This is part one of a two part mini series. Over the next two weeks we will be looking at ways you can get help relieve tightness and pulling from affirming surgery scarring so that you can train more comfortably
Before you try out what I’ve suggested in this episode, I recommend that you check in with your doctor and allied health specialists before you try anything new and treatments for any scarring.
Just to be sure you’re safe and that these practices are appropriate for you.
Now that the formalities are out of the way, let’s get into it.
We all know that affirming surgeries are life changing and life saving.
They can help us express our true selves better and feel so affirmed within our identities.
They also leave behind their mark. These scars can themselves impact folks differently and create a whole range of emotions.
They don’t just affect folks emotionally but also physically. Scar tissue doesn’t like to stretch and move nicely and can make getting active post surgery quite uncomfortable.
Caring for your scars is a really important process, even if it may feel a little tedious as rehab can sometimes tend to.
Long term though, good scar care practices help make changing your body through physical activity far more comfortable.
Let’s begin though, with a look at how scar tissue forms.
Wound healing is characterised by three sequential and overlapping phases
Inflammation:
In the first phase the body tries to heal the skin wound by a process of inflammation. During this time the scar will be swollen, tender and red. This phase can last up to two weeks.
Proliferation:
In the second phase the body starts the skin repair process by depositing scar tissue within the wound. In this phase, which may last up to six weeks, the scar will become raised and hard as large amounts of collagen are being laid down within the scar.
During the proliferation phase a scar is considered immature and is characterised by being red, raised and rigid.
Remodeling:
In this third phase the body works on the scar to soften and flatten it. During this period the scar will become more mature as some of the collagen disappears. This phase can last from twelve to eighteen months.
Scar formation and scar maturation are ongoing processes. Scars continue to grow and change throughout the recovery process which may take from twelve to eighteen months.
It’s common for scars to pull when you do certain movements in training or during your every day life.
This is because as the body heals and scar tissue forms, the body does not know exactly how to arrange the healing collagen cells during the repair process. So scar tissue is not the same as healthy unscarred tissue, that can resist tensile and stretching forces.
As an incision heals, the collagen cells can begin to ball up and clump, losing their natural flexibility and structure.
It won’t always be like this, remember that remodelling process I touched on a moment ago.
While just pushing through is an option, there are also some things that can be done to help scars get more mobile so that movements are more comfortable.
Scar massage for long term scar tissue flexibility.
Scar massage is an effective way to decrease scar tissue build up and help make scars less noticeable. Please note that massage will not help soften a scar more than two years old.
Scar massage is the most common method of softening and flattening scars. It serves several important functions:
- Promoting collagen remodeling by applying pressure to scars
- Helping to decrease itching
- Providing moisture and flexibility to the scar
You can generally start massaging your scars two weeks after surgery. Wait until the sutures have been removed and all scabs have fallen off by themselves. Do not pull your scabs off.
Use the pads or soft tips of your fingers to massage the scar and tissue around the scar.
Massage in three directions.
Circles: Using two fingers make small circles over the length of the scar and the skin surrounding it.
Vertical: Using two fingers massage the scar up-and-down.
Horizontal: Using two fingers massage the scar from side-to-side.
Use a non scented moisturising lotion or vitamin E cream and begin by massaging your scar once or twice a day for just 60 seconds each time to begin with.
When massaging your scar apply as much pressure as you can tolerate. It’s best to begin with light pressure and progress to deeper and firmer pressure as your scar becomes more flexible.
As you become more comfortable and your scars become most flexible, you can increase this time.
Try to massage your scars for at least six months following your surgery. Massaging for more than six months will not hurt your scars and may actually prove beneficial.
Stop massaging or taping and contact your doctor if you experience;
Redness
Bleeding
Scar feels warmer than the skin around it
More pain than usual at the site of the scar
While your scars are healing, you should avoid sun exposure. Sun exposure may cause your scars to hyper pigment, or turn darker than the surrounding skin.
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