When I look at my own surgical scars, I think of them as little cracked contorted deserts thirsting for fluid, nourishment, and flexibility. After 12 years with no sensation in my knee due to major surgery, I decided to try Acupuncture. Keep in mind I had a fractured patella and torn ligaments and I needed surgery. Thank you Western Medicine for putting me back together! Still, after months of physical therapy, I had no idea that scar tissue could lead to such a loss of flexibility, lack of range of motion, pain, change in sensation, swelling, and overall dysfunction. I can now happily report that through rigorous acupuncture treatments and maintenance, I now have full sensation and mobility.
So I’d like to talk a little bit about what scar tissue is, how it can impede our daily functioning, and how acupuncture can help. Scars are areas of fibrous tissue (fibrosis) that replace normal skin after injury. Scar formation is a natural part of the healing process in response to wounds. Scar tissue itself is made of the same protein (collagen) as the tissue it replaces, but its composition is slightly different. Instead of a neat basket weave formation of tissue that is flexible, the collagen of scar tissue forms in a randomized more chaotic cross-linked pattern.
This new formation of tissue has a different alignment than the original tissue that was injured. Scar tissue is tougher, can contract, pucker, and tighten. It also gets less blood flow and is less resistant to ultraviolet radiation. Sweat glands and hair follicles do not grow back within this tissue. Again this makes me think of a desert or a little barren wasteland that just needs a little help and nourishment to regain function.
A person doesn’t have to undergo surgery or have a traumatic injury that leads to an open gash in order to have scar tissue. Scar tissue also forms internally when we injure muscles, ligaments and tendons due to repetitive stress injuries, sprains, or strains.
While scars allow us to quickly heal, the tissue is not as functional as the tissue it replaces. Normal tissue in the body has a consistent form and sits in a striated fashion (each fiber lines up parallel to the next). This arrangement of tissue allows for normal contraction and flexibility. Scar tissue doesn’t always allow for flexibility.
There are many types of scars and severity of scars. Some are atrophic, where the skin appears to be sunken. Skin appears this way when the underlying structures supporting the skin, such as fat or muscle are lost. This type of scarring is often associated with acne, MRSA infections, chicken pox, and some surgeries. On the opposite end of the spectrum are hypertrophic scars, in which the body over produces collagen, and this causes the scar to rise above the surrounding skin. Hypertrophic scars take the form of a red raised lump on the skin. They usually form within 4 to 8 weeks following wound infection or wound closure. Then there are adhesions, which are fibrous bands that form between tissues and organs, often as a result of injury during surgery. They are thought of as “internal scar tissue” that connects tissues not normally connected.
Not all scars cause dysfunction. Many are only superficial, or have healed in a way so that the deeper energy of the body is not affected. In general, variables such as scar size, abnormal coloration, thickness, and sensations associated with the scar: numbness, tingling, itchiness, heat, cold, swelling, achiness, and tendon/muscle restriction, indicate whether or not the scar needs treatment.
We have many tools in acupuncture to treat scars. One most notable is moxabustion. This is a warming technique using an herb called Ai Ye or mugwort leaf. Ai Ye has the ability to denature or gently break down the proteins that form the scar tissue, and it also infuses the body with “Pure Yang”. Yang allows the body to move fluid and blood circulation to the site of injury where there was no flow before. The acupuncture needles themselves act as conductors, directing the body’s resources to the site of injury. Estim can help repair damaged or blocked sensory nerve tissue at the surface. Topical liniments like Zheng Gu Shui move static blood, stop pain and promote healing. Gentle massage and more rigorous TuiNa can help correct muscle imbalances surrounding scar tissue. And at home, one can do gentle stretches, and use aloe and vitamin E topically.
I remember the first time I felt warmth and sensation in my knee- it was like regaining a long lost friend. I had a part of my self back, and was able to do more of the things that make me happy and healthy, like jog (though I am a turtle) and hike. I wish I had known about Acupuncture sooner and made it part of my post-operative care. if you’re walking around with a part of you that feels disconnected or like you’ve got a little desert in need of nourishment, please do consider acupuncture.