What is Scar Tissue?

Scar tissue replaces normal skin tissue after the skin is damaged. Though scar tissue is made up of the same substance as undamaged skin, it looks different because of the way the fibers in the tissue are arranged. Scars form every time the skin is damaged beyond its first layer, whether that damage comes from a cut, burn, or a skin condition like acne or a fungal infection. Though there are ways to minimize the appearance of scars, there is no way to remove them entirely.

How it Forms

Human skin is made up of three main layers, the epidermis, dermis, and hypodermis. When the dermis — the pink middle layer in the cross-section of skin — is injured, the body first responds by making blood clot in the area to close off the wound. After the blood clots, the body then sends in fibroblasts, a type of cell that helps rebuild skin tissue. These cells break down the clot and start replacing it with proteins, primarily collagen, that make up scar tissue.

Though both scar tissue and normal skin are made with these collagen proteins, they look different because of the way the collagen is arranged. In regular skin, the collagen proteins overlap in many random directions, but in scar tissue, they generally align in one direction. This makes the scar have a different texture than the surrounding skin. Scar tissue is also not as flexible as normal skin, and does not have a normal blood supply, sweat glands, or hair.

Types of Scar Tissue

How an individual scar looks depends on a few things, including the circumstances of the injury and a person's skin tone. For instance, a puncture wound causes a different looking scar than a burn wound, and whether the wound gets infected or not can also influence the appearance of the scar. A wound in a place where the skin is stretched tight, like the chest, often causes a thicker scar, since the body has to make more tissue to keep the wound from pulling open. Skin tone plays a role too. Though scars in general tend to turn white over time, those with dark skin may get scars that get darker with time. Those with darker skin may also be more prone to keloid scars.

There are five main types of scars:

Atrophic scars: These scars are sunken down into the skin. This type of scarring is often seen with acne scars or with wounds where skin or muscle is removed by an injury. This type of scarring can also happen when the body produces so much scar tissue in one area that it prevents new cells from growing where the wound took place.
Hypertrophic scars: These are usually red or purple and are slightly raised above the skin. They tend to fade and get flat over time.
Contracture scars: These types of scars often happen with burns, and end up pulling the skin in towards the site of the injury. This can make the skin look puckered around the wound.
Keloid scars: These are very elevated, red or dark scars that form when the body produces a lot of extra collagen in a scar. Keloid scars are actually a benign type of tumor, and often grow bigger than the area of the original injury. Those with darker pigmented skin are thought to be more prone to keloid scarring, but it's not clear why.
Stretch marks: Also called striae, these are considered a unique type of scar since they don't happen in response to an injury, but because of the skin being stretched rapidly, often during pregnancy or adolescence. The tissue here is often sunken a little into the skin, and tends to fade with time.


Preventing and Treating Scar Tissue

Though there is no way to entirely get rid of scar tissue aside from avoiding a skin injury, there are ways to minimize its appearance both while the wound is healing and after a scar has formed. Except for keloid scars, most scars will fade on their own even without treatment.

While the wound is healing:

Covering the wound with a bandage — This is particularly important before going out in the sun, since UV rays can cause the newly formed tissue to get discolored and may slow down the healing process.
Cleaning wounds properly — Doctors recommend cleaning a wound with a gentle soap and lukewarm water. Cleaning with hydrogen peroxide, alcohol, or iodine can all damage the newly forming cells and lead to a more noticeable scar.
Soothing gels — Rubbing aloe vera gel on the skin after the wound has closed can help lessen redness. Vitamin E gels are not recommended, since studies show that they are not very effective are minimizing scars.
Anti-itch cream — This can help with the urge to scratch or touch the healing wound, which could irritate it and make a more noticeable scar.
Pressure bandages — Some doctors say that putting a specific type of pressure bandage on a wound can help prevent the appearance of elevated scars since it pushes the collagen down. There are several different brand name versions of these bandages, which are often called scar therapy bandages or scar sheets.


Ways to minimize scars after they form:

Massage — Massaging a scar with lotion or a doctor-recommended gel can help fade many types of scars. This is particularly recommended for keloid scars, since this can keep them from getting sensitive and painful, and can help break down some of the built-up collagen.
Injections — Steroid injections may help with hypertrophic or keloid scars, and atrophic scars can sometimes be filled in with collagen injections. One downside to this type of treatment is that it is almost always temporary, and has to be repeated regularly.
Skin resurfacing — This can be done with lasers or with equipment that works like very fine sandpaper in a procedure called dermabrasion.
Cryotherapy — This is a technique of freezing the scar, and can reduce the appearance of keloid and hypertrophic scars.

