Dan Perez, D.C.

When muscles, ligaments and tendons (soft tissue) sustain an injury (sprain / strain), the body naturally attempts to repair the damage using collagen, which is produced by special cells called fibroblasts.  Oftentimes the fibroblasts make excessive amounts of collagen, which then interferes with proper muscle function.  Therapists refer to this as scar tissue.  Sometimes scar tissue can be felt through the skin as small, hard nodules.

Scar tissue is weaker than the original tissue it repairs as it is less “organized;” analogous to a repair patch on an inflatable raft.  If a significant soft-tissue injury is not rehabilitated properly with passive, active, and active-resistance exercises then the scar tissue will not align itself in the axis of muscle contraction.  This can increase the risk of re-injury.  It is also theorized that the hard, brittle nature of scar tissue causes nerve endings to concentrate around it, as they cannot penetrate through.  This may explain the nature of chronic muscle pain and trigger points.

Myofascial pain is the general term used to describe the presence of soft tissue pain without recent trauma.  It is commonly found along the neck, upper shoulders, and elbows and wrists but can affect any muscle.   Past injury, such as from auto accidents, sports, and repetitive strain/cumulative trauma are associated with myofascial pain conditions.

I use instrument-assisted soft tissue mobilization (IASTM) in cases where scar tissue is affecting the proper function of muscles.  This procedure incorporates a special edged instrument made of medical grade stainless steel called the MyoBar.  It is similar to the Chinese medicine procedure called Gua-Sha, and the Graston technique.

The problem area is evaluated, and an emollient base is applied.  The MyoBar is then used to “strip” the muscle, effectively softening and breaking apart scar tissue adhesions from previous injury.  In some cases, deep tissue laser is administered to the area of pain to soften and vascularize the affected soft tissues.  While simple in nature, IASTM can be very effective in reversing chronic muscle pain due to prior injury.