published by Massage World Magazine by Nina Frizoni on March 7, 2018

Jenny is 53 years old. She came to me with chronic low back issues, lack of mobility and constant pain. She also felt depressed and had severe gastrointestinal problems. Jenny had a large scar on her abdomen following removal of part of her bowel.

Raj is 47. He had been diagnosed with a frozen shoulder some months previously following a traumatic incident involving being trampled by some cattle. He had pain and a lack of range of motion his shoulder. He found it difficult to get dressed and to carry out normal activities of daily living. Raj had a large scar on his torso due to the life saving surgery he received after his accident.

Eileen is 27. Following the birth of her daughter by Caesarian section she has experienced extreme SI joint pain and discomfort in the abdomen that cannot be explained by her GP. She finds traditional massage and chiropractic approaches leave her in pain for days afterwards. She told me that she feels labelled as “difficult” and that other practitioners have suggested that the pain is “all in her head”

Three clients, all with different types of presenting pain. Yet there is one common link that lies at the basis of their successful treatment. Yes that’s right – the presence of a scar.

Scars are often the “missing link” when working with tricky cases of ongoing pain or lack of mobility.

I am happy to report that the pain and emotional issues of the above clients (all real people, names changed, who approached me at my pain clinic in Brighton) have all improved dramatically. All received a course of treatments that addressed their particular issues through a combination of advanced soft tissue techniques and, importantly, particular focus on their scar tissue.

Scar tissue techniques can have amazing results in both improving the appearance of scars and helping to get results with tricky pain conditions.

What is a scar? The dictionary defines a scar as:

1. A mark left on the skin after a wound, burn or sore has healed over
2. A lasting effect on somebody’s mind by a personal misfortune or unpleasant experience

This definition nicely sums up both the physical and emotional factors that are involved in “scarring” – I find with my clients that a physical scar often holds a dramatic emotional component and working on scars can help clients safely release this.

My favourite definition of a scar comes from the myofascial release expert, John Barnes who states

“ A scar is the tip of a fascial iceberg”

This great quote shows how even a small scar on the surface can be connected to deep fascial restrictions and adhesions. It is important to take into account the possible effect of scars on a client’s pain condition as working a scar can often give fantastic results where other techniques have only been partially effective.

What are scars made of?

Scar tissue is a collagen- based tissue that develops as a result of the inflammatory process following injury. The inflammatory process and the production of scar tissue are necessary for healing damaged tissue- skin, muscle, tendon, ligament, fascia or nerve. When the collagen used to mend the injury matures it is referred to as scar tissue.

Interestingly, the scar is weaker than the tissue it is replacing. For example, scar tissue replacing damaged dermis will only reach about 80 percent of the strength of the original tissue.

Causes of scar tissue are:

o The inflammatory response that results from wounds, burns, musculo skeletal trauma, or the late stage of osteoarthririts (after cartliage is destroyed)
o Prolonged immoblisation of a structure; for example in a cast following a fracture
o Paralysis of a structure due to a peripheral or central nervous system problem.

Interestingly the medical and plastic surgery professions both advocate that patients self massage their own scars to reduce pain, reduce itching and improve appearance. Patients are generally advised to start self -massage once the scar has healed – in other words when the sutures are fully removed and all scabs have dropped off.

Why work a scar?

There are 3 main reasons that it may be useful to address your client’s scar during treatments:

1. To improve appearance: Scar tissue work can dramatically improve the appearance of scars. Ongoing work can help scars to become:
o lighter in colour
o less raised
o blended with surrounding tissue

2. To decrease pain: Scars can be related to pain conditions in many seemingly unlikely ways. I have had cases of clients with hip pain that resolved with treatment of appendectomy scars, knee pain that immediately improved with work on tiny keyhole surgery scars and countless cases of back and SI joint pain that were related to Caesarian scars.

3. To improve range of motion at a joint: Contractures and adhesions around a joint can dramatically affect range of motion as this leads to shortening of muscles and connective tissues. This prevents the joint from being able to lengthen to its full position.


About Rachel Fairweather and Jing Advanced Massage
Rachel Fairweather is author of the best selling book for passionate massage therapists – ‘Massage Fusion: The Jing Method for the treatment of chronic pain”.
She is also the dynamic Co-founder and Director of Jing Advanced Massage Training (, a company providing degree level, hands-on and online training for all who are passionate about massage. Come and take part in one of our fun and informative short CPD courses to check out the Jing vibe for yourself!
Rachel has over 25 years experience in the industry working as an advanced therapist and trainer, first in New York and now throughout the UK. Due to her extensive experience, undeniable passion and intense dedication, Rachel is a sought after international guest lecturer, writes regularly for professional trade magazines, and has twice received awards for outstanding achievement in her field.
Rachel holds a degree in Psychology, a Postgraduate Diploma in Social Work, an AOS in Massage Therapy and is a licensed massage therapist.