Scar tissue can restrict movement in adjacent joints and eventually create injury to the joint itself. This type of restrictive tissue can become stronger and inelastic like connective tissue like tendons and cartilage. After an injury, the collagen fibers are arranged in a sporadic and disorganized pattern to prevent recurrence of the injury. If you’ve ever patched a hole in a pair of jeans with the zigzag stitch on your sewing machine, you know how it works.

Scar tissue occurs as a result of injury, surgery, or repetitive motion. These are very different types of injuries that will create variation in the type of scar they create. For example, a shear injury would be a cut caused by surgery, or a cut with barbed wire, or you see them often on the forehead of a horse due to a trailer loading incident (sound familiar?) In this case, the fabric is cut, never to be perfectly matched again.

A compression injury is caused by force trauma. An example of this type of injury would be being kicked by another horse, causing a large, round swelling under the skin that would leave behind a hard mass of scar tissue that resembles a hard mass. The injured part becomes resistant to movement due to pain, so the immobile area begins to scar the bruised cells. Although this is not the worst type of injury, it can become the thickest and most difficult tissue to pass through.

Lastly, in a repetitive motion injury, the tissue wears down from constant friction. The body forms scar tissue as the muscle or joint continues to break down by defying signals from the body. This type of scar build-up can occur in the form of soft tissue hardening or bone spurs due to osteoarthritis. If you’ve ever seen a horse with a giant, immobile knee, this is a long-term result of the body trying to heal a chronic condition by sending more and more bone to the site. Although this type of bone build-up cannot be removed with massage therapy, the adjacent soft tissue can be mobilized and possibly detached from bone growth.

There is no guarantee that manual therapy will break down tissue, and you should understand that by mobilizing tissue that has grown like a scar, you will be prompted to create a new lesion by pulling adhering tissue from adjoining tissue. This can be painful and requires a new healing process accompanied by more therapy.

In many cases, when an athletic horse has been retired due to an old injury, it is well worth the time and effort. I have worked with many cases of scar tissue and to see the benefits of my efforts it has been worth the long process.

Make sure you understand the physiology of the tissue and bone in the part of the body you are working with before starting this type of therapy, and I always recommend consulting with your horse’s vet for approval of your plan.

First, try to find out the exact etiology of the injury. More importantly, how old is the scar? If an old injury involves chronic inflammation, there could be several months and perhaps years of tissue accumulation. A general rule of thumb is that it takes as long to break down scar tissue as it does to form. This could give you an idea of ​​what you are facing.

Second, assess the injury. If there is still heat in the area, it has become chronic and could still be forming scar tissue. You should not massage an inflamed area. You should discuss this with the horse’s vet. It may be necessary to administer anti-inflammatory medications or an icing program to stop the chronic process before moving on. Also, assess whether the knight has been compensating by not wearing the piece. In the event that the injury is to a limb, a horse will sometimes stop using that particular limb and may be over-developing muscles in other parts of the body. If this is the case, you may need to incorporate some additional bodywork into these areas as part of your scar therapy.

Be careful here. A long-term painful injury can have the horse on the verge of handling this sensitive area. Do not perform these techniques unless you have consulted with your veterinarian and they are confident in your ability as a handler. This can be a dangerous undertaking. Be open to changing your plan based on the horse’s response. Remember, you will create a new injury by working through the scar tissue. You may have to work in short sessions, mobilizing adjacent joints, icing, and then letting it sit for a day or so. As the scar begins to loosen, you will need to keep the area mobile while the damage it creates heals properly. Never force an adjacent joint. Release the soft tissue, then gently stretch the area while mobilizing the involved skin and fascia.

Below is an example of how to use manual therapy on adherent tissue;

Begin by Effleuraging (gently stroking) the surrounding areas towards the heart. Drop in a glass of ice (paper cup of frozen water that you can pop off like a popsicle) or rub the area with a glass of ice before you begin. This will desensitize the area.

Once the area is numb, begin to cross the scar with your thumbs back and forth and up and down to move the tissue in each direction. If you are on a limb, you can use your hands to “twist” the handkerchief back and forth. Follow this mobilization by Effleuraging the area back toward the heart to move the blood. Alternatively, you can stroke the tissue crosswise, followed by Effleurage towards the heart a few times.

Mobilize the area. You can do this by walking or gently stretching. If the scar is not on a limb, but perhaps a compression scar on the rib cage, you can perform “carrot” stretches by inviting the horse to lean away from the scar. This mobilization will remind the brain to bring this area back into the chain of motion.