Road Rash Scars: Scar Rehab for Invisible Scars

Scars are sometimes invisible.  Look at the picture. Can you see the road rash scar? No, obviously, there’s nothing there. But that’s the point. The scar is there, but there is nothing to see on the surface.

This client had a spectacular fall off his long board in his late teens. It left angry road rash in many places on his body, including the right side of his ribcage. How long does it take a road rash scar to heal? In this case it looked healed just a few months later. His skin looks perfect now and there are no visible marks of this accident a decade later. However, he said he could still feel it. The scar still needs rehab. There’s a pull there, a restriction, and that restriction is contributing to his back pain and his breathing issues.

Road Rash Scars are Burn Scars.

The scars from road rash work in the same way as those caused by burns. They are contracture scars–which means that the skin around the burn area contracts into it, causing mobility problems and pain. Just like burn scars, road rash scars come in degrees. A third degree road rash scar will expose the muscle and sometimes bone beneath scraped away skin and fat. Burn contracture scars, including road rash, can often have a very high impact on motor control because they can damage the nerves more easily than scars created by cuts in the skin. Their impact can be incredibly diffuse. Last year I wrote a blog about Burn Scars where you can read more. Because this scar is on this client’s rib cage it restricts the bucket handle movement of the rib cage as it expands outwards during the inhale. This is causing breathing issues. But the area of the scar was actually much larger than what had originally been visible on his skin a decade ago.

Contracture Scars are diffuse

On this particular client the 3 inch area of the actual road rash was just the epicenter of a contracture. This scar reached all the way to his opposite hip through his abdomen’s mid line. As an assessment specialist I used Neurokinetic Therapy to establish how his motor control was being effected by his scar. I found it had created a micro diastis recti, or separation of the two sides of his rectus abdominus, and was causing a down regulation of his right internal oblique.  This motor control problem was leading to back pain, stiff hips, and a bad slumped posture. He was unable to laterally flex his rib cage more than a millimetre before the treatment.  Within a few days of the first treatment his mobility was remarkably improved and his back pain decreased.

Scar Rehab of Burn Scars is slow

The fascial release I performed on this area took about 40 minutes — I made only 3 passes from the epicenter to the mid line of his abdomen over this 40 minutes, which tells you how slow I had to go. The direction of the release was guided by NeuroKinetic Therapy testing, which showed how the scar was impacting his motor control of his core muscles as well as which direction I should release in to get the most improvement in muscle activation. While the pressure I exerted was very strong and deep, it was also so slow and comfortable that the client fell asleep during the treatment. It was relaxing for him and afterwards his body wanted to sleep. Since sleep is when bodies do most of their repair work I take it as a great sign if my treatments induce sleepiness. 

If you are in the Kitchener Waterloo area and have burn scars or road rash scars that you would like to have assessed for scar rehab, please contact me tmkachroo@gmail.com or book an appointment.

Breathing has improved so much

I went to Tara because my breathing problems. She started to work on an old scar I had from a thyroid surgery. After only two sessions where she released some of my scar tissue using Neurokinetic Therapy, my breathing improved so much. She also equipped me with very effective breathing exercises I could do at home. I can highly recommend a visit if you are stuck with your traditional treatment (as I was). Tara is so caring. This makes every treatment wholesome and healing. — Nicole

Birth Trauma and Forceps: Forceps scar causing chronic back pain more than 50 years later

Full histories are important

I started working weekly with a new client in her mid 50s a few weeks ago. My intake sessions are long; we dug pretty deep into her history. She came to me because she saw one of my IG posts of scars. This client has a large scar on her knee, which she thought might be related to her persistent back pain.  As I asked about scars I felt the need to reiterate — “but do you have any OTHER scars?” This is when she pointed out the small scar on her left temple, as if it were unimportant. I hadn’t even gotten to asking about birth trauma yet when she told me this scar was from the use of obstetrical forceps. I knew immediately that it wasn’t something we could ignore. Why?

Face Scars can create dysfunctional movement patterns

Your face has a huge amount of proprioceptive afference. This is a technical way of saying it has a massive amount of sensory reception. It sends a ton of information to your motor control center about position, tension, temperature and A LOT of other things. The Trigeminal nerve innervates the face. This nerve is divided into three portions (named V1, V2, and V3) that correspond to different parts of the face. Disturbances in any of these areas can cause dysfunction in other structures that are mediated by that same nerve.

For example, a facial scar on the forehead might create dysfunction in the supratentorial dura mater membrane (supplied by small meningeal branches of the trigeminal nerve). What is dura mater? It’s the connective tissue that protects the brain. Issues with the dura mater can cause all kinds of problems, from migraines to low back pain. But that’s not the only reason a scar like this one from obstetrical forceps might have a huge impact.

