would include the calf muscles, and the anterior muscles of your shin.
4. Balance and Proprioception
This phase of the rehabilitation process is often overlooked and is one of the main reasons why old injuries keep re-occurring. When a soft tissue injury like a muscle strain occurs, there is always a certain amount of damage to the nerves around the injured area. This leads to a lack of control of the muscles and tendons, and can also affect the stability of joint structures.
Without this information the muscles, tendons and ligaments are constantly second-guessing the position of the joints and limbs around the injured area. This lack of awareness about the position of the limbs (proprioception) can lead to a re-occurrence of the same injury long after you thought it had completely healed.
Once you feel some strength returning to the injured area it's time to incorporate some balancing drills and exercises. Balancing exercises are important to help re-train the damaged nerves around the injured area. Start with simple balancing exercises like walking along a straight line, or balancing on a beam. Progress to one-leg exercises like balancing on one foot, and then try the same exercises with your eyes closed.
When you're comfortable with the above activities, try some of the more advanced exercises like wobble or rocker boards, Swiss balls, stability cushions and foam rollers.
5. Final Preparation
This last part of the rehabilitation process will aim to return your pulled muscle to a pre-injury state. By the end of this process the injured area should be as strong, if not stronger, than it was before the injury occurred.
This is the time to incorporate some dynamic or explosive exercises to really strengthen the injured area and improve your proprioception. Start by working through all the exercises you did above, but with more intensity. For example, if you were using light isometric exercises to help strengthen your Achilles and calf muscles, start to apply more force, or start to use some weighted exercises.
From here, gradually incorporate some more intense exercises. Exercises that relate specifically to your chosen sport are a good place to start. Things like skill drills and training exercises are a great way to gauge your fitness level and the strength of the injured area.
To put the finishing touches on your recovery, I always like to do a few plyometric drills. Plyometric exercises are explosive exercises that both lengthen and contract a muscle at the same time. These are called eccentric muscle contractions and involve activities like jumping, hoping, skipping and bounding.
These activities are quite intense, so remember to always start off easy and gradually apply more and more force. Don't get too excited and over-do-it, you've come too far to do something silly and re-injure yourself.
How to Get Rid of Scar Tissue in Muscles
Source: https://stretchcoach.com/articles/scar-tissue/