In extreme cases, a doctor might recommend surgery. Though surgery can't get rid of a scar, it can make it less noticeable. Surgery is not recommended for hypertrophic or keloid scars though, since it can make them worse. Another type of treatment for severe scars is radiation therapy, which can sometimes reduce keloid and hypertrophic scars.

 

This article originally appeared on wisegeekhealth.com

Strategies For Eliminating Jaw Pain

Clenching your jaw can cause headaches, tooth damage, and other problems. The habit may occur during daytime or nighttime hours, but correcting it usually requires mindful retraining of the jaw and reduction of any underlying stress responsible for the problem. Home treatment works in most cases, but professional medical care might be necessary in others.

(Don't worry, you can do this)

Part 1

Correcting the Habit

  1. Apply a warm compress. Soak a clean washcloth in hot water. Wring out the excess, then hold the moist cloth over the tensed or pained portion of your jaw for 10 minutes.[1]

    • Perform this procedure as soon as you notice tension or pain in your jaw. You can also repeat the procedure immediately before known times of high stress to help prevent tension before it builds.
    • The warmth should relax the muscles in your jaw and help them loosen up. A relaxed jaw is less likely to tense up and begin clenching again.
       
  2. Massage the jaw. Use your fingers to gently massage the affected muscles. Apply firm yet gentle pressure to the tensed portion of your jaw, then work around the entire jaw and mouth area with small, circular motions.

    • It's best to perform this exercise before you have the opportunity to clench your jaw, but you can also repeat it after you notice jaw tension or pain.
    • Massaging the affected area can release tension in the muscles of your jaw. Once the muscles have relaxed and loosened up, you'll naturally be less inclined to clench them.
       
  3. Practice proper jaw placement. If jaw clenching has become a chronic problem, you've likely trained yourself to hold your jaw improperly at a subconscious level. Practicing proper jaw placement every few hours throughout the day can re-train your brain and muscles.

    • When you close your lips, a slight gap between your upper and lower teeth should still remain.
    • Place the tip of your tongue in between your front teeth. Hold it there for at least five minutes. During this time, your jaw muscles should relax and reset to a more natural position.
    • If this simple correction doesn't feel comfortable or helpful, you may need to ask your dentist to show you the best position for your jaw. Memorize the way it feels and take pictures of the way it looks. Consult those pictures later while practicing the same placement in front of a mirror.
       
  4. Take the right dietary supplements. In particular, you should increase your intake of calcium, magnesium, and vitamin C. Having adequate amounts of these nutrients can help regulate muscle activity, including muscle activity in the jaw.

    • You can increase your intake of these nutrients through diet or by taking daily nutritional supplements.
    • If you choose to take nutritional supplements, know that you should take one part magnesium for every two parts calcium. For instance, you might take 600 mg of calcium and 300 mg of magnesium. The amount of vitamin C should be determined independently; an adequate daily dose is 90 mg daily.
    • Repeat your nutrient ritual daily for at least two months before determining if it has or hasn't been helpful.

Part 2

Dealing with Stress (truly the most helpful consideration)

  1. Identify stress triggers. Stress can cause you to clench your jaw during daytime and nighttime hours. While stress is unavoidable, you can figure out ways of dealing with causes of stress once you identify them.

    • Consider keeping a journal to help track your causes of stress. Make a note of any incident that causes anxiety, even if it seems mild, and pay special attention to causes of stress that occur immediately before or during daytime incidents of jaw clenching.
    • Avoid any stress triggers that can be eliminated. For triggers that cannot be eliminated, balance them out with behaviors that help relax your mind. For instance, you might listen to soothing music, indulge in a warm bubble bath, meditate, or ease your mind with aromatherapy.
       
  2. Regulate your sleep cycle. Following a regular sleep pattern should improve your quality of sleep, which may reduce jaw clenching at night. Getting eight hours of good, quality sleep each night can also reduce your overall stress, and that may make it easier to quit clenching your jaw during the day, too.

    • Go to bed and wake up at the same time each day, regardless of your schedule. Try to schedule a full eight hours of sleep in between.
    • In addition to increasing the amount of sleep you get, you should also try to improve the quality of sleep. Try to completely relax your body and mind before going to bed. Avoid caffeine and alcohol, since both can alter the body's sleep cycle. Sleep at comfortable, slightly cool temperatures, and turn off all bright lights and sources of irregular noise.
       
