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Scar Massage Tutorial: Get Your Mobility Back After Surgery (Video + Full Transcript)

Hey it's Jesse from Sage Bodywork, and I'm going to show you how we went from this to this in 15 minutes of scar massage.

Scar massage is one of my absolute favorite things to offer clients, the results we get are so amazing and so permanent. Yes, I did just say "permanent," a word we never get to use in association with massage, because normally we're working on muscles and muscles can be tight one day and relaxed the next and then tight again the next day... but scar tissue is inert, it's non-contractile, so any change we make is going to last.

Clients report benefits like less pain, pinchyness, and tightness, improved sensation (so less numbness or pins and needles), as well as greater mobility, better movement, better glide, and improved aesthetic result (so the scar might look smaller, flatter, or be closer to skin color).

Whether you're working with clients or you're trying to learn some scar massage for your own body, I'm going to show you my five favorite techniques. [Intro Music]

Safety considerations: scar massage is effective at any point in a scar's life so it's always okay to wait a little bit longer, but there is danger in starting scar massage too soon. You could potentially reopen the incision and that, we really don't want. It should be at least 8 weeks old and when in doubt, wait.

The other thing is we don't massage keloid scars. They might be kind of overgrown like a hypertrophic scar, but you can distinguish the two because the keloid one will be incredibly smooth. So if they have a very smooth looking scar, don't treat it, they're going to have to go to their doctor and there's other treatment options.

If you are working with a burn scar this video is not enough training to do that safely, find a professional in your area who is experienced with burned scars to help you out.

Another thing to be aware of is how emotional scars can be. With every scar, there's always a story, and even if your client doesn't expect it they can be surprised by the memories and feelings that resurface when you make contact with that scar. So be really mindful of that, watch for their reaction throughout treatment, so you can back off if you need to, and also know that this is another benefit: helping them normalize and reintegrate that scar tissue into their awareness can be really healing.

With that in mind my first touch is gentle, respectful, and broad, letting the body acclimate to my touch. If you're working on your own body this still applies: don't be be afraid to touch, let your hand rest on your scar, above and below it.

The funny thing about something like top surgery is how it takes two skin sections that used to be separate, and marries them together. Every cell along this scar got a new neighbor during surgery.  

So when we touch above and below the scar like this we're providing external stimuli that helps the brain recalibrate and understand where the skin is today.

Once we feel settled I'll start with some assessment.

So I'm imagining the layers here, the skin layer, over the fascial layer, over the muscle layer, over the rib cage, and I'm seeing if all those layers can glide or if they're stuck together, if there's an adhesion somewhere.

And you might be looking at my hands and saying "wait Jesse, there isn't a scar there at all." What we're seeing here is the tip of the iceberg. The scar we're seeing is only the scar that's above the surface.

A drain scar is a pretty good example of this... So we have a little hole here where there 

was a little tube sucking out fluid after surgery, and then eventually they pull it out and seal it up. Only a very tiny visible scar, but that's the tip of the iceberg there, and we have a lot more scar tissue just in this area.

I'm creating some tension on it so if there's any little webs, any little arms shooting out and grabbing onto ribs or pecs or this other incision, I can easily feel those strands, and then I'm swiping across them like strumming a guitar. I feel a pretty clear diagonal right here, pretty sure that's a scar, and even though I can't see it I'm going to treat it just like I've treated the rest of this incision.

One helpful assessment tool can be bringing everything together and seeing if it puffs up, in which case good, or if it gets sucked down, in which case we probably have an adhesion happening there. So right here in the center, it's pretty consistent... I'm not thinking about the scars I can see but I'm feeling what is actually 

underneath the skin...

Annnd now I'm getting a bit carried away with my assessment and it's really turning into fascial release, but before we get to the fascial release techniques, I'd love to show you some tools that can be really helpful.

I'll do some vibration therapy now, the technique here is pretty simple, just applying vibration along the scar. Vibration has a couple benefits, it's going to help with lymphatic drainage (swelling/inflammation), vibration is also really helpful for promoting nerve regrowth. Before you start scar massage directly, you can do a round of vibration to help decrease sensitivity and make that treatment more comfortable. I like teaching vibration therapy to my clients because it's something pretty accessible to do at home, you could do it every day, even twice a day, 5-10 minutes at a time. You can find like a vibrating T-bar massager like this, this is designed for the face, nice small surface area. You can also use like the back of a toothbrush or whatever you have that vibrates.

