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Scar Treatment

Have you ever thought about Scar treatment?

By Sarah Richardson, RMT at Anna Belanger & Associates

Massage therapy plays an instrumental role in supporting society’s health and overarching wellness. Among massage therapy’s many functions is scar treatment on scars and the related impairments caused by such scars.

As Registered Massage Therapists (RMTs), we are trained on the physiology of scar tissue and the body’s healing process, how to mobilize scars and how to address the common problems associated with them such as local congestion, swelling, restriction and pain. Scars include: surgical scars (such as from a c section), scars as a result of trauma, or burns. Taking into consideration the mechanism of injury, the current functional limitations, and the client’s attitudes towards their scar, therapists are able to work with their client on a path of recovery.

I hope that this short web-blog will introduce you to and/or inform you on scar treatment: how scars form, different affects they have on the body, and how massage therapy can help.

First off, it should be understood that scars are not the enemy. A scar is a natural response of the body to disruption of tissue.

How scars form:

An acute inflammatory process is initiated within hours when the tissues are disrupted through injury or surgery, causing vasodilation and local edema as well as migration of white blood cells and phagocytic cells to the area.

The phagocytic cells remove tissue fragments and foreign bodies and are critical to healing. The inflammatory process can subside or persist indefinitely depending on the degree of bacterial contamination.
Fibroblasts begin to invade the wound within the first 72 hours and gradually replace the phagocytes.
Collagen fiber formation follows the invasion by fibroblasts, so that by the end of the second week, the wound is rich with fibroblasts, a capillary network and early network of early collagen fibers. The increased vascularization results in the erythema of the new scar.
During the third to sixth weeks, the wound becomes stronger and more able to withstand stresses. (p. 38)
Tissues which have restored gliding have different scar architecture than those which do not develop the ability to glide. With gliding, the scar resembles the state of the tissues prior to injury, while the non-gliding scar remains fixed on surrounding structures. (Kasch, p.39)

We do want scars to form as we heal; however, persistent, adherent scars reduce function and can interfere with the ability to pursue work and leisure activities.

How can massage help?

According to Fionna Rattray (2005), before any scar tissue develops, massage techniques can be used to decrease edema. This is necessary as edema leads to the formation of collagen fibres. Reducing this excess extracellular fluid can ultimately reduce the amount of scar tissue that develops. Massage has been found to soften scar tissue by freeing restrictive fibrous bands and increasing circulation. Therapists need to apply enough pressure to create blanching followed by hyperemia. Stretching the scar tissue especially after treatment is critical so that you work into the muscle and tissue memory.

Massage can help to desensitize hypersensitive scars through tactile stimulation. It has been said to help provide relaxation and decrease the pain; this leads to better compliance with any potentially uncomfortable techniques or modalities used during treatment. If massage is performed before the collagen matures this can prevent hypertrophic scarring, especially in the case of burns.

Postural dysfunctions can result from the presence of scar tissue. This can be directly due to adhesions, which inhibit the full lengthening of affected structures, or secondary to compensatory changes. These compensatory changes can lead to a lot of other sources of pain and stress on the body.

Think about how the tissue has changed on the outside. If you have a scar you can even move it around and note any restricted areas. Now, think about the deeper layers of tissue. And then, consider how the body all works together.

As discussed on http://lafranomassagedynamics.com scar tissue massage includes the combined use of several specific techniques, some of which include:

Myofascial manipulation of fascial planes into the scar tissue matrix from undamaged adjacent tissue. The client’s established movement (expressed in the fascial planes) around the scar is fed, or introduced, into the scar tissue matrix to influence, even control, scar remodeling.
Direct scar manipulation is a technique uses all eight of the therapist’s fingers to play, or work into the scar directly, almost like playing a piano. the therapist allows the tissue to move on its own accord in any direction it chooses. The movements are usually subtle. The pressure is light, really just touching the scar, although the intention is deep into the totality of the damaged tissue. This, like all scar tissue massage, is patient work, waiting for the tissue to lead the therapist. This it will do, because the tissue is seeking to heal.
Cross fiber friction is most effective when applied in all directions over and around the scar area. Work with, against, and diagonal to the direction of the wound. Work directly on the scar progressing outward to the unaffected areas.

