We don’t typically think much about scars beyond the circumstances of how we got them. Was it the result of some kind of negative event like a car accident? Or maybe it resulted in something positive like the safe birth of a baby?
Likewise, when we think of tattoos we don’t think much farther than the artwork itself. What does it mean? Does it symbolize something important? Was it done well, by a talented artist?
Regardless of how much thought we give our scars and tattoos on a daily basis, they are not normal areas of skin. As such, they impact our day to day functions. How much impact do they have? Well, it varies.
Nearly every person on the planet will be physically scarred at some point in their life. The severity of those scars will vary. A person might scrape their knees as a child, leaving minor scarring on their epidermis. While another might tear a muscle, leaving scars deep within the body.
Tattoos, while less common, have been growing in their popularity in recent decades. Where once only bikers, pirates and soldiers sported artwork on their skin, now you’ll find everyone from office execs to stay at home parents showing off their ink. In fact, according to a US study, 50% of individuals ages 25-39 have at least one.
As time progresses and skin abnormalities become more and more ubiquitous it is becoming more apparent that there may be more to them than originally meets the eye.
Let’s look further into what we mean by going back to the basics.
What is a scar? 
Scars are a natural part of our bodies’ healing process. Specifically, they are the body’s way of replacing or healing missing or damaged skin.
When we cut ourselves, for example, the body’s primary function is to repair the damage as quickly as possible to prevent further injury. Because our body’s primary concern is speed, the end result isn’t always pretty and there will be a noticeable difference in the old and new tissue (even down to the direction of the fibres). This is why scars come in all shapes and sizes and while some may fade over time, they never completely disappear.
If the configuration of scar tissue does not line up with surrounding fibres, it stands to reason that the way in which the structure moves will be compromised. Imbalances in the way we move lead to compensations in the body’s structure that will have global consequences over time.
What is a tattoo?
We’ve all seen them. But what exactly are they?
Tattoos are the result of ink that is pushed into the dermal layer of tissue on our bodies at a rate of 50-3,000 punctures per minute. While the epidermis is the outermost layer of skin that we can see, ink must be pushed below that layer in order to achieve a tattoo’s permanence, as the epidermis cells turn over at a much faster rate.
Essentially, we are creating small tears in our skin and injecting into it a foreign substance (ie. ink, metals and microplastics). As a result of this trauma, the body floods the area with white blood cells to help us heal. Yet, do to the material composition of the ink, our blood cells can’t actually eliminate it so they contain it. As cells die off, other white blood cells are sent in their place to contain the material. Each time this happens, a microscopic amount of ink enters our systems and is removed through our lymphatic system.
Tattoo vs Scar
It is important to note that a tattoo and a scar are not the same. With the technology we use for tattooing today, the artist does not typically pierce deep enough to create adhesions or scars when giving a tattoo. However, once upon a time, tattooing practices were different and, depending on the technician, there is a possibility of seeing older tattoos accompanied by raised edges, adhesions and some scarring.
With that said, there are some similarities between the two. Both are abnormalities in the skin that will impact how it moves and responds to stimuli. Additionally, both tattoos and scars impact the glands on the surface of the skin. Scars “do not have a normal blood supply, sweat glands or hair.” Tattoos, have been shown in a number of studies, to reduce the production of sweat produced on the area of skin they cover. Additionally, both have been known to reduce the mobility and flexibility of the skin and surrounding tissue.
Finally, neither scars nor tattoos (in most cases) occur symmetrically across the body. It is rare to find someone who will have a scar on their right shoulder that is identical to a scar on their left. Just as it’s uncommon to find someone with a tattoo on their left bicep that matches an identical tattoo on their right. Even if they did, the body’s response to these marks wouldn’t be identical. The doctor, technician or artist could have used different pressure or made minuscule changes from one side to the other. Either way, as we mentioned above earlier, this creates an imbalance. How do our bodies deal with imbalances? They compensate. What happens when we compensate for a weaker or tighter side for extended periods of time? Pain. Dysfunction. Injury.
Alright, but what does any of this mean?
Well, as we said above, scars and tattoos can create issues and imbalances in bodily tissues that result in things like seemingly unrelated chronic pain and postural imbalances. In fact, more and more therapists (even those in our own facility) are finding that when tattoos and scars are addressed with techniques such as Scar Tissue Release Therapy, cupping and massage, their clients’ complaints improve.
By addressing tattooed or scarred tissue and manually treating them, we might be able to restore balance to the body’s facial matrix, improve blood supply to old injuries and increase the over mobility and flexibility of tissue.
For Trainers & Practitioners
For trainers and practitioners, this means asking about tattoos and scars when completing your detailed intake form and determining treatment (if necessary). Not everyone with a scar will experience issues. Most people will tattoos likely won’t either. However, knowing about them will help if all else fails.
Vicki Ramsdell posted an interesting YouTube video on treating scars and tattoos with cupping. Check it out!
There is also a very interesting case study done on how treating tattoos with massage has had an effect on postural issues. Read about it on the Associated Bodywork & Massage Professionals website here.
For Anyone with Scars or Tattoos
Are we saying that if you have a scar you will undoubtedly have pain? Nope. Are we saying that you should avoid tattoos and if you do choose to get one your movement patterns will be thrown off? Also nope.
What we ARE saying is that for people with scars and tattoos experiencing chronic pain or postural issues without an identifiable source, it could be time to work on those areas. You might want to look into finding a therapist who can tend to scars and adhesions that might be creating restrictions in your body. It could also mean working on these areas on your own with self-treatments like, massage, self-myofascial release and trigger point therapy.
Worst case scenario? You don’t feel any different. Best case scenario? Your fascia thanks you, your movements are easier and you can finally breathe easy.
Ultimately
We know that scars create imbalances. They 100% disrupt the structural integrity of our tissue making it less flexible and less mobile. For people with scars that occur well below the surface of our epidermal layer, treatment isn’t a bad option.
We know a lot less about tattoos and their impact on movement. The topic is ripe for research though as more and more of the population gets tattooed. We’re excited see what comes of it and to be a part of it.
If you, or someone you know, has tattoos or scars that you think could benefit from manual therapy, don’t hesitate to get in touch with us.
—
References:
How many Gen Z and millennials have tattoos, and one big reason they get them. YPulse. (2022, October 27). Retrieved March 3, 2023, from https://www.ypulse.com/article/2022/10/27/how-many-gen-z-and-millennials-have-tattoos-and-one-big-reason-they-get-them/#:~:text=Nearly%20half%20(46%25)%20of,they%20are%20to%20have%20them.
Price, J. (2021, April 15). Is scar tissue causing pain and affecting your performance? NETA, National Exercise Trainers Association. Retrieved March 3, 2023, from https://www.netafit.org/2021/04/is-scar-tissue-causing-pain-and-affecting-your-performance/
Scars. Scars | Johns Hopkins Medicine. (n.d.). Retrieved March 3, 2023, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/scars