Another helpful tool is cupping, this is a little glass facial cup. It is essentially working as a suction cup so we're picking up that scar tissue and decompressing it, helping it unstick from all those layers underneath, and once we have that scar picked up in the cup, we can roll it around to stretch it in all 


When Scar Tissue is laid down, they're laying down these strong, thick, fibrous fibers in all directions, and we're trying to help sort them and organize them. So a lot of the therapies will have you pulling the tissue in multiple directions: up, down, left, right, away, and into the body.

Another benefit of cupping is how it increases local circulation: you can see the pinkness we're creating, that's hyperemia, that's fresh blood flow. This is really helpful for scars because they have low vascularity, they have naturally very poor circulation, so 

we're helping to oxygenate the scar and exchange nutrients to keep it healthy on a cellular level. As well as staying lubricated and pliable.

If you don't have these tools, you can still try to ruffle up the scar tissue with your fingers, so I'm on both sides of the scar, bringing my hands together to push it up off the bone, and then I can just twist my hands, sliding them in opposite directions, to roll that scar around.

And that takes us into our third technique of the day, fascial release.

When I say fascial release, I really just mean that I'm focusing on the connective tissue of the body, so that's tendons, ligaments, that fascial saran wrap that goes around all structures, and of course the scar tissue itself. This collagen rich tissue is naturally stiff and lacks elasticity, so I'm using a generous patient, touch that gives it time to melt away.

So a lot of times right after surgery, it feels okay, because nerves have been cut, we're still healing, we're really numb, and the scar is really new and weak, so there's not a lot of tension yet. Over the next year, over the next 10 years, the nerves start to heal (those peripheral nerves can take months to heal), but sensation starts to come back and that scar starts to become stronger and tighter and bigger... It tightens up for about the first 10 years of its life, because scars are naturally weaker than skin, so scars are always 

tightening and pulling to the center try to be as strong as possible, so you have structure, so it doesn't break.

All of those factors come together and we get these really hidden, deep set compensation patterns, so, again and again, I've seen people come in with with a knee surgery 10 years ago and today they're having a lot of hip pain. They don't think it's because of the knee scar, but if I assess, I can feel that knee pulling on that hip, and when we treat the knee scar, the hip feels better.

And the really cool thing about this is that the knee scar is going to stay better, because that scar tissue is inert, it doesn't have a personality, it's not going to clamp down later, so whatever progress we make in unwinding that will last.

So we can have a really positive, really permanent effect on their hip pain by working with that knee scar. Whereas if we just worked with the hip muscles, we might help them relax and get out of that pain/spasm cycle, there would probably be some relief as that client walks out that day... But as long as that knee scar is still pulling on the hip, it's going to keep reoccurring, and they're going to have to keep coming in for massage forever to manage that tightness.

So even if you don't think the scar is related it's absolutely worth checking out just in case, because if the scar is a cause or is a contributing factor, any treatment you do will have really, really lasting benefits for that chronic pain. And that's why everyone should know scar massage, every surgeon should recommend scar massage, every massage therapist should do scar massage, every patient should receive scar massage.

Okay, almost done. We've really opened up the scar tissue, now to help align that multi-directional scar tissue we're going to do a pin and stretch technique.

And to make this as effective as possible, I want the arm to be in really close to the body when I get my pin, and then I'll get maximum stretch when I open the arm up. And you can do this passively, moving their body yourself, or you can do it actively, having them move their arms. Another way to create your pin is to use a cup again, so I can just put the cup right over the scar. This is where my job gets really easy.

And there you go, that's all five techniques. First we mapped the scar tissue both above and below the surface. Then, we used vibration and cupping to warm up the tissue, decrease sensitivity, and increase circulation. Most time was spent on fascial release, working out all the sticky spots between tissue 

layers, and finally we aligned the fibers with movement and stretching for maximum mobility.

So I hope this inspires you to be more more curious about scars and really include them in your massage. Scar massage is incredibly effective, it can be done very gently, and again the benefits you get from scar massage should really last. I usually recommend people start with three 30 minute treatments, for most people that's enough to make really dramatic change in how their scar looks, moves, and feels.

Let me know if you have any questions after watching this and I would love to hear how it goes as you try these techniques out, I just know you're going to see really cool changes and I want to hear about it. And real quick thanks to everyone who subscribed to the channel over the last few months, I've really been enjoying making videos I want to keep doing it, and your likes, comments, and subscribes make that all possible, so thank you. Also let me know if there's anything you'd like to see me make a video about, I have like 200 pages of ideas, I really do, um, but I'm also open to requests and maybe I can prioritize an idea if a lot of people are interested in it.

I've been Jesse Martel from Sage Bodywork and I'll see you in the next one, bye.


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