Treat every scar. Except these ones.

A scar can look completely healed and finished.

Pale. Flat. Closed. Nothing to see here.

Neurologically? It might still have plenty to say.

When tissue gets cut, burned or torn, the damage doesn't politely stop at the skin. Small sensory nerves and autonomic fibres get stretched, severed, trapped, or forced to regrow through a tissue environment that looks nothing like the one they left.

That's how you end up with a scar that's painful, numb, itchy, hypersensitive, or just plain weird. One that complains when the tissue around it moves. Years later.

The literature on painful scars describes nerve injury, nerve tethering and altered nerve mobility underneath that tidy visible line. Painful hypertrophic scars have been found to contain nerve fibres involved in nociception, circulation, immune signalling and neurogenic inflammation.

So no. Some scars are not inactive piles of collagen.

They can stay neurologically and neuroimmunologically active. Which is seriously cool, and also a little inconvenient for the "it healed, move on" model.

Scarring can mess with local autonomic function too. Those fibres help run blood flow, skin temperature and sweating. Damage them and the area around a scar might sweat differently, change colour, feel oddly hot or cold, or respond differently to stress and movement.

So does that mean every scar is quietly holding your client hostage in fight or flight?

No. Let's not.

But a sensitive, painful or nerve-involved scar keeps feeding information into the nervous system. If movement repeatedly tugs on it, compresses an irritated nerve, or provokes nociception, the nervous system keeps answering. Pain. Guarding. Protective tension.

That's where scars get interesting to us.

We're not smashing scar tissue. We're not breaking adhesions. We're not mechanically erasing anyone's history.

We're changing the input.

We stimulate the scar, its borders, the deeper tissues, and the nerves travelling through and around it. Then we look for results.

Did the pain change?Did movement improve?Did the guarding drop?Is the area less sensitive?

This is why we tell our students to treat every scar they find in the area of the client's complaint. Every one. Not just the angry-looking ones. Not just the ones the client bothers to mention. ALL of them.

Sometimes a scar that looks completely unrelated to the complaint produces a change nobody saw coming.

Not because it was storing trauma.Not because we melted collagen.Because it was still part of the neurological conversation.

But there's one exception.

We tell our students to leave abdominal scars alone until they've taken our core class.

Some of them probably think we're being dramatic. Plenty have already worked through a pile of them and nothing terrible happened.

Here's the thing. Abdominal scars are often part of a bigger faulty stability system. Play with one without understanding what it's propping up, and you can completely destabilize someone's core.

Next week we'll tell you why.

Til next week happy scar hunting

Sherry & Rob

Read the review on painful scar neuropathy → https://pmc.ncbi.nlm.nih.gov/articles/PMC8994628/