This makes the injury site sensitive after healing completes, and contributes to the pain becoming chronic (recurring). Second, the very dense nature of scar tissue can cause pain receptors to bunch up around it, as they cannot penetrate it. abnormal scar tissue deposition that causes disease/dysfunction such as pain and restricted movement. Fibrosis is a term that describes pathological scar tissue i.e. This explains why boxers easily get flesh cuts after getting hit in the right spot-it’s an area of scar tissue from a previous cut that “broke” upon absorbing stress forces. So after it heals, and the area is later subject to substantial stress, the scar tissue will give, and you’ll have a re-injury. It’s tough and dense, which is good for repairing, but can also pose a problem in a couple of ways.įirst, the criss-cross pattern of scar tissue makes it less elastic (stretchable).
Going back to the repair process, as the fibroblasts continue to lay down strands of collagen, they do so in a random, criss-crossed pattern forming the scar tissue. So, excess scar tissue in deeper muscle, ligaments and tendons present potential problems, described next. They are components of all joints in your body, and the function of joints is movement and generating force.
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Unlike the scar tissue of a skin gash, which does not take much physical stress to it, ligaments and tendons by nature are subject to frequent movement and stress (bearing a load). Now imagine this scar tissue in the ligaments and tendons of a healed sprained ankle, knee or shoulder where there is movement and proximity to other structures such as bone, muscle, bursae, and nerves. Upon close inspection, the scar is lighter in color, feels harder, and is raised. If it was a paper cut, you may not see a scar, but if it was a gash/laceration, when it finally heals you will see a scar. You can observe this process if the injury is superficial such as a gash in the skin, but this process also happens in ligament, tendon, muscle and bone tissue injuries where there is no damage to the skin above. Underneath, the reparative collagen fibers remain, forming what we call scar tissue. The blood clot material eventually thins out, falls off, and may even be picked off by the person. The fibrous clot gradually contracts, hardens and pulls damaged tissues together. This fibrous net catches red blood cells, which stack up and form a fibrous blood clot, plugging damaged blood vessels and filling in the space formed by the injury. While this is happening, cells called fibroblasts start laying down a net of protein fibers called fibrin around the damaged tissue, which could be skin, muscle, bone or organ. The swelling also contains noxious substances (“the inflammatory soup”) such as substance p and arachidonic acid that produce pain and therefore discourage movement, protecting against further damage. The purpose of swelling to quarantine the injury site by creating a wall of pressure around it.
This is why edema, or swelling occurs following an injury. Some clotting factors make blood vessel walls more permeable, allowing fluids to exit around the area and accumulate into the extracellular (outside the cells) spaces. This is a complex chain reaction that involves many types of substances, each with a specific role. When you sustain tissue damage, whether from sudden trauma such as spraining your ankle or gradual trauma such as a cumulative/repetitive tendinous strain or joint wear and tear, your body initiates a cascade of events to heal the injured tissue.įirst, clotting factors appear and thicken the blood to stop any bleeding (hemostasis).
When it comes to injury repair, the body’s repair mechanisms can inadvertently create a new set of problems. These complex, biological functions are the result of millions of years of evolution and of course play a major role in the survival and thriving of our species.īut even nature has its faults. The human body has magnificent intelligence to monitor, maintain, and repair itself 24/7.
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