  3. Exercise. Regular exercise can relieve stress while regulating your mood and immune system. As a result, the tension causing your jaw clenching should lessen, and the muscles in your jaw should become stronger and more elastic.

    • You don't need to perform strenuous exercise to gain these benefits. Try walking at a slow to moderate pace for 30 minutes a day, three to five times a week. Make this a regular part of your routine for at least two months, if not permanently.

Part 3

Seeking Professional Medical Help

  1. Schedule appointments with your dentist and your doctor. Jaw clenching is often a multifaceted problem that involves both physical and mental factors. A qualified dentist should be able to treat the oral components of the problem, but you'll need to talk with a general physician to determine a treatment plan for any other factors.
     

  2. Invest in dental splints. Both mouth guards and dental splits can keep teeth separated and protect them against the sort of damage caused by jaw clenching. While more expensive, dental splits are better than over-the-counter mouth guards.[2]

    • Mouth guards are generally made of hard plastic. You'll still feel pain caused by clenching the jaw, and that pain may worsen the underlying tension.
    • Dental splints are made from soft acrylic and fitted to the shape of your mouth. They won't stop your jaw from clenching, but they should reduce the associated pain and may prevent the tension in your jaw from worsening.
    • Note that both mouth guards and splints are generally reserved for nighttime treatment, but in extreme cases when daytime clenching is an issue, you can wear the equipment during daytime hours.
       
  3. Correct misaligned teeth. If your teeth are damaged or otherwise misaligned, they may contribute to your jaw clenching problem. Consult with your dentist to determine the best way to fix the underlying issue.

    • Braces may help correct severely misaligned teeth. In some cases, however, your dentist may recommend strategically placed crowns to fix the problem.
    • If you have a damaged tooth, rebuilding that tooth can help restore the proper alignment of your teeth.
       
  4. Seek professional therapy. There are different types of therapy that may help correct jaw clenching, but the most common are biofeedback and cognitive behavioral therapy.

    • Biofeedback is a type of physical therapy. During the procedure, the doctor will examine the way you hold and control your jaw through specialized monitoring equipment. The doctor can use the same equipment to help train and regulate muscle activity in your jaw.
    • Cognitive behavioral therapy treats the psychological component behind jaw clenching. By talking with a trained psychologist or counselor, you can change the way you approach stress and react to it, which may lead to decreased anxiety.
       
  5. Try acupuncture. Talk with a professional acupuncturist about regular treatments that can reduce jaw pain and tension. While there's very little scientific evidence to suggest the effectiveness of acupuncture, it stands as a popular form of alternative medicine.[3]

    • Similarly, you could also learn about professional acupressure treatments. Acupuncture uses strategically placed needles to control pain in the body, but acupressure applies firm pressure to strategic points, instead.
  6. Learn about muscle relaxants. Muscle relaxants can relax the muscles in your jaw, which should help prevent your jaw from clenching. You can ask your doctor about both oral relaxants and injected relaxants.[4]

    • Oral muscle relaxants must be prescribed by a doctor, and you should only take them for short periods to avoid dependency. These medications relax your entire body's immune response. They may make you drowsy, so you should take them before bedtime.
    • OnabotulinumtoxinA (Botox) treatments are injected directly into the affected area and only relax the surrounding the jaw muscles. These treatments last for prolonged periods but are usually prescribed only as a last resort.
       
  7. Examine your medications. If you're currently taking long-term prescription medications and you didn't clench your jaw before you began treatment, ask your doctor if your jaw clenching habits could be a side effect of the medication.

    • If medications are causing the problem, your doctor may prescribe a different medication to help eliminate the jaw clenching.
    • While there are different types of medications that can cause jaw clenching, some of the most common culprits include antipsychotic and antidepressant drugs, including selective serotonin reuptake inhibitors (SSRIs).[5]
    • Note that alcohol, smoking, and recreational drugs can also cause jaw clenching and should be eliminated.

      This article originally appeared on wikihow.com

      BOOK YOUR APPOINTMENT with Miranda Horvath for Intra-Oral Massage Therapy or Mu Chun Chen or Céline Sandberg for TMJD (Temporomandibular joint dysfunction) Acupuncture to help you release stress and muscle tension around your head, neck and jaw 

Balanced Health Care: Float Therapy & Massage

Float therapy is a form of non-touch therapy for relieving stress and it's symptoms in the mind and body. It's for people of all ages and a range of issues and purposes. A float tank is a large, covered bath-tub-like container filled with a water solution heated to skin temperature and is well saturated with approx. 800lbs of Epsom salts, hence why it feels silky and warm when you lie in it. You will simply step in, lay down and relax.

