Let's talk about scar tissue/knots and possible treatments

[FuriousAngus]

A lot of us have been injecting for some time and I'm sure most (if not all) have either run into or are running into issues concerning long lasting/permanent knots at injection sites or scar tissue.

I used to inject my right quad once a week at the same spot every single time. Over a 2 year period I developed what feels like a fibrous lump (or knot) there at the injection site. Aspirating pulls nothing (no puss) and I had it ultra sounded (I think? some kind of imaging device where they put a cold gel on you first) and the machine did not show fluid, but rather what looks like fat or bits and pieces of separated material.

I have one very tiny lump that shows up on my left shoulder when I flex it pretty hard (hard to notice unless I point to it), and I have one on my right quad now. What can I do to get rid of these knots and get my soft muscles back? I had the one of my right quad for a year now.

I heard that massage can actually help break down these knots but have anyone actually tried that and got positive results from it? Compounds you have used to break down these scars? Other types of therapy or treatment?

Any help would be highly appreciated. I find it very difficult to believe that all these bodybuilders on stage running grams of gear have not found a way to deal with this, but maybe I'm just unlucky...

 

[01dragonslayer]

Six Massage Techniques to Remove Scar Tissue

As soon as the wound is knitted, massage therapy can be performed. During the initial immature stages of wound recovery, it is imperative that a gentle approach be taken. The following six techniques are well-known ways bodyworkers can improve scar tissue:


1. Manual Lymph Drainage optimizes lymphatic circulation and drainage around the injured area. Gentle, circular, draining motions within the scar itself or a firm stretch to the skin above and below the scar, first in a straight line and then in a circular motion, are two drainage techniques. Placing the fingers above the scar, then making gentle circular pumping motions on the scar also helps drain congested lymph fluid. As the massage therapist gently works down the scar, the tissue will feel softer. Drainage techniques should not hurt or make the scar redden.

2. Myofascial Release helps ease constriction of the affected tissue. To stretch the skin next to the scar, place two or three fingers at the beginning of the scar and stretch the skin above the scar in a parallel direction. Then move the fingers a quarter of an inch further along the scar and repeat the stretch of the adjacent tissue, working your way along the scar. An alternative method is to follow the same pattern of finger movements using a circular motion instead of straight stretches. Work your way along the scar in a clockwise and counterclockwise fashion.

3. Deep Transverse Friction can prevent adhesion formation and rupture unwanted adhesions. Applied directly to the lesion and transverse to the direction of the fibers, this deep tissue massage technique can yield desirable results in a mature or immature scar. Never progress beyond a client’s comfort level.

4. Lubrication of the scar helps soften and increase its pliability. Mediums such as lotion, castor oil, vitamin E oil or other oil can prevent the scar from drying out and re-opening.

5. Stretching aids in increasing range of motion. This is most important when approaching scars that cross over a joint. Scar tissue will lengthen after being stretched, especially if the stretch is sustained for several seconds and is combined with massage.

6. Heat Application helps the pliability and flexibility of the scar. Common tools used to apply heat are paraffin wax, moist heat packs or ultrasound.

 

[FuriousAngus]

Six Massage Techniques to Remove Scar Tissue

As soon as the wound is knitted, massage therapy can be performed. During the initial immature stages of wound recovery, it is imperative that a gentle approach be taken. The following six techniques are well-known ways bodyworkers can improve scar tissue:


1. Manual Lymph Drainage optimizes lymphatic circulation and drainage around the injured area. Gentle, circular, draining motions within the scar itself or a firm stretch to the skin above and below the scar, first in a straight line and then in a circular motion, are two drainage techniques. Placing the fingers above the scar, then making gentle circular pumping motions on the scar also helps drain congested lymph fluid. As the massage therapist gently works down the scar, the tissue will feel softer. Drainage techniques should not hurt or make the scar redden.

2. Myofascial Release helps ease constriction of the affected tissue. To stretch the skin next to the scar, place two or three fingers at the beginning of the scar and stretch the skin above the scar in a parallel direction. Then move the fingers a quarter of an inch further along the scar and repeat the stretch of the adjacent tissue, working your way along the scar. An alternative method is to follow the same pattern of finger movements using a circular motion instead of straight stretches. Work your way along the scar in a clockwise and counterclockwise fashion.

