Healing old scars

Dan Loch of Jackson County Physical Therapy works on Rhonda Taylor using a deep-tissue massage technique called Active Release Technique, or A.R.T.

For 13 years, Rhonda Taylor suffered from pain and a shrinking range of motion in her shoulder and neck.

She tried a variety of treatments, but the problem kept getting worse until she discovered a deep-tissue massage technique known as A.R.T. — Active Release Technique — that got down to the root of her problem.

Originating with an auto accident those many years ago, her shoulder pain was making routine daily tasks increasingly difficult.

"I couldn't even raise my arm up high enough to lift a brush or dry my hair. I was not able to reach across and rub a washcloth on my other shoulder," says the Medford resident, a teacher at Griffin Creek Elementary School.

Frustrated with her deteriorating condition, Taylor submitted to an MRI. The results revealed that although her shoulder joint was fine, a massive volume of scar tissue and muscle adhesions surrounded it. Each time she reached too far or too high, the muscle would tear a little more, and it would heal back with more scar tissue.


"I had only about 20 to 25 percent mobility in the shoulder; I was limited in reaching up high, out to the side or behind my back," Taylor explains.

Dan Loch, an A.R.T. practitioner at Jackson County Physical Therapy, used the deep-tissue technique to help Taylor break up her muscle adhesions and restore her range of motion.

"You take the muscle into the most shortened position and gently pin it down, usually with your thumb," says Loch. "Then you allow a slight glide of the soft tissue, and in the process take that muscle and joint and lengthen it to its max. You get most of your improvements in disruptions of scar tissue and muscle adhesions through that last 10 percent of the range of motion."

The process is repeated several times in each treatment session, often varying the direction slightly.

"It was pretty painful," Taylor recalls. "It was not an enjoyable position to go through, but each time he did it, I had more mobility. Right away I could feel it move more."


Muscle strains — minor tears — are quite common, and they usually heal without a problem. The body will lay down a matrix of scar tissue, much like a scab, that often is reabsorbed into the body during the healing process. When a person doesn't allow enough time to heal and repeats the motion that caused the strain, however, scar tissue can accumulate.

When the cause of the injury is known, such as an auto accident or when an athlete pushes too hard, the pain can be easier to diagnose and treat. Chronic cases, often caused by small, repetitive motions in the workplace, can be harder to pinpoint and treat, says Brian Johnson, a Medford massage therapist who uses deep-tissue massage to break up scar tissue.

"Long hours at a computer, you get scar tissue built up around your neck and shoulders," says Johnson.

Two preventative measures for avoiding subtle muscle strains are drinking more water and varying your motion, says Johnson.

If muscles start to dry out from not drinking enough water, they can break down because they're dehydrated, Johnson explains.


"That's how a lot of office workers will get those muscle tears."

The process for healing scar tissue, says Johnson, involves manually forcing the adhered muscle fibers apart so they can heal parallel to each other instead of in a crazy tangled mass that forms the scar.

"With massage, you're working cross grain, to try to break down that scar tissue to reabsorb into the body or at least break down so the muscle can flow freely again," says Johnson.

Taylor estimates it took 13 A.R.T. treatments to get her where she is now — beginning a weight-training regimen in the gym.

The number of treatments, says Loch, "depends on how bad the buildup is. Sometimes I've been able to break it down on the first treatment, other times it's taken three to four to five sessions."


Loch specializes in athletic rehabilitation and has treated many high school and college athletes, he says. He once had a patient who competed in ultimate fighting, and he's used to treating the shoulders of baseball pitchers and volleyball players, but he's found A.R.T. a useful tool at times to treat carpal tunnel syndrome.

When you go in (surgically) and have that carpal tunnel released, you still have adhesions on that nerve binding it up closer to the spine. The symptoms have a higher likelihood of returning," says Loch. "A.R.T. should definitely be tried before surgery."

In the meantime, Taylor says she's nearly back to normal.

"I'm at 97 to 98 percent mobility right now," says Taylor. "Just having full use of the arm, I can dry and style my hair normally again. It seems simple, but when you can't do it, it's frustrating."




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