Our bodies are very good at communicating to us when something is wrong. A fever when we are sick, a rash when we are allergic to something, and pain when there is dysfunction. The origin of pain can be very hard to isolate. No doubt pain can be associated with an acute episode such as a broken arm, sprained ankle or appendicitis, but more often pain is related to a low grade chronic problem.
When a joint or body part does not move as freely as it should and feels painful, this is your body’s way of telling you something. Listen to it!!! If you are like most people, we tend to ignore pain, hoping it will go away. If it persists, maybe take an Advil or see if you can stretch it out. This may solve the problem temporarily and relieve the pain for a brief period, but often times, pain persists and has a way of creeping back up again! The reason the pain reoccurs is that the original issue has not yet been resolved. Why hasn’t it healed and why does your pain still linger? A common reason for this, that often gets overlooked, is myofascial adhesions and scar tissue.
As athletes, activity enthusiasts and outdoors-people in the mountains, soft tissue injury is common. We put our bodies “through the paces,” and with this comes different types of trauma. Joint sprains, muscle strains and ligament tears are something we are all familiar with and there are a number of fantastic therapists, surgeons and healthcare providers in the area to help manage these types of acute trauma. Chronic pain can ensue from these injuries, however, if the residual adhesion or scar tissue from injury is not addressed.
So let’s talk about what an adhesion is and how it forms. Scar tissue, or adhesion, is most commonly recognized as fibrous connective tissue that forms around a damaged area as the body attempts to repair this injured tissue. This new fibrous tissue binds to surrounding structures for stability and support, creating a collection of fibrous tissue that is the adhesion. Adhesions can form due to an acute injury such as a fall, tear or surgery, or they can develop over time due to a repetitive motion, overuse, poor posture, or hypoxia (lack of blood flow and therefore oxygen).
Scar tissue and adhesions can cause muscles to “catch” between each other and impede normal functioning. For example, an adhesion within the muscles and tendons of the rotator cuff in the shoulder will prevent the layers from gliding smoothly past each other, and the result can be pain and pinching with motion and associated weakness. This can lead to tight areas of high friction within the muscles, tendons or ligaments that can cause microscopic tearing every time we stretch, contract, or use those regions. Hypoxia or inadequate blood flow to the tissue can also arise due to adhesion formation. This can lead to further tissue damage and repeated inflammation, which commonly presents as a constant ache in an injured area.
The effects of this dysfunctional tissue on the nerves can also be significant. When binding around a nerve occurs, entrapment can ensue, preventing the nerve from gliding through the soft tissues. In my office, I commonly hear the complaint of a “pinched nerve”, resulting in pain, numbness, tingling and weakness. This can be due to adhesions around a nerve or nerve bundle, which often feels very tight and inflexible. Appropriate treatment of the scar tissue can be very effective in relieving the “pinched” feeling thus restoring proper function to the joints. Additional signs of injury due to scar tissue or adhesion include stiffness, increased pain with exercise, a decrease in flexibility and range of motion as well as loss of strength and inflamed joints.
There are some good options for the treatment of scar tissue. Most important, is a therapist or practitioner that can appropriately identify the area in need of treatment. Techniques of treatment range from a “hands on” approach like transverse friction massage, Active Release Technique and myofascial release to high tech devices and tools like laser therapy and frequency specific vibration. Some other treatments include dry needling and soft-tissue instrument-assisted mobilization (Graston).
Staying healthy and active is important to all of us in this great mountain community, and chronic pain and injury can be a big deterrent to getting out there! Seek out some specific soft tissue treatment to optimize function and heal faster!
For further information or to schedule an appointment please contact Dr. Jessica Balbo at Alison Palmer Physical Therapy and Wellness Center 612-384-3529 ordrbalbo@gmail.com We are located in the Cimarron Lodge at the bottom of lift 7. Wellness is the full integration of mind, body and spirit. We look forward to helping you towards a healthier life.