Physical Therapy is beneficial after all types of surgical procedures including Total knee replacements, carpal tunnel release, Rotator cuff repairs, Laminectomy or spinal fusions. Etc
In all these cases, patients are healing from a surgical incision and the incision site leaves scar tissue long after the staples or steri-strips are removed.
Can scar tissue be harmful?
Collagen tissue which helps to form scar tissue can create what is called keloid formation. Based on hereditary factors the body can make an excessive amount of scar tissue. Not only does this look disfiguring, it can cause restriction to the muscle or joint motion underneath.
How soon can I start to loosen the scar tissue and prevent keloid formation?
Surgical scar tissue can be mobilized as soon as the stitches get removed which typically occurs 10 days post surgery. In Physical Therapy here at All Health PT we teach you how to mobilize your own scar tissue using techniques such as skin rolling, picking up and if the scar is sensitive, light petrisage techniques to reduce sensitivity.
What is alodynia?
Alodynia is a condition whereby the peripheral lnerves which are in an excitatory state, become over-active. Instead of infrequent firing of the sensory nerves, there is a collective firing in response to touch. If the scar tissue is on the hand or the foot, the pain or hypersensitivity can cause the patient to limit their use – either by not walking as much (to prevent foot pain), or not using the hands for daily activities (to prevent hand pain). Lack of use results in the condition worsening as sensory nerves start to run amock. A dampening effect is needed in order to prevent mass firing. Therefore forcing use, or introducing touch in gradual and varied ways, can actually reverse the condition and prevent hypersensitivity from persisting. The body then adapts to repetitive contact which results in a lowering of the response to the sensory input as the threshold to the stimulus increases. Over time pain lessens and disappears leaving a normal sensation on contact.
What are the techniques that can be used for desensitization?
We teach the patient a daily routine of simply starting to touch the scar. The direction of pressure as well as the depth of pressure can be varied. Contact can also be made using a washcloth, cottonball, or lightly tapped. The initial response will be one of discomfort therefore monitoring the intensity of the discomfort as well as the time it takes for the sensitivity to return to baseline is encouraged. The patient can make a daily report to track their progress and modify the input given to the scar based on the reactivity of the tissue and the response to the home program.