Physical therapy techniques to reduce scars
Every wound follows the same wound healing process marked by four distinct stages: hemostasis, inflammation, proliferation, and maturation. During the maturation stage, also known as remodeling, collagen fibers restructure themselves in a cross-link pattern. This stage can sometimes last for up to two years. Over time, the scar tissue is reduced in thickness due to the restructuring of collagen and the tensile strength of the damaged skin increases. In some cases, however, abnormal scarring can occur. This can be seen with keloids and hypertrophic scars. These scar types develop when there is an overabundance of collagen production during the proliferative stage. When the skin overcompensates by producing too much collagen, a buildup can lead to an overgrowth of scar tissue.
Scar tissue overgrowth can be burdensome by limiting a person’s range of motion and causing pain and itchiness. Some scars from knee replacement surgery, for instance, can range anywhere from 6-10 inches in length. If the scar keloids, it can constrict the skin around the knee and reduce mobility. Physical therapist can use techniques such as massaging, stretching, and taping to encourage the collagen fibers to promote tissue remodeling without tearing or breaking. Some physical therapists will utilize a type of massage referred to as the Graston technique, which implements metal tools to gradually release the adhesions caused by severe scarring. Massages and stretching exercises are standard physical therapy practices, but kinesiology tape is a novel technology that can help flatten scars. Kinesiology tape can be applied to scar tissue to hold the skin in a stretched position. This promotes blood flow and remodeling in the area by creating space between the scar tissue, fascia, and muscle.