Adhesions and Scar Tissue

"What’s an adhesion?" you may ask. Adhesions are fibers of inelastic tissue that stick small tears in muscle or connective tissue back together after an injury but can also form from inactivity and limiting range of motion (ie. sitting at a desk, then in a car, then on a couch for years on end).

Let’s clear up some confusion about the terms “adhesions” and “scar tissue”. Some books or articles will use these terms interchangeably which is ok because they’re basically the same thing. When we strain a muscle or sprain a ligament scar tissue forms around the injury to stick things back together. Often times the term adhesions will be used when there isn’t a noticeable tear or rupture to the musculoskeletal unit but when micro tears occur in a broad area of tissue. This can affect a muscle, tendon, or fascia which has several layers. This situation is often referred to as a “repetitive stress injury”.

You may be a runner putting in the same miles every week and being diligent about warm ups and stretching after a run. Suddenly you have pain in one of your hamstrings. This type of repetitive stress injury can build up when micro tears occur over several months or years of the same movement. When enough adhesions occur the muscle begins to lose flexibility, starts sticking to surrounding tissues that it should be gliding past and will cause pain by pinching or pulling nerve endings in the surrounding tissue.

Let’s look at what occurs when tissue, either muscular or connective, is injured. First the tissue is torn. This may be on a microscopic level and may even go unnoticed but the process is the same whether on the microscopic level or on a large scale as in a noticeable injury . The inflammation process begins and cells that create collagen fibers fill the area. Collagen is a strong tough fiber that’s great for repairs however it’s very inelastic so it decreases the ability for the repaired tissue to stretch the way it used to. When this new collagen fiber is laid down it’s in an unorganized jumbled pattern which also leads to less elasticity.

Our bodies are usually over achievers when it comes to tissue repair and will lay down more collagen fibers than necessary, causing surrounding structures to stick to the original site of injury. This inelasticity coupled with adhering to surrounding structures that have nerve endings and pain receptors can cause local pain.

Almost all of us have scar tissue. If you are having unexplained pains contact me and we can assess you for scar tissue and work on healing. Feel free to send me an email with any questions or comments you may have.

Stay well