How does it feel?
A guiding principle in scar tissue massage is the client’s pain response or comfort level. Scar tissue massage causes pain in the local pressure receptors as well as the sensory nerve endings monitoring the interstitial chemical environment. Scar tissue has nerve endings bound up in its matrix. As the collagen fibers are worked apart, pressure receptor thresholds will be crossed, and various trapped and released toxins will contact chemo-receptors and cause pain. Pain will likely only be significant and sustained when the scar is older than nine months and all other manipulations of the area fail to create improvement

I myself have had over ten treatments done on a scar I have on my elbow. As my therapist applied direct scar manipulation it felt as though there was glass beneath the surface. The therapist worked within my comfort level. After about five treatments this sensation reduced and the pliability of my scar was incredible. It is definitely something worth considering and talking to your therapist about.

References for the above have been taken from the various sites:

Kasch, Mary A. Clinical Management of Scar tissue: 1998.

Rattray,Fiona. Clinical Massage Therapy. Understanding, Assessing and Treating over 70 Conditions: 2000.

http://lafranomassagedynamics.com/scar-tissue-massage-technique/

http://lafranomassagedynamics.com/scar-tissue-massage-research/

This entry was posted on Tuesday, April 16th, 2013

Breast Massage

The Ins and Outs of Breast Massage

By Maryann Wyatt Cooney, RMT at Anna Belanger & Associates

Breast massage has been used as a means of breast growth promotion and healthy lymphatic drainage. It is also practiced as a post operative therapy for women who have undergone mastectomies and breast surgery helping break down scar tissues and tissue regeneration.

Research has shown that Breast Massage and Lymphatic drainage techniques help to reduce swelling, pain, scar tissue, and anxiety due to breast surgeries. Research has also shown that patients were less depressed, their tissues healed faster and they had an increase in their white blood cell count (natural killer cells) boosting the immune system.

Breast massage can also be used as a pro-active disease fighting method. “It is believed that the breasts can store many chemicals within the fatty tissue and because the breasts are largely constrained within a bra for many hours a day the body has no way of flushing out these toxins.” The use of breast massage on a regular basis can help flush out these toxins into the lymphatic system and bring nutrients back to the breast tissue, promoting health breast tissue.

With regular massage, you will help to flush the lymphatic system, flushing your lymph nodes and stimulating your glandular system. Breast tissue does not have muscle to help the lymph move.

anatomybreast extent structure

Breast massage has been known to help/do the following:

Reduce fibroids and cysts.
Help relieve post- surgical symptoms.
Relieve pain and discomfort associated with PMS or from bra compression.
Relieve pain and tension from stress in the muscles of the chest wall.
Increases circulation and drainage of your breast tissue.
Decreases the symptoms of PMS, menopause and menstrual cramps.
Lessen discomforts associated with breast cancer treatments.
Reduce discomfort from pregnancy, breastfeeding and weaning.

“It’s important to let your massage therapist know about your diagnosis, treatment, and any symptoms you may have. Massage can be very helpful. But it has the potential to cause harm.

Keep these things in mind:

If you’ve just had breast surgery, you should lie on your back for a massage until your doctor decides it is safe for you to lie on your stomach.
Deep massage, or any type of massage that involves strong pressure, should NOT be used if you are undergoing chemotherapy and radiation. People undergoing chemotherapy may have a decrease in red and white blood cells, so with deep massage, there is a risk of bruising. Since deep massage can be taxing to a system already vulnerable from chemotherapy and radiation, it is not recommended for people currently in treatment. Light massage can be used instead.
If you’re currently undergoing radiation, your massage therapist should avoid touching any sensitive skin in the treatment area. Massage and massage oils can make already-irritated skin feel much worse. Your therapist should also avoid touching any temporary markings in the corners of the radiation treatment field. If you don’t have skin irritation in the treatment area, any massage to this area should be done very lightly through a soft towel or cloth.
If you have had lymph nodes removed, the massage therapist should only use very light touch on your affected arm and the area around the underarm.
If you have arm lymphedema, the massage therapist should avoid the affected arm and underarm areas completely. Traditional massage therapy can worsen lymphedema. A massage therapist who has experience with breast cancer patients may already know this, but it’s important to make sure he/she understands.”

“There is no evidence that massage can cause an existing cancer to spread.”

