Does Muscle Scar Tissue Cause Pain During Exercise?

Muscle scar tissue can form after direct or indirect injuries (contusions or strains). Unfortunately that scar tissue can cause pain and limit mobility, which is why appropriate medical intervention is so important for treating injuries and restoring the fullest function possible.

Scar tissue forms on an injured muscle as part of the healing process. That process may be triggered by direct injuries (contusions) or indirect injuries (strains) and, depending on how the scar tissue forms, it may cause pain, limit range of motion and contribute to your risk of re-injuring the muscle.

Unfortunately, there's a lack of clinical consensus — and overall, a high degree of variability — in studies of how to conservatively treat muscle injuries and the resulting scar tissue. However, a few clear principles are generally accepted.

The authors of a data review published in the April 2012 issue of ISRN Orthopedics note that the best known treatment for immediately after a muscle injury is the standard first aid of "RICE" (rest, ice, compression, elevation). The goal is to minimize the hematoma and thus the subsequent formation of scar tissue. But the authors also note that despite its widespread acceptance, the effectiveness of this approach hasn't been proven in randomized clinical trials.

They go on to note that following this with a short period of immobilization, followed by therapeutic mobilization, usually benefits the healing process.

However, the timing of immobilization vs mobilization /introduction of physiotherapy can significantly affect the muscle's post-recovery strength and risk of re-injury — which is why this sort of decision should be made under the care of a medical or rehabilitative professional.

Another common treatment for muscle scar tissue is soft tissue mobilization. As explained by Physical Therapy Central, this involves a licensed physical therapist using a variety of hands-on techniques to break down or reduce adhesions. The goal is to ultimately improve your muscle function, decrease pain and restore as much functionality and range of motion as possible.

Needless to say, all of these interventions (except in the case of RICE as a first aid measure) must be prescribed and carried out by qualified medical or physical therapy professionals — and that begins with receiving an appropriate diagnosis of your injury's severity. If your injury was some time ago and you're struggling with scar tissue that limits your function, consulting a medical professional is still the best place to start.

Read more: How Soon After You Pull a Muscle Should You Exercise?

As noted in an analysis published in the December 2013 issue of the Journal of Multidisciplinary Healthcare, even surface scars and changes to the subcutaneous fascia (thin layers of connective tissue under your skin) can cause pain or restrict movement in unexpected parts of your body. For example, elbow scars may cause neck pain; abdominal scars may manifest as a dysfunctional gait; alterations in the fascia near your elbow can affect the fascia of your shoulders, chest or neck.

In an article intended for fitness professionals, the International Sports Sciences Association (ISSA) notes that these changes to fascia can even limit nerve function and flexibility. They liken the situation to a telephone call that used to go through clearly, but is now transmitted with static. Fascia connects every part of your body, so you might experience pain in muscles, bones or connective tissue in parts of your body that don't seem connected to your scar.

And ultimately, the ISSA affirms the need for a medical professional to diagnose and prescribe treatment for scars that affect your body's function — whether those scars are on your skin or deeper inside your body. Once your doctor or physical therapist clears you to exercise, she may recommend a qualified trainer to help you choose exercises that work with your body's ongoing healing process to maximize your strength and function.

Read more: 4 Sleeping Position Tips to Help You Recover From Muscle Strains