Birth Trauma is a big deal

Trauma to cranial sutures can have a HUGE impact on neuromotor habits. Your brain’s safety is pretty much the highest priority for your unconscious neuro-motor system. If it were the highest priority consciously people wouldn’t play hockey or football. Additionally, trauma to cranial sutures in infancy means that the whole neuro-developmental process adapts to the stress of this malpositioned safety wall that is your skull. A 2004 publication by Gayle Giboney Page states that “significant and long-lasting physiological consequences may follow painful insults in the very young, including changes in the central nervous system and changes in responsiveness of the neuroendocrine and immune systems to stress at maturity.” 1 The cerebellum, where the motor control center lies, is of course, part of the central nervous system. I have seen plenty of very significant dysfunctional motor control issues stemming from birth traumas. I will have more to say on this in future posts.

Foreceps are a pretty brutal tool for birthing

trauma from forceps birth causes back pain later in life

My interest in birth trauma is not purely professional. I had a lot of birth trauma myself, which still affects my cervical movements. It’s a long story and best kept for another post.

When I heard this client mention forceps my ears pricked up. My own complicated birth trauma includes forcep use also. Foreceps are a pretty brutal tool for assisting in birthing. Infants are often bruised and sometimes left with worse injuries. I tested her reflexive stability and the neuromotor responses for her intrinsic core. There was absolutely no question that this small scar (AND the fairly largish lump directly on the other side of her skull where the other side of the forceps would have been) did affect her stability and ability to move. The scar was inhibiting much of her posterior chain.

Assessment is my focus

I spend a lot of time taking histories for a reason. Whereas some therapists might hope to treat as many clients as possible, I focus on depth.
Often my clients come to me after years of conventional treatments that didn’t get them results. They might have seen physiotherapists, chiropractors, trauma therapists, massage therapists, doctors, osteopaths and osteopathic surgeons, each with their own bias. Conventional assessments have not dug deep enough. There’s a mystery. I am keen to document all the evidence possible in order to solve it.

Of course a history on it’s own is not enough. I ask a lot of questions. But it’s also important to gather many other kinds of information. I assess global movement patterns (like a toe touch or overhead reach). Further more, I examine specific ones movement patterns related to the complaint; like the movement of the hyoid on swallowing in the case of jaw pain. Additionally I carry out careful palpation and assessment of the tone of different structures. The energy signatures of different tissues provides invaluable information. I check joint movement both passively and actively. And importantly, I use Neurokinetic Therapy to test my hypotheses. Assessment dominates theses sessions.

Correct corrections often don’t take long

Treatment and assigning homework comprise a much smaller portion of the time I spend with clients. With this client the assessment wasn’t just the most important thing, it definitely took up most of our time together. Once we had found what needed to be worked on, the work itself didn’t take long. However, it still had enormous effects. I did some simple and gentle cranial adjustments that took maybe 10 minutes.

This client’s long standing back pain disappeared after just 10 minutes of cranial adjustment. Furthermore, her movement reflected this change. Lumbar extension was smooth, with no hinge points. What’s more, her pain remained reduced by 80% when she returned to my office two weeks later. In the second session we worked on the effect of those same birth injuries on hip centration and made big progress there too. This is exciting work and I can’t wait for week three.

1 Page, Gayle Giboney. “Are there long-term consequences of pain in newborn or very young infants?.” The Journal of perinatal education vol. 13,3 (2004): 10-7. doi:10.1624/105812404X1725

Chronic plantar fasciitis is dramatically improved

Tara has expanded my understanding of my body’s dysfunctions, and given me tools to correct them. After a few sessions with Tara, I move with more ease and less pain. My handstand is stronger, and my chronic plantar fasciitis is dramatically improved. For me, what separates Tara from other healers (I have been to massage therapists, physical therapists, and osteopaths) is that she focuses on long-term sustainable solutions rather than temporary fixes. I used to suffer from painful tension in my neck. Many healers have been able to release it, but soon after it would tighten up again. Tara taught me that tension is a balance. If my neck is under too much tension, then another part of my body is probably slacking off. Tara’s magic was finding which part of my body needed to pick up the slack, and helping me train it to do so.