3. Deep Transverse Friction can prevent adhesion formation and rupture unwanted adhesions. Applied directly to the lesion and transverse to the direction of the fibers, this deep tissue massage technique can yield desirable results in a mature or immature scar. Never progress beyond a client’s comfort level.

4. Lubrication of the scar helps soften and increase its pliability. Mediums such as lotion, castor oil, vitamin E oil or other oil can prevent the scar from drying out and re-opening.

5. Stretching aids in increasing range of motion. This is most important when approaching scars that cross over a joint. Scar tissue will lengthen after being stretched, especially if the stretch is sustained for several seconds and is combined with massage.

6. Heat Application helps the pliability and flexibility of the scar. Common tools used to apply heat are paraffin wax, moist heat packs or ultrasound.

Thanks for quoting this. It sounds feasible and helpful, but I'm looking for actual anecdotal reports/success stories but I've looked around for ages and I only see people complaining but I have yet to hear or read of someone who was able to flatten out/completely hear old knots/scar tissue caused by pinning.

 

[cricket_fire]

As a massage therapist, I would suggest a few things..

Although a seemingly popular belief, we really cannot manually alter mature scar tissue. There is however, some evidence that was can alter scars while they are still remodelling. This means a couple things for bodybuilders:

-early intervention is important (anecdotally - even just minor massage to injection sites frequently will help a lot more than trying to "smash" a large buildup of scar tissue)

-it is thought that immature scar tissue can be altered by stretch through tissues (leading to a cytokine release which helps with scar elasticity and formation). This means we might be better off putting light stretch through the skin/fascia around the area and moving the area through full ROM, opposed to physically trying to "smash" up the scar

-as much common practice as deep tissue stuff is in strength sports, it might not be entirely necessary (depending on the patient's presentation). The effects of manual therapies are much more neurologically-driven, and very little tissue-based changes occur (if any at all). A lot of the changes we see around mature scars after treatment are more due to changes in sensation and threat perception opposed to actual mechanical changes to the scar. The "no pain no gain" mantra does not apply to manual therapy.

Deep pressure is great as long as it is perceived as "pleasant" or "helpful". If you're having to bite your lip, hold back grunting etc, it's likely unnecessarily rough. If you're interested in more on this look up Descending Noxious Inhibitory Control (this explains why painful therapies often make us feel better, but also that it can be a gamble, and often will exacerbate symptoms further - we have no way to determine who will respond positively and who will respond negatively. Since we can achieve similar positive results with less painful methods, these should be utilized).




In my opinion, the best bet for most strength athletes is really simple basic stuff:
-ensure you regular move your body through full ranges of motion (in all available ranges). That can be under load, dynamically, or just static stretching
-self massage for injection sites could be useful but won't make a world of difference. Try using enough pressure to engage the tissues, then apply a drag to the skin and hold for a while (30 secs to 2 mins... doesn't have to be exact). Reposition, drag in a different direction, and repeat
-if you do get an injury, treat appropriately right away. Don't "push through the pain" - train around injuries, but don't train through them. And find someone to work with who is really up to date with both current physical therapy evidence, and also understands bodybuilding/weight lifting

 

[cricket_fire]

Thanks for quoting this. It sounds feasible and helpful, but I'm looking for actual anecdotal reports/success stories but I've looked around for ages and I only see people complaining but I have yet to hear or read of someone who was able to flatten out/completely hear old knots/scar tissue caused by pinning.

You will likely be able to find anecdotes, but the problem is anecdotes in this regard fly directly in the face of known physiology. Mature scar tissue is STRONG. It is difficult to cut through with a scalpel. We can't really manually "break up" this tissue. What you might find though, is people who "feel" they have had these changes due to altered sensory perception post treatment. There is nothing wrong with that (hell if someone comes in to see me with a problem around a mature scar, that is the goal!). It's just important to keep in mind the mechanism of that change (neurological opposed to mechanical), because it helps keep us away from unneeded, potentially damaging treatments.