We recommend you try 3 floats within 10 - 14 days to understand how it feels and how it works. By consistently relaxing you help calm the mind and body, which in turn restores the body's own healing systems, allowing stress hormone levels to drop, enabling better repair of injuries, normalizes metabolism, improves circulation and cellular transport and absorption of nutrients, and reduces soft tissue and joint pain, all from relaxing.

With your first float you will familiarize yourself with the environment, salt water and buoyancy. You will also experience deep relaxation and probably sleep quite well that night.

The second float is when you will experience an even deeper sense of relaxation where you enjoy peace and quiet, and perhaps notice your aches and pains diminish or disappear completely. 

During your third float and having learned previously from the environment and float you will feel significant benefits of deep relaxation and can release yourself in to a calm state easily and sooner than before.

Some known benefits of regular floating:

  • reduces anxiety, blood pressure (anxiety related), and inflammation (cortisol levels drop)
  • excellent strategy for pain management and treatment of arthritic pain, joint pain, neck & back pain, Lactic acidosis, Sciatic pain, tension/migraines/headaches, PMS and whiplash.
  • helps resolve PTSD, insomnia, Chronic Fatigue Syndrome, MS (Multiple Sclerosis).
  • improves circulation, tissue repair and mobility.
  • prepares to the body for and relaxes it after physical activity or strain, like cycling, running, hiking, golfing, gardening, etc.
  • helps to improve coping skills by physiologically clearing the body of stress symptoms.
  • increases resistance to stress.

If you have been on your feet all day, Float Therapy reverses gravity's effects on your body. 

The buoyancy produced by the salt water solution helps relieve, release and expand joints to their normal spacing and position. The heated temperature of the water soothes soreness and helps expand blood vessels, improving circulation all over the body.

Enjoying one hour of Float Therapy is equivalent to a restful 3-4 hour sleep. Floating helps restore normal sleeping patterns.

The pressure from pregnancy is resolved and released during a float and is perfect for women in their 3rd Trimester for relieving heavy back and hip pain and reducing inflammation.

Float Therapy along with Massage Therapy offers a balance for resolving patterns of pain, relaxing tensions away, restoring health and improving coping skills in mind and body. Combining the two therapies is complete health care. 

Sports Massage and Float Therapy - Rest / Recovery, Pre / Post Training

Wear and tear and the inability to heal (well or quickly) is frustrating and creeps up if neglected. It holds you back and can cause debilitating problems for the future. These are quickly resolved with combining massage and floating.

Float Therapy helps accelerate restoration of tissue and recovery between training sessions, helping you build muscle and repair injuries. 

Relaxed athletes have better performance and mental stamina to keep up with the demands.

With regular floating, Float Therapy helps athletes overcome exhaustion, fatigue, poor sleep, fogginess, anxiety, depression and weak immune systems.

Rehabilitative Massage and Float Therapy - Restore strength and balance.

Chronic pain, old injuries, poor posture, accidents, lifestyle (changes), mental stress, anxiety, depression, PTSD all play a roll on how our body feels, endures stress and moves in it's environment.

Massage reduces tensions locked in muscles and helps realign joints and fascia to improve nerve communication, mobility, strength, and in turn increases flexibility, range of motion and balance.

By regularly floating you will restore your sense of well being, reduce pain and nurture your body to repair itself between massage appointments. Float Therapy will reduce stress hormone levels 

If you find yourself struggling with aches and pains that are a result of old physical/mental traumas, misalignment, injury or mental stress, by giving your body the opportunity to regularly relax will restore it's ability to heal itself better and improve your coping skills.

Floatation Tanks and Hygiene

Water is circulated by filtration pump through a 20 micron filter between each Float Therapy appointment and further sanitized with ozone, UV light, a safe, non-toxic pool-grade oxidizing solution, Peroxysan, and enzymes. Water quality checks are performed regularly.


Currently available at our clinic is a special maintenance package:

5 Massages + 5 Floats for $495 - regularly $800. This package is perfect for a year long maintenance plan. Float Therapy and Massage appointments can be made back to back or spread out. To purchase your package, follow this link to our online store.

