“I don’t want to die without any scars.” - Tyler Durden

Fight Club is awesome. Just had to get that out of the way.

What resonates with me about Mr. Durden's wisdom is that you can’t simply go through life sheltered, protected, and afraid of what life may throw at you. Ultimately, if you want to become the most authentic, strongest, and fully integrated version of yourself, you need to take the red pill, dive deep, and confront your fears and beliefs that are holding you back. Whether it be through improving your ability to move or working on breaking through emotional and psychological barriers, it is imperative that we work on addressing our scars.

Scars can be thought of dense connective tissue in our physical bodies, just as much as scars can be thought of as emotional trauma or self-limiting beliefs. No matter what level you classify your scars, they are the inevitable marks left upon us as we journey through the harsh realities of life. However, for the purposes of this article we are just going talk about scars of the physical nature.

Last week, I worked with a client who had recently had knee replacement surgery. As a result, he was left with a 6-7 inch scar running vertically through the front of his knee. While recovery of the tissue itself had basically already happened, his ability to fully flex his knee, use his quads, and ultimately movement without restriction was still severely compromised. As well, there was still quite a bit of swelling.

I tested the function of some of the main players when it comes to knee function and strength: quads, hamstrings, popliteus, rectus femoris, etc. There were plenty of other muscle we looked at, but the overall finding was the same: his surgery scar was creating all kinds of neurological disorganization and compromising his ability to utilize those muscles, and as a result, his knee still felt painful and stiff. After clearing a variety of dysfunctions from his nervous system (nociceptors, mechanoreceptors, and reflexes related to ascending sensory pathways of the spinal cord), the majority of the previously tight, weak, and dysfunctional leg muscles were normalized. The range of motion in his knee improved tremendously, the tension in his muscles was drastically reduced, and the strength of his muscles and ability to lunge, squat, and bear weight felt significantly better.

The next day I got a text message from my client telling me that the swelling in his knee had reduced by about 80%. I saw him one more time the following week, cleared out some of the remaining neurological dysfunction, and we integrated his previously dysfunctional, stiff, and painful knee back in with his ankles, hips, and core. After session two, he said it felt 100% better. Like surgery never happened at all. Weeks later, he’s still 100% symptom free, able to golf 18 holes, do yard work, and get back to his training the way he was before.

I share this story not to toot my own horn, but to demonstrate the power of scars, and just how much they can potentially wreak havoc on your body. If you think purely from a mechanical and tissue perspective, scar tissue is stiff, unpliable, and thus restricts the ability for tissues to glide smoothly past each other during muscular contraction. This creates not only increased friction and reduced movement (and thus increased heat, irritation, and weakness), but it also creates severe neurological disorganization. If tissues don’t move well mechanically, the body has to compensate for that. If muscles don’t coordinate well with each other, the body is likely to eventually start creating adhesions and scar tissue to compensate.

From a purely neurological perspective, what we are seeing is that the lingering dysfunctional stimuli providing information to the brain is creating an aberrant response. The brain is perceiving that there is still potential damage to the area, which then tells our brain to continue to create an inflammatory response to the area, even if the tissue has already healed. This swelling compromises the integrity of the joint, and it also creates hypertonicity and chronic weakness of surrounding muscles. If left untreated for too long, the body will have to continue to operate with poor information, and thus continue to create new ways to compensate around the knee.

By simply addressing the neurological disorganization within the scar itself, we can often times get drastic improvements in muscle function, tissue quality, and overall function.

Scars are a big deal. We all have scars. Some big, some small. Some from scraping our elbow on the sidewalk as a kid, some from massive surgeries or traumas (physical or emotional). No matter the size, type, or severity, the chances are high that your scars are creating less-than optimal compensation patterns with your movement. It is important to not only address scar tissue with physical manipulation techniques that help break down the scar tissue itself, but to also have the neurological components cleared from the system as well. The latter often times prove to have a far greater and lasting impact on muscular function and pain.