References for the above have been taken from the various sites:

1. http://www.cidpusa.org/breast%20lymph%20drainage.html

2. http://www.homeopage.com/Breast%20Massage.pdf, Breast Massage Reduces Breast Cancer Risk -By Beverly Smith

3. http://www.breastcancer.org/treatment/comp_med/types/massage

4. http://www.breastcancer.org/treatment/comp_med/types/massage

This entry was posted on Sunday, March 10th, 2013

Crock Pot Party!

This New Year I promised myself that I would learn to save money and save time. As many of you know I work full time in my clinic, manage my clinic, am active in the community and teach for Algonquin College. Away from from the office I am a mother of 4, housekeeper, laundry service, chef and just name it…all the duties that involve being a parent. So seeing the crockpot post on Pinterest gave me idea of how I could lighten my load, have fun, save money/time and feed my family while I work my long shift on Wednesdays.

Last year I gathered a bunch of women to do a group canning project. During the evening we socialized, chopped and minced veggies, had a glass of wine and after all that fun we each left with 8 jars of homemade salsa. It was wonderful to not only spend time with some wonderful women but I also came home with food. When I saw the crockpot article I put out an email to the same women I cooked with last year, and a couple more, and got the same, “count me in” response.

I ordered the frozen crockpot digital cookbook online for $9.99 USD, which I shared with my 6 friends. We were to each pick two recipes and triple the ingredients. Each recipe made 2 dinners and with 6 women this would make 12 dinners each that we could exchange. Only 5 were able to make it, so we each got to keep an extra supper that we made.

All in all it was a success! This is what we made:

Ginger Beef, Cinnamon Cumin Beef Stew,Cranberry Chicken,Cumin Beans, Sesame Chicken,Thai Chicken, Cilantro Chicken, Parmesian Chicken, Polynesian Chicken, Flank Steak Fahitas ( multiply the 10 double dinners by 3 and we got 60 dinners!)

We each bought our own groceries and met up at my house. Different women brought extra tools: chopping boards, knives, lime juicer, measuring cups, sharpie pens for labeling the bags and mixing bowls.

Lesson learned by the experience:

None of expected how much meat we would actually need. My two beef recipes called for 4 pounds of beef each- multiply that by 3 and double it and I was buying 24lbs! Another person had to buy 36lbs of chicken! We also had many ingredients that overlapped that we all bought. My recipes together called for 24 cloves of crushed garlic! Thankfully, I was surrounded by brilliant women and two of them bought massive jars of pre chopped garlic.

Tips that we will take for our next crockpot party and for you to consider when having your own party:

One massive grocery shop: one of our smart shoppers got a discount from her butcher for buying so much meat.
Combine recipes: look for overlapping ingredients example: cumin, salt…etc Add this to the massive grocery shop
Share the bill: all of us get the same amounts of dinners so we should equally pay the same amount
Bring a cooler: great way to carry your loot away and keep food cool
Ask prior to picking out recipes if anyone has food allergies or aversions. ( we all eyed a peanut recipe, but out of consideration for others ingnored – no one had peanut allergies)
Label bags before filling – hard to label wet bags or bags full of food

Thanks to Jaima Schutt for her wonderful cookbook and website @ Ring Around the Rosies

This entry was posted on Saturday, January 5th, 2013

New Therapist!

I would like to take this moment to welcome Maryann Cooney to our clinic! I met Maryann last year at a hot stone massage clinic here in Ottawa – we got partnered up to practice on each other. ( lucky me!) Once I had a treatment from Maryann I knew I had to get her intuitive hands working at our clinic. Maryann shortly later started visiting our clinic as she was pregnant! She will now be returning from maternity leave and will joining our team Saturday, January 5th !

Maryann Cooney is a Registerd Massage Therapist and a member of the RMTAO. She Graduated Massage Therapy from Algonquin College in 2007.
Maryann is trained in trigger point work, myo fascial release, lymphatic drainage, pregnancy and Hot Stone Therapy. She has treated people with fibromyalgia, cancer, sever scaring, whiplash and depression/anxiety. Maryann believes in the healing power of our own bodies and uses her learned skills and intuitive hands to help heal and relax the body.

Book online with Maryann!

This entry was posted on Monday, December 24th, 2012

Perimenopause

So at the wonderful age of 40 I have started to have perimenopausal symptoms. I have to admit I am still in denial!

