The term ‘scar tissue’ is commonly used to describe the formation of weak tissue at the site of injury. Following injury to any soft tissue structure in the body there is disruption to the blood vessels and a resultant bleed. The blood carries repair cells to the injured area called fibroblasts which start to lay down new fibers. These new fibers are susceptible to re-injury for two main reasons:
- They are immature type 1 collagen fibers which are considered to be weaker than there type II and III counterparts
- The new fibers are layed down in an irregular crossed linked manner one on top of the other, this cross linked pattern means the new network of fibers is less resistance to withstanding forces placed through it and more likely to fail or re-injure.
In cases where there has been excessive bleeding and inflammation following tissue injury this can lead to increased fibroblast activity and the laying down of too much weak collagen fibers in an irregular fashion. This is one reason why it is recommended that we apply ice and compression to the injured area in the initial days following injury to help minimise bleeding and excessive fibroblast activity which can be detrimental to recovery.
One of the biggest mistakes made following injury is the assumption that rest alone is enough to allow for adequate healing and recovery. Without progressively loading the injured tissue through controlled pain free exercises the new weak collagen fibers will remain and the manner in which they are aligned will not change either. This is the main reason why it is important that you start as soon as possible to progressively load the injured area with pain free exercises prescribed by your Chartered Physiotherapist. Loading the newly laid fibers through exercise will do the following.
- Convert weakened type I fibers into stronger type II & III counter parts
- Re-align new fibers along the lines of tensile force making them more resistance force and less likely to injure
Inadequate rehabilitation is one of the main reasons for recurrent or chronic injuries. At Portobello physiotherapy we use a combination of progressive exercise rehabilitation, manual therapy techniques and therapeutic modalities to minimise scar tissue formation and promote full healing and return to pain free activity.