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Muscles, scar tissue, and re-injury

Brad Walker explains how scar tissue affects recovery and re-injury of pulled muscles.

Have you ever had an injury that will not heal? And then when you think it has healed, you go and re-injure it again. You may have a problem with scar tissue.

So, you have pulled a muscle. Over-stretched it, torn it, strained it, or sprained it. Call it what you want. From an injury point of view, the initial healing process is all the same.

Sprains (ligament) and strains (muscle or tendon) are the most common type of soft tissue sports injury and are often caused by activities that require the muscles to stretch and contract at the same time. A lack of conditioning, flexibility, and warm-up can also contribute.

While most people are well aware of the importance of applying the R.I.C.E. regime to a sprain or strain in the first 48 to 72 hours, it is after this that most people get stuck. Let us start by looking at what happens during those early 72 hours and then moving on to what is needed for a full recovery.

The First 72 Hours

Without a doubt, the most effective, initial treatment for soft tissue injury is the R.I.C.E.R. regime. This involves the application of (R) rest, (I) ice, (C) compression, (E) elevation, and obtaining a (R) referral for appropriate medical treatment.

The R.I.C.E.R. regime has been used immediately after an injury; it has been shown to reduce recovery time significantly. R.I.C.E.R. forms the first and most crucial injury rehabilitation stage, providing the early base for the injury's complete recovery.

24 hours after soft tissue injury, when R.I.C.E.R. has not been used, there is a large amount of uncontrolled bleeding and swelling. However, the application of rest, ice, compression, and elevation will significantly reduce bleeding and swelling.

The Problem with Scar Tissue

When a muscle is torn, you would expect that the body would repair that tear with new muscle. In reality, this does not happen. The tear, or rupture, is repaired with scar tissue. When the R.I.C.E.R. regime is used, this limits the formation of scar tissue.

Now, this might not sound like a big deal, but if you have ever suffered a soft tissue injury, you will know how annoying it is to keep re-injuring that same old injury, over and over again. Untreated scar tissue is the major cause of re-injury, usually, months after you thought that injury had fully healed.

Scar tissue is made from a very brittle, inflexible fibrous material. This fibrous material binds itself to the damaged soft tissue fibres to draw the damaged fibres back together. What results is a bulky mass of fibrous scar tissue surrounding the injury site. In some cases, it is even possible to see and feel this bulky mass under the skin.

When scar tissue forms around an injury site, it is never as strong as the tissue it replaces. It also tends to contract and deform the surrounding tissues, so not only is the strength of the tissue diminished but the flexibility of the tissue is also compromised.

So, what does this mean for the athlete?

Firstly, it means a shortening of the soft tissues which results in a loss of flexibility. Secondly, it means a weak spot has formed within the soft tissues, which could easily result in further damage.

Lastly, the formation of scar tissue will result in a loss of strength and power. For a muscle to attain full power it must be fully stretched before contraction. Both the shortening effect and weakening of the tissues mean that a full stretch and optimum contraction are impossible.

Getting rid of the scar tissue

To remove the unwanted scar tissue, you must start a course of deep tissue sports massage. While ultrasound and heat will help the injured area, they will not remove the scar tissue. Only massage will do that.

Find someone who can massage the affected area for you, or if the injury is accessible, massage the damaged tissues yourself. Doing this yourself has the advantage of knowing just how hard and deep you need to massage.

To start with, the area will be quite tender. Start with a light stroke and gradually increase the pressure until you can use deep, firm strokes. The more you massage the affected area, the harder and deeper you will be able to push.

Use deep, firm strokes, moving in the direction of the muscle fibres. Concentrate your effort at the direct point of injury and use your thumbs to get in as deep as possible to break down the scar tissue.

A few final points

Be sure to drink plenty of fluid during your injury rehabilitation. The extra fluid will help to flush a lot of the waste products from your body.

Also, I recommend you purchase a special ointment to use for your massage called Arnica. This special ointment is extremely effective in treating soft tissue injuries, like sprains, strains, and tears. You can purchase this ointment in most health food shops and pharmacies.

Article Reference

This article first appeared in:

  • WALKER, B. (2007) Pulled muscles, scar tissue and re-injury. Brian Mackenzie's Successful Coaching, (ISSN 1745-7513/ 45/ September), p. 10-11

Page Reference

If you quote information from this page in your work, then the reference for this page is:

  • WALKER, B. (2007) Pulled muscles, scar tissue and re-injury [WWW] Available from: [Accessed

About the Author

Brad Walker is a prominent Australian sports trainer with more than 15 years of experience in the health and fitness industry. Brad is a Health Science graduate of the University of New England and has postgraduate accreditations in athletics, swimming, and triathlon coaching. He also works with elite level and world champion athletes and lectures for Sports Medicine Australia on injury prevention.