Can We Break Up Scar Tissue?

Can You Really “Break Up” Scar Tissue?
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Foam rolling, massage guns, deep tissue/”Swedish” massages…they all feel great, right? And they’re a big component of warming up for a workout or recovering from one. But what is actually happening? Are you reallybreaking up scar tissue? Are you really “realigning” joints and muscles? Are you really “restoring” blood flow and nerve function?


Look, we are definitely not anti-massage, anti-foam rolling, or against any instrument-assisted pain relieving or mobility tools. We just want you to be aware of what’s actually happening so you don’t fall victim to a false narrative and when, why, and how much to use them to reduce your pain, improve your mobility, and get the most out of your workouts without becoming dependent on these tools. The real “tool” is you and your independence of movement.

But, per usual, let’s look at the science.

What is actually happening during any manual treatment or foam rolling/massage gun work is that you are providing a stimulus to your nervous system that, in response, produces a “neurophysiological cascade effect” that consists of changes in chemical mediators, your brain, and your spinal cord (Bialosky, 2009, Manual Therapy). It is from this point where the narratives promoted by some healthcare practitioners go awry. Yes, things like decreased resting EMG activity and muscle inhibition occur, which allows more range of motion due to an inhibition or decrease in the stretch reflex response and perhaps you get some increased surface blood flow, but to state that the circulatory and nervous system have been “reset” is taking extreme liberty with the conclusions of the research. The redness you see in the skin is superficial blood flow, so it is not part of the circulatory system that is claimed to be “reset” or have its function improved. This redness is simply the tiny blood vessels close to your skin being ruptured, as in a bruise.

Scar tissue is not broken up in any of these instances, either. I know that you swear that deep tissue massage feelslike your muscles are being tenderized by your masseuse’s hands, but not even Zydrunas Savickas, a multiple World’s Strongest Man Champion, has enough force to break up scar tissue or remodel tissue. Why? Because it takes TWO-THOUSAND POUNDS of force to deform the IT Band by one percent and it takes ONE-THOUSAND POUNDS of force to deform the plantar fascia by one percent (Chaudhry, 2008, Journal of American Osteopath Association).

The point is that we’re getting a transient, short-lived effect on our nervous system with any of these tools. And they can be useful during a warm-up for some psychological prep work to ready you for your workout, but we are not getting permanent changes with these interventions. When and how should you use them? For maybe 5 minutes during your warm-up before your workout to reduce pain and improve a sense of mobility to then almost immediately get underneath a bar or a weight and load into that new range of motion. This, over time, will actually lead to those permanent mobility changes you seek to improve your performance in the gym and in life.

Sure, those narratives make for good stories. But we’re all about that non-fiction here at Premier. What’s better than a true life story anyway?

By Dr. Hays Estes, DPT



Author: admin

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