This summer while on a run with my good friend I started to tell her about these weird feelings and symptoms I was having. As we were running I was telling her about the changes I was experiencing and the confusion of not knowing what was going on with my body. I assumed it was stress related and that it would go away. However, over the summer months I was getting more and more anxious about going to sleep because of the what was happening during the night. I was waking up frequently with my skin on fire, my heart beating extremely fast and then next thing you know I was having an anxiety attack. Could you imagine going from deep slumber to bolting out of bed with your skin on fire. Some nights it would take a few minutes for my body to return to normal other nights it could be up to an hour or two. If I had any alcohol the symptoms would multiply and usually the anxiety turned into full blown panic! Other things that had been changing was that when I did have my menstrual cycle it would be extremely heavy and painful. The first couple of days the pain would radiate down my leg and sitting was not an option. So to compensate I would take Advil every 4 hours for those two days as it was too painful to bare. I thought that when you had children menstrual cycles got lighter and less painful…boy was I wrong about that! I also had the most tender breasts – it was just like being pregnant! What my friend said to me on my run shocked me. ( I should mention she is a doctor and is doing an extra year in women studies) The symptoms I was describing are typical of perimenopause and that she hears these exact symptoms all the time. ( In my brain this is what I was saying, ” I’m too young, this can’t be happening already, it’s stress it will go away”)

I thought perimenopause meant that I would skip a period, that I would be moody and irrational and that eventually my period would stop and then I would be menopausal. I was in denial of what she told me. I’m only 40, my mom was 60 and my oldest sister is menopausal at 52. Truthfully I thought maybe my sister was going through this earlier as she had a hysterectomy. So staying in denial and thinking it was just stress I had another sign – a 30 day long menses cycle! I kept thinking it would stop but it didn’t and then I started experiencing heart palpatations during the day and feeling really anxious. I went to the doctor and sure enough this is also a sign of perimenopause. The prescription was birth control! Really…birth control! I have four kids, my husband has had a vasectomy and birth control made me crazy in my younger years. All I wanted was my period to stop! They suggested three months of birth control pill to regulate my cycle, so I took their advice and went for it.

To my surprise three days into the pills the bleeding stopped and the anxiety and palpations also faded. Then after the first month I was not waking up at night and the hot flashes subsided along with the night anxiety. I have now completed my first three months on the birth control and this is what I have also noticed. On the last pill, day 21 I start to have restless sleep. I wake up with hot flashes, but they are less intense and very little anxiety with them. My menses cycles are shorter, lighter in flow and no pain at all! The breast tenderness is far less than before and the PMS emotional side is also far less.

I am meeting with my doctor next month to discuss other options; possibly some more natural choices and what other options I have other than the Pill. I am slowly coming to terms with the changes that are happening with my body and hoping I can embrace this new stage. Looking back for my daughters I bought cards and gifts and celebrated their first period. I’m thinking that a celebratory tradition should also be set for this change. I have to remember my body made, carried and delivered four beautiful children and I’m so blessed for that. So ending on the note of how busy my reproductive years have been I think a vacation is the best way to start celebrating!

I went online and gathered some information that may be helpful to all of you.

The most common menopause symptoms are:

Copied and pasted from: http://www.womentowomen.com/en-ca/menopause/symptomrelief.aspx?id=24&campaignno=menopause&adgroup=ag2symptoms34&keywords=34+menopause+symptoms&gclid=cimw-rzn7licfys7mgod1x0aoa

Hot flashes and/or night sweats
Fatigue
Cravings for sweets or carbohydrates
Diminished sexual desire, vaginal dryness
Irritability, mood swings, depression, and/or anxiety
Insomnia or restless sleep
Fuzzy thinking (difficulty concentrating, memory problems)
Weight gain, especially around the middle
Stiffness and joint pain
Irregular periods

Other menopause symptoms include headaches, worsening PMS, heart palpitations, thinning hair, dry skin, dry eyes, increased facial hair, urinary dysfunction and digestive problems. You may have noticed one or two of these symptoms yourself in recent months — or you may be suffering from several.

Although the average age of menopause is 52, your symptoms can start many months or several years before your periods end. Several years can be 10+.

This entry was posted on Sunday, October 21st, 2012