SCAR TISSUE AND ADHESIONS 

Scar tissue and adhesions are part of the body's natural healing response following injury, surgery, inflammation, or trauma. While scar tissue itself is normal and necessary for healing, excessive scar tissue or adhesions can sometimes restrict movement, cause discomfort, and affect function.

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What Is Scar Tissue?

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Scar tissue is fibrous connective tissue that forms when the body repairs:

• Muscles

• Tendons

• Ligaments

• Skin

• Fascia

• Internal organs

The body produces collagen fibers to repair damaged tissue. During healing, these fibers may not align in the same way as the original tissue.

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What Are Adhesions?

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Adhesions are bands of scar-like tissue that develop between structures that normally move freely against one another.

Adhesions can form:

• Between muscles and fascia

• Around tendons

• Around nerves

• Between layers of connective tissue

• After surgery

• Following significant inflammation

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Causes of Scar Tissue and Adhesions

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Surgery

One of the most common causes.

Examples include:

• Knee surgery

• Shoulder surgery

• Hip replacement

• Abdominal surgery

• Caesarean section

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Muscle Injuries

Scar tissue forms during healing of:

• Muscle strains

• Muscle tears

• Severe bruising

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Tendon Injuries

Examples:

• Achilles tendinopathy

• Rotator cuff injuries

• Patellar tendinopathy

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Ligament Injuries

Examples:

• Ankle sprains

• Knee ligament injuries

• Wrist sprains

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Fractures

Bone healing often involves surrounding soft-tissue healing and scar formation.

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Burns and Skin Injuries

Scar tissue commonly develops after:

• Deep cuts

• Burns

• Surgical incisions

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Chronic Inflammation

Persistent inflammation can contribute to adhesion formation around tissues.

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Symptoms of Scar Tissue and Adhesions

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Restricted Movement

The most common complaint is:

• Reduced flexibility

• Reduced range of motion

• Feeling of tightness during movement

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Stiffness

People often report:

• Morning stiffness

• Stiffness after inactivity

• Feeling "stuck" during certain movements

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Pain

Pain may occur:

• During movement

• During stretching

• With pressure on the area

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Pulling Sensation

A common symptom is:

• Feeling that tissues are being pulled or tethered

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Weakness

Restricted movement may contribute to:

• Reduced strength

• Poor muscle activation

• Altered movement patterns

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Tenderness

Scar tissue can be:

• Sensitive to touch

• Tender during massage or stretching

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Altered Movement Patterns

The body may compensate for restricted tissues by:

• Moving differently

• Overusing nearby muscles

• Developing secondary pain elsewhere

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Common Locations

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After Muscle Strains

Examples:

• Hamstrings

• Calves

• Quadriceps

• Groin muscles

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After Tendon Injuries

Examples:

• Achilles tendon

• Patellar tendon

• Rotator cuff tendons

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After Surgery

Examples:

• Knee surgery scars

• Shoulder surgery scars

• Hip surgery scars

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Skin Scars

Following:

• Cuts

• Burns

• Surgical incisions

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Scar Tissue vs. Adhesions

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Scar TissueAdhesions​

Normal healing tissueBands of tissue that bind structures together

Forms at injury siteCan extend between tissues

Necessary for repairMay restrict movement if excessive

Often harmlessMore likely to cause mobility issues

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When Scar Tissue Becomes Problematic

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Problems are more likely when scar tissue:

• Restricts joint motion

• Causes pain

• Limits athletic performance

• Interferes with daily activities

• Entraps nearby nerves

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Common Signs of Adhesions

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People often describe:

• A feeling of tightness that stretching alone does not relieve

• Localized stiffness

• Pulling during movement

• Reduced mobility despite exercise

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When to Seek Medical Assessment

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Consider professional evaluation if:

• Movement remains limited long after healing

• Pain persists for months

• Scar tissue becomes increasingly painful

• There is numbness, tingling, or nerve-related symptoms

• Function is significantly impaired

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Important Misconception

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A common belief is that therapists can "break up" or "remove" scar tissue completely.

In reality:

• Scar tissue is a normal part of healing.

• It cannot usually be completely removed by massage.

• Treatment aims to improve tissue mobility, flexibility, and function rather than eliminate scar tissue.

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What Usually Helps

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Management may include:

• Progressive movement and exercise

• Stretching

• Strengthening exercises

• Soft tissue therapy

• Scar mobilization techniques

• Sports massage

• Deep tissue massage

• Physiotherapy or rehabilitation programs

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Key Signs of Problematic Scar Tissue or Adhesions

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A typical presentation includes:

• History of injury or surgery

• Persistent tightness

• Reduced range of motion

• Pulling sensations during movement

• Localized stiffness and discomfort