A Must Read For People in Pain: 'Explain Pain'

If I could make only one recommendation to individuals living with chronic pain, it would be to read the book Explain Pain by David Butler and Lorimer Moseley.

Directed at both clinicians who work with chronic pain patients and patients who live with chronic pain, Explain Pain shows how the discoveries of modern pain science can be put to practical use. Written in understandable language with a touch of lighthearted humor, Butler and Moseley take a complex subject and make it possible for the average person to understand and use. One client remarked that she thought it would be hard to read and was delighted that she did not find it difficult at all. 

Pain education can help

Research has demonstrated that pain education can help to reduce chronic pain. For instance, a recent study by the army followed 4,325 soldiers over a two year period and found that one session of pain education could help lower the incidence of low back pain. Understanding how pain works is not a magic bullet that will make pain go away immediately, but it can help to take some of the fear and anxiety out of the experience which can then begin to help alter the experience. With time, thinking a little differently about pain can lead to more successful strategies for reducing, limiting, and eliminating pain.  

Pain is useful and should not be ignored. Pain is a protective mechanism generated by the brain in response to perceived threat. However, when pain is chronic and there is no direct or immediate threat to the body, understanding how the body can get "stuck" in pain can suggest ways to help it get "unstuck." 

Butler and Moseley provide some amazing stories to illustrate the surprising discovery that pain is not directly related to tissue damage. While this concept may, at first, seem odd and difficult to grasp, they produce convincing evidence to support this idea. Consider this: a paper cut produces very little tissue damage, yet can cause a lot of pain. A soldier can get shot in battle, yet not realize he is injured until he is off the battlefield. Amputees may experience phantom limb pain in tissue that no longer exists. How does that happen? The part of the brain that corresponded to the amputated limb can still generate the sensation of pain, even after the limb is gone.

Pain can be influenced by context. If everyone around us seems to be in pain, we may also expect to be in pain. Athletes involved in vigorous sports ignore impacts that would upset most of us because to them it's all part of the game. In that context, it is expected and not a threat. 

Butler and Moseley describe how pain is generated by the nervous system. Understanding that pain is generated by the brain, rather than by damaged tissues, does not mean that pain is "all in your head" and should be ignored or dismissed as imaginary. In fact, understanding that pain is the body's alarm system highlights the importance of treating pain so that the alarm system does not become oversensitive. 

The book describes what happens in different systems of the body and how they may be affected by pain. Normal responses to painful stimuli are contrasted with what happens when the responses become altered. The influence of our thoughts and beliefs is examined for the role it can play in chronic pain.

Practical suggestions

The last few chapters of Explain Pain suggest practical tools that can be used to manage chronic pain. Using "the virtual body" is explained, as is the use of graded exposure to break the association between particular movements and pain and to cultivate successful movement without pain. 

Pain education should be part of every client or patient's rehabilitation.Explain Pain provides an excellent model for pain education.

One of my clients suffered for many years with a painful chronic condition and found this book immensely helpful. Although she had seen many doctors and therapists, she had never been given any pain education. After reading this book, she asked, "Why didn't anyone tell me this?" My response was, "They didn't know." Although Explain Pain was first published in 2003, pain science is still only slowly finding its way to practitioners. 

Since I've begun studying pain science, I've incorporated information the information presented in Explain Pain into my practice. It has been a useful tool for helping clients get out of pain and feel in control of their lives once again.

Additional resources

I've posted a fifteen minute TED Talk by Lorimer Moseley on Why Pain Hurts in a previous post. There is also, in the same article, a forty-five minute lecture to a professional audience for those geeky folks who want to understand details about the biology of pain. Recently, I've found a twenty-five minute video by Moseleywhich has become a favorite because he addresses how we think about conditions like herniated discs and how our thinking can feed and perpetuate fear, anxiety, and pain. If you watch only one of these videos, this is the one I recommend. These videos are educational and entertaining. Moseley, who is both researcher and clinician, has a charming Australian accent and a great sense of humor. Imagine Crocodile Dundee giving an introduction to pain science and you'll get the picture.

For more information about understanding pain, I also suggest the following: 

Painful Yarns by Lorimer Moseley (stories to help understand the biology of pain)

Also, check out this article about understanding how pain works by Paul Ingraham of SaveYourself.ca. 

Cory Blickenstaff, PT, has put together some useful videos of "novel movements." Here are links to the ones on the low back, neck, and hand, wrist, forearm, and elbow. 

This article originally appeared massage-stloius.com and was written by 'Ask the Massage Therapist'.