 

[LK3]

i have a bunch of perma lumps. lol
one is slighting visable on left arm.

injecting into the lumps is a nono. lol

i find aas pretty easy for the most part, unless using basses or high mg stuff.

years of injecting other weird shit has caused more issues for me.
i have no real solution, i have tried all sorts of things that have varrying degrees of success. though literally a pain in the ass to keep up with. lol :banghead:

try no to hit the exact same spot over and over.
doing a weekly rotation is good but each time try to move just a lil bit.

to limit lumpyness stick to 100mg compounds with esters.:lightbulb:

 

[mytreefiddy]

Cricket..... on the 1st page I have a thread called Theragun G2Pro... claims to "break up" scar tissue..... $599..... worth it?

 

[devenidas]

Cricket..... on the 1st page I have a thread called Theragun G2Pro... claims to "break up" scar tissue..... $599..... worth it?

Gino hold [emoji91] don't buy yet. I will give u my thoughts on it in detail after holidays, as a physical therapist. The u can make your decision.

I have written about a bit here and there on board.

Sent from my Moto G (5) Plus using Tapatalk

 

[mytreefiddy]

Gino hold [emoji91] don't buy yet. I will give u my thoughts on it in detail after holidays, as a physical therapist. The u can make your decision.

I have written about a bit here and there on board.

Sent from my Moto G (5) Plus using Tapatalk

Oh hell yeah....i'll stand by until I hear from you.... Thanks Dev

 

[devenidas]

Oh hell yeah....i'll stand by until I hear from you.... Thanks Dev

Anatomy gangsta got you covered mate

Sent from my Moto G (5) Plus using Tapatalk

 

[cricket_fire]

Cricket..... on the 1st page I have a thread called Theragun G2Pro... claims to "break up" scar tissue..... $599..... worth it?

I wouldn't suggest it. If you have access to one already, and if you feel it helps you move/feel better, maybe... but I definitely wouldn't buy one especially with that price tag.

Manual therapies are all currently thought to work by non-specific, neurally-mediated effects. Using a tool like that to provide some novel stimulus to the nervous system could *potentially* lead to changes in sensation (ie. pain reduction). But it DEFINITELY will not "break up" scar tissue (neither will any therapist's hands, despite what many will lead you to believe).

It really depends what you'd be using it for. If you're worried about scar tissue that is currently asymptomatic (buildups at injection sites with no pain or altered function for example) I would just suggest regular "mobility" work (I fucking hate that word lol... I just mean move the structures involved through their full ROM, in whatever way you damn well please... and do a little self-massage to the area).

If you'd be using it more to treat a painful area, I would suggest hooking up with an evidence-based physiotherapist or massage therapist who understands everything that goes into bodybuilding (I emphasize evidence-based because there is a LOT of pseudoscience and misinformation in the field of MSK health). A good therapist will be able to show you some solid home-care stuff that doesn't involve contraptions and do-dads lol.

 

[FuriousAngus]

I wouldn't suggest it. If you have access to one already, and if you feel it helps you move/feel better, maybe... but I definitely wouldn't buy one especially with that price tag.

Manual therapies are all currently thought to work by non-specific, neurally-mediated effects. Using a tool like that to provide some novel stimulus to the nervous system could *potentially* lead to changes in sensation (ie. pain reduction). But it DEFINITELY will not "break up" scar tissue (neither will any therapist's hands, despite what many will lead you to believe).

It really depends what you'd be using it for. If you're worried about scar tissue that is currently asymptomatic (buildups at injection sites with no pain or altered function for example) I would just suggest regular "mobility" work (I fucking hate that word lol... I just mean move the structures involved through their full ROM, in whatever way you damn well please... and do a little self-massage to the area).

If you'd be using it more to treat a painful area, I would suggest hooking up with an evidence-based physiotherapist or massage therapist who understands everything that goes into bodybuilding (I emphasize evidence-based because there is a LOT of pseudoscience and misinformation in the field of MSK health). A good therapist will be able to show you some solid home-care stuff that doesn't involve contraptions and do-dads lol.

Cricket, are you saying that the only real way to break down these knots (one of mine is slightly visible when I flex my left shoulder) and scar tissue is by stretching the muscles and doing light massage? These knots are some kinda fibrous structure they're not necessarily scar tissue, but rather results of bad injection that just never went away etc.

