What is scar tissue, and how does it affect athletic performance?
Physio Danni Thorn explains all you need to know about scar tissue
What is scar tissue?
Scar tissue is dense fibrous connective tissue that forms over a healed wound or cut. Sounds bad right?! However, scar tissue is part of the body’s natural healing process after a tissue becomes damaged. It is formed during the remodelling phase of injury (see Juliet’s blog on soft tissue injuries).
Scar tissue is made of collagen, a natural substance that is found all over the body in differing types; collagen in the skin has differing qualities to collagen found in ligaments and muscles.
How can scar tissue affect athletic performance?
Scar tissue, if left untreated/mis-managed, can mean that strength and range of movement aren’t sufficient for the demands of your sport. Take for example a swimmer, who requires an extreme range of shoulder movement and strength. If the shoulder lacks one of these factors, your body may try and compensate elsewhere in the body, potentially leading to an injury.
- How can I strengthen my shoulders for swimming front crawl?
- Swimmer’s shoulder: what causes it, and three exercises to treat it
Or maybe your sport requires explosive power – e.g. that sprint finish at the end of a race. Your muscles need to be able to absorb load, and scar tissue may inhibit that ability to act as a shock-absorber.
How long can it take for scar tissue to go?
The extent of the injury will affect the length of time of remodelling – from days, to weeks, and in some rare cases, some scars will never repair fully.
What are the different different types of scar tissue?
- Hypertrophic scars – essentially a raised scar but usually fades and lightens over time
- Keloid scars – this is when extra tissue grows, it is usually pink or red and can be itchy and painful. It tends to be more common in darker skin
The obvious scar is a post-surgical scar where stitches are required to join two surfaces back together. But scars are not always as a result of trauma – e.g. tattoo, acne, burns, piercings, insect bites.
How can you treat scar tissue?
This is dependent on the cause of injury, type and duration of scar. For example:
- Scar tissue from a muscular or ligament injury needs physiotherapy – a combination of advice and education, manual therapy and exercises to allow the collagen to orientate optimally. It is important to exercise the area through full range of movement when appropriate
- post-surgical treatments can include physiotherapy e.g. scar tissue mobilisation, silicone and laser therapy
- Keloid scars can be treated in some cases with a steroid injection
The goals of treatment is to restore function, improve aesthetics (if desired) and reduce pain.
What can happen if I don’t seek treatment?
Inappropriate treatment can inhibit the healing process therefore it is recommended to see a physiotherapist to ensure you are managing the soft tissue injury optimally. In summary, scar tissue is a helpful process, but if in doubt then contact a physio to ensure you are managing it optimally not just for injury, but for performance too.
If you concerned at all about any medical issue always seek advice from a doctor or chartered physiotherapist
Danni Thorn is a rehab & pilates physio with Six Physio Mansion House
- Do tendon injuries or ligament injuries heal faster?
- What muscles do you use in triathlon?
- How do you tell the difference between a soft tissue injury and a stress fracture?
- What are the healing phases of a soft tissue injury?
Danni Thorn
Rehab and hand physiotherapist 
