As an at-home personal fitness trainer and bodyworker, I am always asked to work with clients who want to reach their fitness goals. But they often have shoulders issues from either a shoulder replacement, rotator cuff surgery, or past shoulder injury that has not been properly rehabilitated. In my experience, shoulder issues are the most difficult to rehabilitate. We want to provide the client pain relief while also restoring the joint to its proper function. Rather than seeing treatment, many clients just learn to adjust to daily pain and dysfunction. And then, when they do seek treatment options, it’s often only basic physical therapy assigned “cookie-cutter” exercises and stretches.
One of the issues that makes it particularly difficult to treat shoulder issues is Scars.
What are scars? Scars are the result of trauma caused by:
- Cutting of skin, muscle, and fascia to get to an area for surgical repair.
- Joint replacement surgeries that require aggressive cutting and manipulation of joints are then replaced with artificial materials.
- Trauma injuries such as falls, or impact hit during sports.
- Overuse or repetitive motion injuries during sports like tennis, weightlifting, golf, baseball, etc
- Pain after an injury
- Additionally, there can be a great emotional component to scars and the way people got them.
After an injury or surgical procedure, many people just perform some light physical therapy exercises or movements believing that the issue is resolved. They try to return back to life or an active lifestyle only to realize that they are still confronted with pain. How could this be? They think, “I did have the surgery and rest? I took the time off to heal?” Here are some reasons why a return to an active lifestyle slowed them down. Scars, no matter how big or small, may cause complex problems. In order to understand how scars affect our bodies, we also have to understand the role of Fascia in our bodies:
- “Fascia is the thin, but tough membrane that surrounds all structures of the body. It is mainly composed of collagen that attaches, stabilizes, encloses, and separates muscles and other internal organs. Fascia is classified by layer as superficial fascia, deep fascia, or visceral fascia according to the function and anatomical location.” 1
- Fascia has contractile abilities. When Fascia is surgically cut, the scar penetrates deep into the fascia layers, shutting down the contractile abilities of muscle around the area. The scar can also downregulate the function of other muscles that work together, like the shoulder’s rotator cuff. In other words, the scar could prevent the centration of the acetabulum, humerus, and scapula to work in rhythm together.
- Scars can also affect other areas of the body. Because fascia is all interconnected, dysfunction in one area may cause another area to overcompensate or undercompensate. Depending upon the movement pattern of the individual, most of us already move improperly. Scars can inhibit other areas to compensate, causing muscle imbalances and improper movement. This can lead to pain and future injury.
- The scar can cause medium to long-term loss of mobility to the shoulder The patient is going to have a build-up of fibrous tissue that further restricts mobility over time.
So, I have a scar. How does that affect my shoulder health and function?
The shoulder region is a complex area. The proper movement around our shoulder region is called Forced Couples. Forced couples are relationships of the muscles around the shoulder girdle. The muscles of the rotator cuff, neck muscles, scapula, and humerus have to work in concert. When they don’t, the motor control center in our brain alters the movement to help us move. This creates a muscle imbalance. When the supporting muscles can no longer take up the slack because they are overworked or underworked, the result is pain, because the body can no longer compensate.
When there is a scar around the region of the shoulder, no matter how old or new, it could also be down-regulating the forced couples of the shoulder. There are instances where a person has had previous shoulder problems. When a scar is formed around the area, it could compound the dysfunction. Scars can cause tremendous problems anywhere throughout our bodies. They can actually shut down proper movement much further from the scar. For this article, I focused on scars around the shoulder region.
There is an amazing modern scar release technique called the McLoughlin Scar Release Technique, MSTR for short. It was invented by UK bodyworker and Massage Therapist, Alastair McLoughlin. He is a lifelong bodyworker with many skills geared towards pain relief and movement. He is a Master Instructor for Bowen and also a medical massage professional. He has perfected a special scar release protocol. His protocol is designed to help access the scar by figuring out the line of pull. Then a special technique releases the scar. Many therapists believe if you just stimulate the scar you can get it to release. But actually, you can stimulate it and make it more rigid and dysfunctional. Through McLoughlin’s technique, practitioners are taught to study and observe the scar, feel for moisture, and feel for the rigidity of the skin around the scar. These are just a few of the observations that lead the practitioner to perform a special form of release. It is a highly successful, gentle, and prioritized protocol that gives tremendous relief to the patient. Strict attention is given to the tissue surrounding the scar as well. MSTR® is also really good at reversing this natural response to immobility.
MSTR is a very successful scar release. It has been researched even in medical settings and testing with great results. It is an amazing protocol to help people find relief from pain.
MSTR+HOPE = Pain Relief
Michael Metchikian, NASM, MSTR,CPT, CES
Michael is a lifelong Corrective Exercise Specialist. He has dedicated the last 30 years of his life to getting people out of pain and returning back to an active lifestyle. He practices the MSTR protocol Daily on his clients. He is located in South Florida in Delray and Boca Raton area. He is an at-home fitness trainer and also has a private studio.