At what point would you consider a knot a "mature scar tissue" as opposed to whatever comes before that point? The one on my shoulder has been there for about 6 months now and my leg about a year maybe a bit more.

Your input is highly appreciated.

 

[FuriousAngus]

Gino hold [emoji91] don't buy yet. I will give u my thoughts on it in detail after holidays, as a physical therapist. The u can make your decision.

I have written about a bit here and there on board.

Sent from my Moto G (5) Plus using Tapatalk

I'd love in on this too. Looking forward to your review, man. I don't think you can put a price tag on keeping muscle shape and smoothness despite pinning for years.

 

[Heath82]

When I was in rehab they talked about using ultrasound to break up some big lumps of scar tissue I had, but due to metal plates they were unable to try

 

[11sh11]

This is my work specialty also, and like others have said, mature scar tissue cant be 'un-done'. There are stripping teqhniques that can soften it and improve appearance. You can keep the surrounding areas from becoming involved.
Percussive tools can make it feel better and maintain range of motion, but your best option is to keep rotating sites, use proper inj technique, and massage inj sites reqularly with a lacrosse ball or foam roller.
Simply put, you cant turn gristle back into steak

 

[Pericles]

You can't remove scar tissue. ART etc will not remove it.

 

[WhyIncision]

Cricket..... on the 1st page I have a thread called Theragun G2Pro... claims to "break up" scar tissue..... $599..... worth it?

I wouldn't buy it. A guy in my clinic has one and I wasn't impressed by it. It's loud as hell too. I still prefer MRT and IASTM.

 

[tren_plz]

Ive had one used on me 10+ times. Badass. Personally wouldnt drop the money on it, but if you're a pt, chiro/art i would. Saves your hands and loosens everything up waaaaay quicker.

 

[cricket_fire]

Cricket, are you saying that the only real way to break down these knots (one of mine is slightly visible when I flex my left shoulder) and scar tissue is by stretching the muscles and doing light massage? These knots are some kinda fibrous structure they're not necessarily scar tissue, but rather results of bad injection that just never went away etc.

At what point would you consider a knot a "mature scar tissue" as opposed to whatever comes before that point? The one on my shoulder has been there for about 6 months now and my leg about a year maybe a bit more.

Your input is highly appreciated.

It's worth noting that a small visible lump in the delt could possibly be a sterile abscess (just in case you hadn't thought of that). In which case treatment should be a wee bit different haha.

If they've been there a long time, you can minimize new damage and improve the feeling of the area (if there is associated pain/dysfunction). But in terms of the old, more "solidified" scar tissue, there isn't a whole lot you can do to "break it up".

As for how long it takes a scar to be mature - it depends, but it can take months to years to complete. And with the nature of the trauma (repeated injections in regular intervals) I'm honestly not sure how long it would take in this case (I imagine it is a very fluid process, with areas right next to each other undergoing different stages simultaneously and effecting the other areas).

The best things you can do (in my opinion) is focus on prevention - like someone else said, rotate injection sites, take precautions to cause the least damage possible during injections, and regularly stretch and massage the injection sites.

And just to clarify - it doesn't need to be light massage, I'm just not a fan of *painful* massage. I generally tend to work sort of "deep but gentle". Painful soft tissue treatments can sometimes help, but they can also sometimes cause more damage and pain, and there's no way of knowing ahead of time who will respond positively (and the same person could get kickback pain even if they've had previously positive results from painful treatments). I don't mean to harp on this, it's just so common with bodybuilders and athletes in general who feel like they need to be tortured to benefit from treatment - it's not needed! haha





This article is a decent view of wound healing for anyone interested:
https://www.physio-pedia.com/Soft_Tissue_Healing

 

[Dragonball]

Gino hold [emoji91] don't buy yet. I will give u my thoughts on it in detail after holidays, as a physical therapist. The u can make your decision.

I have written about a bit here and there on board.

Sent from my Moto G (5) Plus using Tapatalk

Just say it's fucking garbage please. Nobody should spend $600 on that thing. Just buy a jigsaw and they have massage attachments for sale. Tha t guy is robbing people.