What does the course aim to cover?

This course covers the theory and practical skills needed for safe and effective manual treatment of scar tissue after a surgery or trauma, including burn and non-burn injuries. 

Scars present with different symptoms and formations, which are dependent on many factors. 

To address a variety of common complications and scar types, participants will learn a comprehensive and diverse range of manual scar massage techniques, including:

• active and passive scar stretching
• slow fascial release
• decongestive techniques
• scar massage for sensory dysfunction
• negative pressure/vacuum massage using silicone cupping for scar tissue and adhesions
• inter-oral techniques for facial surgery or trauma
• scar care by the patient, including selfscar massage and topical products.

Physiotherapists will learn multiple manual scar massage techniques to promote scar improvement as well as ways to support emotional recovery and acceptance. 

They will be able to differentiate between techniques needed in very early healing and techniques that are appropriate when treating more mature scars.

Why should physiotherapists attend this course?

Physiotherapists working in many specialties will see people with scars after surgery or an injury on a daily basis.

In particular, musculoskeletal, oncology and women’s health physiotherapists as well as hand specialists who complete the course will gain practical skills and knowledge that they can take into their clinic for the management of scar tissue, along with a wide choice of scar self-care techniques to prescribe to patients.

Participants will also learn to assess skin tension and to apply scar therapy techniques and self-care advice to reduce
the tensional forces and promote normal wound healing.

Wound healing and scar tissue are complex; understanding fascial connective tissue in more detail makes it easier to see how tight, restricted or adhered tissue in one part of the body can be causing symptoms in another area. 

Increasing a physiotherapist’s ability to assess and treat scars is therefore likely to improve the results possible within their
patient population.

Who would benefit most from enrolling?

This course is ideal for any physiotherapist who is looking to expand their practical skills in scar assessment and manual scar
treatment. 

This includes physiotherapists who see patients with restrictive movement, acute pain, oedema, lymphoedema and sensitivity and patients who have developed excessive fibrotic, hypertrophic or widespread scar tissue.

The power of touch can also play a role in supporting a patient’s emotional wellbeing.

Many patients, after a severe trauma or life threatening injury, will have post-traumatic stress disorder, high anxiety or depression.

Often patients are not able to look directly at or touch their scars. Hands-on touch by a physiotherapist can support healing and
help acceptance.

What overlap is there between scar therapy and physiotherapy?

Scar massage sits as a specialty within manual therapy to which physiotherapists may have had an introduction within their
degree. 

However, most physiotherapists will benefit from revisiting, updating and expanding on their basic understanding of scars and from gaining more confidence and skills in the variety of ways that they can support their patients. 

Scar management or scar therapy is a complementary skill for all physiotherapists working with postoperative or trauma patients.

Combining hands-on skills with rehabilitation exercises can be very helpful compared to exercise alone.

Why is scar therapy necessary? 

Scars are an unavoidable consequence of injury and surgery. The body is not able to create a perfect repair of like-for-like cells
after an injury such as surgery or trauma. Scar tissue can leave patients with pain, sensitivity, restrictions with movement and
adhesion formation.

For some patients, symptoms may be limited to the first 12–24 months, while the scar is still progressing through the
remodelling phase, but other patients will continue to have symptoms—and in some cases worsening symptoms—
years after the initial injury.

Even keyhole procedures can cause adhesion formation. 

With rising numbers of people having cosmetic surgery, an increase in cancer (and cancer survivorship) rates and higher rates
of caesarean section births and other medical interventions, even more people will be walking into a physiotherapy clinic
with scars. 

Being able to assess and treat the scar tissue will be a key skill for physiotherapists.

‘Scar therapy practitioner’, presented by Vickie Maher, will run 7–8 January in North Ryde, New South Wales. Visit australian.
physio/pd/pd-product?id=10343 to find out more and to register.

>>Vickie Maher has been specialising in scar therapy since 2018. In addition to teaching, she is part of the Restore Scar Therapy Clinic in London, UK. She has worked with Invictus athletes and volunteered with burn injury survivors. Vickie has a special interest in women’s health. 

>>Emma Holly is a clinical scar massage therapist and a leader in her field, with a particular interest in non-invasive treatment approaches. Emma has almost 30 years of experience as a therapist. She is a scar therapy educator and has presented on the subject at international conferences for therapists and surgeons.