— Ben, Age 25, Mathamatician

Scar Rehabilitation from Abdominal Surgery

Hands that heal! Tara was able to release layers of tension and
allowed me to move freely again.  I came to her to help soften 12″ of abdominal surgery scaring. After one session I noticed a difference in texture of my scars but more importantly, how much easier it was to move. – Tanya, Marketing Executive

The best kind of medicine

Tara is health! She walks her walk, and tells her students “to be a student of your body”. Four years ago I thought I would take a yoga class. Within the first month I was hooked and became more in line with my mind and body’s needs. I had/have neck and shoulder issues which Tara addressed. In the past 4 years I have been seeing Tara privately and taken group workshops (which were outstanding), as well as continuing with Tara’s regular group fitness classes. Tara’s understanding of physiology is exceptional and has assisted me to understand my body function. Tara has assisted my breathing, posture, emotional blocks, to core strength and balance. Tara recognizes her students and clients needs and motivates them to success. My neck stronger, more flexible and able to function. My shoulders are off my ears, allowing me to open my heart. I am more balanced physically and emotionally! Even a 40 year old serious injury to my diaphragm has found greater movement and softness. Thank you , Tara, for your presence in my life; You have helped this student find “sankalpa” at 61.

— Carina, retired elementary teacher

In-depth assessment

I’ve struggled with daily neck pain and a few episodes of severe pain over the past few years, and had been feeling very discouraged, frustrated, and hopeless about finding a solution. I’d tried speaking to doctors and had tried massage, physio, and chiro without finding any permanent relief or solution. Working with Tara has finally given me a sense of hope and progress; she takes the time to do an in-depth assessment and explain her findings in a way that feels empowering. I now feel like I have an understanding of my problems and a sense of control over my pain.

— Amanda, Social Worker

Dramatic Improvements in Chronic Back Pain

Tara has helped me so much; I have had chronic back pain for many years and now, and I improve dramatically with every visit. Tara is very knowledgeable, intuitive and amazing. Every visit is fascinating and educating – I love our appointments!  — Stacey, Home Care Specialist

Burn Scars and Scar Rehab

Scars from burns are serious business. The skin and fascia around the burn contracts and can cause motor control problems far from the area of the burn itself. Moreover, burns often damage nerve endings. The nerves then need to be stimulated appropriately to be regrown and integrated into the vast information system that is our nervous system. Burn scars DO NOT release on their own.

My 6 year old son, like his mom, is a little bit reckless. He tries everything, sometimes with a wicked sense of enthusiasm and a lack of caution. Thus, he’s got a lot of scars. He has a big one on his belly from leaning over a frying pan. This one is recent, central and also pretty big. Cooking shirtless is now banned in our household — for all of us! This scar on his belly has been causing him pain particularly during swimming lessons. He can feel it ‘burning and itching’ with the repetitive twist and reach of his front stroke. It’s inhibiting his obliques.

There are a variety of treatments for Burn Scars

Often the first treatment used for burn scars is a silicon gel treatment. These can be purchased at the pharmacy. Carbon dioxide laser therapy is also a treatment that is being used to treat bad burns. For really bad third degree burns skin grafting is sometimes considered. There are other treatment methods too. Traditional acupuncture has very effective treatments for burns. I use manual therapy techniques that release scar tissue that is adhereing various structures together and providing misinformation to the motor control center creating movement dysfunctions and / or chronic pain.

Fascial Release Techniques for Burn Scars

Each burn scar requires individualized release techniques. The choice of technique takes into account the sensitivity of the nervous system to the release method.  Directed, slow and methodical releases are usually the ones that work best for burn scars. However, occasionally the release only takes a few moments and needs to be done quickly. The direction and type of release is also systematic and precise. How is the technique, direction and type of release chosen?

First of all, the direction of releases are based on the testing of NeuroKinetic Therapy. NKT testing shows which motor functions are inhibited by the scar. It also shows the neuromotor response to different types of release. Additionally, I pay close attention to the anatomical structures beneath the scar and surrounding it and how they have been affected by the adhesions created by scarring. Furthermore, the moment by moment physiological and emotional response of the client is really important to monitor as the release is happening. This anatomical understanding of the layering of tissue, the fiber directions of fascia and muscle, and the functional attachments of the layers of muscle and connective tissue right down to the bone is crucial is getting good results; but it’s no more important than the emotional aspect.

For more information on Burn Scars check search my blog. If you’d like to really learn the abdominal anatomy I mentioned in this blog in more depth consider taking the Immaculate Dissection courses offered by Dr. Kathy Dooley and her team. If you live in South West Ontario and have a burn scar that you haven’t had assessed or treated contact me for a scar rehab appointment by email tmkachroo@gmail.com, or book an appointment for an Initial Assessment.

Moving better with Multiple Sclerosis

My name is Donna. I am 73 years old and I was diagnosed with multiple sclerosis in 1997. I do not take any prescription medicines for my MS and I try to do everything holistically.
When I first started working with Tara, my balance was very poor and certain parts of my body had little or no sensation.
Working with Tara, on a weekly basis, my ability to balance on 1 foot has gone from a few seconds to over a minute and sensation is starting to return to my damaged areas.
My ability to move freely and my general health have improved. I am very impressed with Tara‘s knowledge of how the body works and how to make it work better.