Scar Recovery After Surgery: What You Need to Know

Scar Recovery After Surgery: What You Need to Know

Surgical scars are an unavoidable part of healing after an operation — but how they form, heal, and integrate into the body can vary significantly from person to person. Some scars remain soft and flexible, while others become tight, raised, or painful. Understanding the healing process and how to actively support scar recovery can make a dramatic difference to your comfort, mobility, and long-term outcomes.

In this article, we’ll explore:

  • How surgical scars heal in phases
  • Common scar-related issues and complications
  • Evidence-informed methods to optimise scar healing
  • The role of nutrition, light therapy, and topical care
  • And why manual therapy is one of the most powerful tools for helping scars heal well

How Scars Heal: The Three Phases

Scar tissue is made primarily of collagen, produced to close and rebuild the surgical site. This tissue is structurally different from normal skin and fascia — it’s less elastic, more fibrous, and slower to integrate with the surrounding tissue unless guided properly.

1. Inflammatory Phase (0–7 days)

  • Bleeding and clotting
  • Immune response clears debris
  • Redness, heat, swelling are expected

2. Proliferation Phase (1–6 weeks)

  • Collagen is laid down in a disorganised mesh
  • New blood vessels grow (angiogenesis)
  • The wound begins to strengthen but remains vulnerable

3. Remodelling Phase (6 weeks–12 months)

  • Collagen is broken down and rebuilt in stronger alignment
  • Scar becomes flatter and stronger
  • Skin regains some elasticity and flexibility

This last phase is the critical window for scar mobilisation and deeper work like manual therapy and red light therapy.

Common Scar Issues and Risks

While many scars heal without issue, complications may include:

  • Adhesions: Scar tissue binds to muscles, nerves, or fascia, reducing mobility
  • Restricted range of motion: Especially common over joints
  • Numbness or hypersensitivity: Due to nerve disruption or entrapment
  • Pain: Localised or radiating
  • Raised or thickened scars: Hypertrophic or keloid scars

Scars that are not addressed early may also contribute to postural imbalances, compensatory movement patterns, and even referred pain in distant areas.

How to Optimise Scar Healing

Early Wound Care

  • Keep the wound clean and dry
  • Follow all surgeon instructions
  • Avoid creams or oils until the wound is fully closed

Scar Mobilisation (from 3–4 weeks)

Once the wound is healed:

  • Start with gentle stimulation: stroking, tapping, and skin rolling
  • Progress to scar massage: circular, cross-friction, and multidirectional techniques
  • Focus on improving tissue glide and preventing deep adhesions

Red Light Therapy

  • Wavelengths of 660nm and 850nm (red and near-infrared):
  • Stimulate collagen remodelling
  • Improve circulation and reduce inflammation
  • Help with nerve regeneration
  • Use daily or every other day during the remodelling phase

Topical Treatments

After healing, consider:

  • Silicone gel or strips (evidence-based)
  • Natural oils such as rosehip, tamanu, or vitamin E (use with caution)
  • Avoid highly perfumed or synthetic creams that may irritate

Nutrition to Support Healing

  • Protein: Provides amino acids (glycine, proline, lysine) for collagen
  • Vitamin C: Essential for collagen synthesis
  • Zinc: Supports epithelial repair
  • Omega-3s: Modulate inflammation

Whole-Body Movement

  • Gentle movement improves blood flow and lymphatic drainage
  • Avoid letting the area “freeze” due to inactivity
  • Walking, stretching, and breathwork support global tissue health

Manual Therapy and Scar Recovery

Manual therapy is a highly effective, hands-on approach that helps improve how a scar integrates with the rest of the body.

How It Helps:

  • Breaks down adhesions between layers of tissue
  • Restores sliding and gliding between skin, fascia, and muscle
  • Stimulates circulation and lymphatic flow
  • Reduces protective tension and guarding around the scar
  • Improves postural alignment and whole-body movement

Manual therapists use techniques like:

  • Myofascial release
  • Cross-fibre friction
  • Skin lifting and multi-planar mobilisation

This work is especially important in surgeries near joints (e.g. hip, knee, shoulder), where scar stiffness can limit range of motion.

Nervous System Modulation Through Manual Therapy

Scar work isn’t just physical — it has a powerful effect on the nervous system, particularly through two mechanisms:

1. Gate Control Theory

  • Manual pressure stimulates mechanoreceptors in the skin
  • These sensory signals travel faster than pain signals
  • They help "close the gate" at the spinal cord level, reducing the brain's perception of pain

2. DNIC (Diffuse Noxious Inhibitory Control)

  • When one area is stimulated (e.g. via firm touch or manual therapy, the brain releases natural pain-inhibiting signals to suppress pain elsewhere
  • DNIC is your body's built-in system for modulating chronic or residual pain
  • Together, these effects help decrease discomfort, improve movement confidence, and reduce overactivation of protective patterns in the nervous system.

Healing from surgery is more than just waiting — it’s an active process. Surgical scars require care, attention, and sometimes therapeutic intervention to restore healthy, pain-free movement.

Whether you’re recovering from a hip replacement, C-section, or abdominal surgery, supporting your scar with manual therapy, red light, nutrition, and targeted mobilisation can make a profound difference in your outcome.

Have questions about your scar or want to support your recovery with manual therapy?

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