You booked your first session with an Osteopathic Practitioner at Ananta Wellness & Osteopathy. Maybe you are having lower back pain. Maybe your knee is giving you some trouble. Maybe you have been constipated for a long time. Maybe you have headaches. Then amongst all the million questions your therapist asks on your first appointment one of those question is: Have you had surgery for anything, do you have any scars? You are wondering: What does it have to do with my back pain?

The Secret Structure: the fascias

To understand how scars affect the body, we have to understand the fascial system. Fascias are fascinating! It is a type of connective tissue that basically wraps around everything found in the body from small bundle of muscle fibers, to whole muscles, to organs. Think of your body as an onion. Multiple layers going from bones to many layers of muscles – that in turn have blood vessels, nerves and lymph tissues travelling in between and through them, fat layers and the skin. All these layers must be protected from one another and must be able to glide on top of each other; allowing for greater range of motion and restrict friction that could potentially lead to inflammation and injury. The fascial system does all of this for us. Fascias are moist and therefore keep all the layers of the onion lubricated. They keep organs suspended in the different cavities to fight against gravity. Through them travel blood vessels, lymphatic tissue and nerves. Ultimately, these fascias connect together into fascial chains creating connections between different structures travelling from your head to your toes and hands.

Your Scar and Your Pain

To remove your gallbladder, for example, your doctor will cut through several of the mentioned layers. They remove the gallbladder and start sewing the area with stitches. Now what was a perfectly gliding on each other collection of layers isn’t as perfect as it used to be prior to the surgery. Maybe your doctor is standing on the right side of the operating table and that creates a bit of a pull on the scar in that direction. When it comes to the healing of the scar, many factors come into play that impact how the scar will heal in the long term. Your scar might be different than mine for the same surgical procedure. But chances are, some of the layers involved are no longer able to glide on top of each other. Some layers might even be pulled in one direction or another.

Depending of the size of the scar, the way it healed and its location, it will involve different chains and different adjacent structures. Take a caesarian section scar, which we see in our practice all the time. Located in the lowest part of the abdomen, it can affect the muscles, fascias and organs located in the anterior part of the body. It not only impacts the local area of the scar but it will create a restrictions in neighbouring regions, potentially traveling all the way to your head, slightly pulling it forward. Maybe your scar is pulled to one side, which again, is very common. Now your center of gravity is a bit forward but also a bit more to one side, this means you are no longer weight bearing equally of both hips but on one sacro-iliac joint. You come in to see your Osteopathic Practitioner in Vancouver 10 years after you gave birth because you have tension in the neck, chronic lower back pain on one side, and maybe your opposite knee is starting to bother you – think scar!

Surgical procedures 20, 30, 50 years ago didn’t use to be what they are now. There has been a great deal of improvement in the procedures themselves and some aren’t even performed anymore because of the long-term findings in research. Think of someone who had an appendectomy 50 years ago. Chances are that this particular scar is much larger and impactful that someone with the same scar done 5 years ago. When it comes to scars, everything is possible. I have seen people with lower lumbar disk hernias; desperate because of the amount of pain they were in. Some of these patients have had multiple surgeries: 2 c-sections, a full hysterectomy, gall bladder removed using laparoscopic procedure, and on top of it all, a tummy tuck. There was so much tension in the anterior wall of their abdomen that the disks of the lumbar vertebrae were completely pulled forward and no longer able to support the weight of the body. Some of these patients couldn’t even have normal bowel movement anymore. There are so many success stories in the world of healing scars with osteopathy treatment – improving pain, mobility, function and overall vitality of the body. And people say: “nobody told me about it after my surgery”.

Treating the Structure Affects the Function

Some scars heal better than others. Some are bigger. Some are on top of another scar and can implicate structures that are more important for different functions of the body. Before starting the treatment of the areas where you feel your pain, an Osteopathic Practitioner will work at removing as much tension as possible on the scar, in between the different layers involved and between the adjacent structures. This enables the scar to be free of tension and to ensure that what caused your postural and fascial imbalances is addressed at the route cause. Help for scars with osteopathic manual therapy can help reduce pain when you’ve tried everything else, having a long lasting effect.

In order to feel the different layers, your therapist only needs to use a gentle touch. You will most likely think to yourself that he or she isn’t doing much. But you will be surprised as you stand off the table or in the upcoming days that things are shifting. First of all, you have most likely had your scars for a long time so your body became used to the challenges and compensations created by the scar. Your sense of posture and balance, which you are not aware of at every giving moment, is organized in the cerebellum at the back of your head and takes its information from the feet and the inner ear as part of the proprioceptive system. It will take a few days or even weeks for your body to integrate its new position in space. Because of the nerve endings that travel within the fascias, you might be feeling different sensations around the scar. Many patients realize after the session that there was some numbness around the scar that they had never noticed before. The treatment of scar and post surgery follows up help to improve postural balance, restore proper fascial tension, allows proper flow of blood and lymphatic fluid, increases nervous supply that in turn affects all the systems of the body.

Better safe than sorry…If you had a surgery or know that you will be having one in the near future, talk to your Osteopathic Practitioner at Ananta Wellness & Osteopathy. He or she will develop a treatment plan to make sure that you aren’t left with long-term tension in your body. If you know of a friend or relative who have had surgery, talk to them because now you know a bit more about how and why scars can affect your health and quality of life.