How do you work with a client with older scar tissue? Here’s a video about my strategy:
I talk about some myofascial-inspired techniques for working with scar tissue, but mostly I discuss my general approach.
When I work with an area with extensive scarring, my primary concern is with the client as a whole. When someone has a visible/palpable area of past trauma, it can be easy to become hyper-focused on the region. While plenty of direct work may be warranted, this can leave the client feeling dissected, and it can feed into the narrative that this is their “bad leg” or “bad shoulder.” Certainly focus in, but always integrate the area back into the bigger picture.
Conversely, it can be tempting to avoid an area of past trauma. With a burn scar, or hip replacement, or amputation, we might feel like treating the area carefully. While I like this impulse (I think we should always approach the body with kindness and care), it can also unconsciously feed into a stigmatizing narrative where the site of past injury feels like “that thing” rather than “me.”
When I have a client with past injuries/surgeries, I try to have a conversation about their expectations, as well as their feelings about receiving direct contact in those areas. While some clients will be gung ho about you diving right in, others may express some trepidation. If they have fear surrounding the area, or if they’re concerned that you might cause pain, then ask about starting with some brief, gentle contact. By communicating before, during, and after, you may find that you can approach the area more directly as time goes on. Do keep in mind that some clients may prefer to keep areas of past trauma “off limits” indefinitely!
Newer massage therapists, how do you feel about working with sites of past surgery or injury? Massage veterans, do you have any illustrative stories that might encourage your fellow MTs to work with these areas more directly?
I’d also love to hear from those of you who receive work for your own scar tissue. Did it take you a while to receive contact? Did your massage therapist do anything to help you accept massage in that area, and has it had positive effects?