TOUCH vol. 2 - Page 7

evidence base to support postsurgical massage purely for the aesthetic benefits it provides, decreasing redness, and the perceived surface area of the scar. Although there is currently a lack of firm evidence regarding massage protocols, there are some promising hypotheses generated through more precise scientific methods. It makes logical sense that massage should help in the resolution of scar tissue given the following evidence: Mechanical disruption of scar tissue has been shown to increase its pliability, and alter the extracellular matrix environment, ultimately changing the structure and functional capacity of the tissue. Very simply, this helps release any restrictions in functional movements. Consistent stretching of scar tissue has been shown to limit the production of tissue growth factor, which may prevent excess or abnormal scarring. Another study also showed that mechanical loading of scar tissue reduced the levels of tumor necrosis factor-alpha, which is a key factor in apoptosis (organized cell death). This means that stretch and pressure promote the removal of excess tissue, thus reducing the overall size of the scar given long-term treatment. So, while the literature doesn’t necessarily support the use of massage for scar tissue resolution with any clearly outlined protocols, it also doesn’t refute it. Hopefully the hard science will back us up in the near future! But what does this mean and how can this information be of use to us? Based on study recommendations, post-surgical massage treatments can begin after primary closure of the incision – typically 10-14 days after surgery, though this may vary. Also, any non-dissolvable sutures should be removed prior to beginning scar massage. From here, any self-massage techniques should begin with the use of little to no oils to avoid risk of infection and should occur multiple times a day. There is no standardized protocol, but a suggestion would be to perform five minutes, three to four times daily. Use gentle pressure to begin and ensure that there is no pain associated with the pressure.