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54 Wimpole St, Marylebone, London W1G 8YJ

Dr. Inglefield

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Scar Tissue Therapy London

Until recently, the only choice medical science offered to repair adhesions and problematic scar tissue were surgical procedures called “lysis of adhesions or ‘scar revision.” Although Scar revision surgery may reduce tightness and tethering of surface scarring and have aesthetic benefits, the surgical procedure itself causes the formation of more scar tissue and possibly adhesions.

Adhesion Lysis, whether performed by laparoscopy or open surgery, involves cutting or burning the adhesions. While adhesion lysis can be very effective, it has two major drawbacks: 1.surgeons must avoid areas where they might damage delicate underlying structures, a situation they cannot see until you are already under anesthesia, and 2, despite the best skills of the finest surgeon, the body creates more adhesions to heal from the very surgery designed to remove them.

Adhesions composed of strong microscopic strands of collagen

Adhesion or scar tissue formation occurs after trauma to the tissues, and is caused by an inflammatory response to tissue damage. As the body’s tissues heal and scar tissue and adhesions are formed, the tissues begin to shrink and pull, which results in restricted movement of the area. This ‘pull’ creates more mechanical irritation, often perpetuating the cycle of adhesion formation.

One reason for the recurrent nature of the problem is that scar tissue and adhesions tend to persist long after the original trauma has healed. In fact, the body does not have a natural remedy – nor does it have any way to decrease adhesions once they have formed. Once they form, adhesions may bind together organs, nerves, muscles, and other neighbouring structures in a strong, glue-like straight-jacket, with a strength approaching 2,000 pounds per square inch.

Scar tissue adhesions usually form after surgery, infection, inflammation, trauma, or radiation therapy treatment. As shown in the drawing above, scar tissue is composed of strong, microscopic strands of collagen. Like a nylon rope made of a thousand tiny strands, these tiny collagen fibres (called crosslinks) bind together to create sheets, ropes, or blankets of tissue in areas of the body that have been injured by infection, inflammation, surgery, or trauma.

Whether these adhered tissues are called crosslinks, micro-adhesions, adhesions or scars, is all a matter of size. Whether they form ropes, sheets, or some other shape depends on how we heal, and how our body moves and pulls against existing adhesions, after trauma to the tissues.

Adhesions may be filmy or coarse, thick or thin. They may be small enough to join individual muscle cells, deep within a structure (as shown in the anatomical box below) or they may grow so large that they stretch down an aging person’s torso from neck to waist, bending that person forward so s/he literally cannot stand erect.

Adhesions may occur on the surface of our bodily structures, or deep within them. They can join any structure in the body to its neighbour, or to distant structures. In doing so, they can cause confusing symptoms, of pain or dysfunction.

When adhesions totally encase or close an organ (e.g., bowel or intestinal obstruction), they can become life-threatening. In areas where they impose on pain-sensitive structures, they can cause constant or recurring pain. They may also pull into structures distant from the original tissue trauma, causing referred pain or distant dysfunction

Remarkably, when adhesions form in areas that are not highly innervated, they may not cause pain at all. Thus, some people find themselves slowly losing function or range of motion over time, whether or not that loss is accompanied by pain.

Summary

In short, adhesions form as the first step of the healing process, whenever we undergo any trauma or inflammation to our bodily tissues. Crosslinks (scar tissue) rush in and lay across each other in a random pattern to help protect and isolate the area that has been injured or inflamed. Adhesions join structures that should be free to move independently. In doing so, they can create unusual symptoms, whether or not accompanied by pain.

Once the body has healed, the adhesions remain in our body wherever we have healed. There, they persist throughout our lifetime, unless removed by a skilled manual therapist, or by a surgeon.

Causes of Adhesions

Adhesions may cause problems near sites of former surgery, inflammation, or trauma.

Surgery is a primary cause of scar tissue and adhesions. As noted above, surgery to remove adhesions has itself been implicated as a major cause of adhesion formation.

Many people experience decreased function, increased tissue tension, or loss of range of motion after an injury, surgery, or infection. Like surface scars that form on the skin, adhesions create “internal scars.” They may become painful and inhibit proper function by adhering tissues and organs that are designed to move freely. Mechanical problems can occur in the body due to adhesions from the postures the body takes to compensate after the original injury, surgery, or infection.

Adhesion-causing traumas include falls or accidents. The trauma of radiation therapy can cause massive adhesion/fibrosis formation at or near the sites of cancer treatment. Inflammation following trauma or radiation therapy may cause adhesions to spread to neighbouring tissues unless they are removed or diminished by a surgeon, or a therapist trained to treat them. Symptoms sometimes appear far from the site of the original trauma.

Treatment

“Hands-on” Treatment Without Surgery or Drugs

It has been found that adhesions and scar tissue are composed of thousands of tiny strands of collagen, made strong by binding together like a rope or a cloth, made of thousands of individual fibres. After further investigation, it appears that the chemical bonds that attach each of the tiny collagen fibres to its neighbour dissipate or dissolve when placed under sustained pressure over time. Scar Tissue Release Therapy techniques are based on the principles of Myofascial Release techniques in that it involves a stretch or release of the tissues. Scar Tissue Release Therapy is very specific to the area(s) involved. The primary goals of this manual therapy are to increase mobility and decrease pain and more importantly to some patients, improve aesthetic appearance. Our specialist Petra has helped patients who suffer ongoing pain or dysfunction due to adhesions and improved the appearance of surface scars, making them more flush with the skin surface. Treatments are individualised and last one to two hours depending on individual needs.

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Mr. Christopher Inglefield

Mr. Christopher Inglefield BSc, MBBS, FRCS(Plast) was born in Trinidad, West Indies, and obtained his Medical Degree from the University of the West Indies in Jamaica and Trinidad in 1985.

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