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As an occupational therapist and certified hand therapist, I would say majority of my cases have had surgery so I see scars all the time! They all need some amount of scar care after surgery. Can hand therapy help with scar tissue? Absolutely!!
But what is scar tissue? We focus on the hand, wrist, elbow, and shoulder here at Hands on Therapy Services so that is where my focus will be for this blog post. Size of scar, type of surgery, and where on the arm can be a huge factor on how much of a problem that scars can cause. When you have surgery, the body sends proteins and collagen that I like to describe as “fibers” to that area to help close the wound. That’s what scars are made up of, and that’s why they look different then your normal skin. Scars initially by nature then can be red, hard, dry, and not flexible. Scars on the outside are typically what people think about when they think about how to take care of their scar and what to do to minimize it. But in therapy especially, we work on also taking care of the scar tissue that is underneath that is not seen.
The types of scars that we may see in hand therapy are Keloids, hypertropic, and contracture types of scars. Keloid scars are when the “fibers” are sent in to close a wound and they keep sending and sending and over produces in the amount of “fibers” or scar that it sends. The scar can be red or dark but very raised from the skin. Hypertropic scars are red or purplish and slightly raised at the area but over time will lighten up and flatten out. This is the most common type that I see. Contracture scar types tend to be when the scar is pulling the skin in commonly seen in burns or areas that sustained a lot of skin damage. I see this type of scarring a lot in finger types of injuries.
The nature of scar tissue is like a bundle of fibers all thrown together and all mixed up in a tight wad. It can be thick and dense. It is what needs to happen to close the wound. But when the scar is on a finger or cross a joint like the wrist or elbow, that thick dense scar makes it very hard to move. Over time, with constant stress to the scar, the fibers will start to soften and become more mobile. If at first the bundle is all mixed up and tight, well then with the stress to the scar, the “fibers” will start to lay straighter.
dry, red scar after distal radius fracture surgery
So if we know that scars are dry and hard, one of the things we need to do is use a cream or lotion to massage and keep the scar moisturized. It helps to also soften the scar and make sure that the scar is not over sensitive. Since the scar is hard and not flexible, motion is also a very important aspect of managing the scar as well. Don’t be discouraged if you lotion and move the scar, and within a few hours or in the morning it feels hard and stiff again. It’s the constant stress and motion that will affect the scar over TIME! Scars can be active up to one to two years but the best window of opportunity is in the 1st 6 months so DON’T GIVE UP!
scar after 1 year, clavicle surgery
Besides scar massage and motion, some scars need a little help to flatten and move. My professional favorite is the use of paper tape over the scar to help with moving it. How to tape just depends on what the issue is and where.
use of paper tape for the back of the elbow scar
Another is the use of silicone gel pad, but sometimes those roll off and can be a little expensive. People as me about those scar creams all the time, and as a therapist, it’s not something that I really recommend. Scars are red and dark by nature at the beginning and will lighten over time. Does that happen ALL the time? Well no…but does the cream lighten, flatten, and make the scar disappear? I haven’t really seen it but some people love it and some people don’t think it works. You will have to try it yourself and make that decision. As an occupational therapist and hand therapist, I can use several different techniques to see what works depending on the problem. Not everything works for every problem every time.
This is pretty much what I tell my patients when they ask about their scars and what we need to do to manage the scar. Still have some questions about what to you with your scar after surgery? Give us at Hands on Therapy Services a call and schedule your appointment!!
Hands on Therapy Services is a leading Miami certified hand therapist, specializing in rehabilitation of shoulder, elbow, wrist, and hand injuries resulting from injuries, surgery, or naturally occurring conditions. Our Miami hand therapy services are provided by our certified hand therapist in Miami. We also offer occupational therapy in Miami with our on site occupational therapist. Plus – coming soon – we will be offering physical therapy in Miami.
Disclaimer: As with all our pages, this is NOT a substitute for formal medical treatment or occupational therapy. It is intended to inform only. Hands on Therapy Services disclaims any liability for the decisions you make based on this information.
