How does scar tissue affect the body and how muscles fire?
Hi there! Thanks for your question about the impact scar tissue has on the body and muscle efficiency. The short answer is that a change in a joint's range of motion, surface-level skin appearance, and a development of chronic pain or discomfort are the top effects of scar tissue on the body. Below you will find a deep dive of my findings and methodology.
I began my search by looking for information that identifies what scar tissue refers to and proceeded to search for information talking about the short-term and long-term effects of scar tissue. Some instances referred to myocardial scar structures and scar tissue, which I have also provided. I generally focused on the operational level of the body as a whole and then focused on the operational level of the muscular structure. Overall, I ensured that the search perspective was on the rehabilitation needs of the body and muscular structures. None of the information provided is more than two years old to ensure that the research provided is the most recent that is available to the public.
Additionally, the kinds of scar tissue vary in cause. For example, some scar tissue may be as a result of a physical accident or injury. Others include surgical scarring, which has complications and rehabilitative needs of their own. All the above has been addressed in the findings below.
SURGICAL SCARRING DEVELOPMENT
US News identifies "oozing wounds and incision pain" as the most prevalent short-term effects of surgery and the catalysts for scar tissue. The article provides the following example of how scar tissue develops and is addressed by surgeons: "bend and straighten your elbow. The folds that form in your skin, known as Langer's lines, represent the direction and orientation of the collagen fibers, similar to the grain of wood, says Dr. Robert Klapper. . . During surgery, it's not always possible for surgeons to cut parallel to the grain with their scalpels." Klapper explains that violating the Langer's line is what "can often lead to keloids and bumps and poor healing, and extra scar tissue can take place."
According to Dr. Janet Yueh, scarring largely the result of inflamed or swollen tissue as a result of surgery that leads to scarring. She also notes that "healthy young people tend to form more surgical scar tissue than older patients, she says, because they have a bigger scar response to surgery."
Common surgeries that cause scar tissue include:
--Joint (knee, wrist, or ankle) surgery
Livestrong reports that the following factors decide the depth and intensity of scar tissue development: "wound size, depth and location, a person's age and skin characteristics, including skin color or pigmentation."
SCAR TISSUE IMPACTS
Of the impacts listed below, the effects that are most closely associated with muscular efficiency are chronic pain and discomfort, hypoxia, muscular atrophy, and nerve impingement. These impacts directly affect the efficiency of the muscular level, as well as their firing process. In the cases of hypoxia and muscular atrophy, muscles are weakened due to disuse or de-oxygenation, which causes a weakening of the immediate area but can spread to neighboring structures and muscles.
The NIH reports that "scar tissue typically is thicker, pinker, redder or shinier than the rest of a person's skin." Scar tissue will typically fade over time and lose its denser, redder, or shinier complexion, but it "rarely fully resolves."
Range of Motion
Livestrong reports that "according to the University of Washington's Department of Orthopedics and Sports Medicine, post-surgical scar tissue tends to recur and can reduce joint range of motion unless movement therapy and stretching is begun immediately after surgery." This is typically a short-term effect that will resolve itself (somewhat, if not fully) with attentive physical therapy and efforts to guide the joint through the able range of motion and progressively return the joint to its original range of motion.
However, chronic pain is a concern with joint motion after surgery. This is largely because "scar tissue is weaker, less elastic and more prone to re-injury than normal, healthy tissue, and can lead to chronic pain if it affects the functioning of other structures."
Discomfort or Chronic Pain
A possible long-term effect of scar tissue is chronic pain that is unresolved by attentive physical therapy or dermabrasion or laser treatments that are geared towards normalizing scar tissue and promoting healthy skin growth. The Myofascial Release Clinic reports that "scar tissue put down after surgery may pull on other areas, compress nerves, blood vessels and organs and limit physiological functioning. This can cause pain or dysfunction."
Organ Obstructions, Barriers, or Structure Weaknesses
Scar tissue is designed to provide support for injured areas. In the case of heart surgery, scar tissue will develop over the sternum to provide additional support to the heart as it heals. Scar tissue may also develop in the heart itself or in surrounding areas that may cause complications. Healdove explains that "adhesions often cause no symptoms, but they sometimes produce pain and other problems. They may cause organs to change their shape or move out of their correct positions. They may also prevent the movement of a structure that should be moving." For example, "scar tissue in the heart may increase the chance of an irregular heartbeat (arrhythmia) because the damaged tissue interferes with the electrical signal that triggers the heartbeat."
That said, "while the central importance of scar structure in determining pump function and remodeling has long been recognized, it has proven remarkably difficult to design therapies that improve heart function or limit remodeling by modifying scar structure."
This is one of the top concerns for muscular efficiency. Hypoxia is an effect of tissue not receiving as much oxygen as it needs, which results in the production of additional scar tissue. ActiveRecoveryBoston explains that "hypoxia is more common than one may think. Poor posture, athletic pursuits, repeated use, and sustained pressure (as in sitting) all increase muscle tension and result in hypoxic conditions. When muscle tension is increased, blood supply to the area is reduced. A healthy blood flow is so important because blood carries oxygen to muscles. A reduced blood flow means less oxygen and that means hypoxia."
Some effects that came up in my research were referred to as minimal or unlikely, or generic effects that are part of post-surgical or post-injury healing. They are:
--Nerve Impingement: Most commonly associated with shoulder pain, caused when a tendon scrapes against a shoulder blade, joint, or other bone.
--Muscular Atrophy: Usually a result of the healing process that involves a disuse of the affected muscles, "muscular atrophy refers to a decrease in size of muscles."
In short, an altered appearance, a hindered range of motion, and chronic pain or discomfort are the top impacts of scar tissue on the body and on muscular efficiency. As requested, I focused my research on a rehabilitation perspective and provided both long- and short-term impacts.
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