Thursday, December 19, 2013

Scar Tissue: Is it Too Much of a Good Thing?

 by Susan E. Davis, PT

You may think your dog is the peace-loving sort of pet, but I can assure you that its body is designed for war!

Similar to the human, a dog’s body reacts to trauma or disease with an all-out fight!

At the onset of any injury, the “troops” are sent in:  white blood cells invade the area, especially in cases of infection by foreign objects and by bacterial or viral organisms.  “Weapons” are discharged in the chemical form of histamines to dilate blood vessels, causing blood flow needed to flush out damaged areas.

To further provide protection and defense, cellular fluids are leaked into the tissues, resulting in redness, warmth, swelling and acute inflammation.


 
When the fight is over, the healing and repair phase begins. 

Here is where we encounter the formation of scar tissue. The body does this by building a scaffold of sorts in and around the injured area.

Various cells produce and release chemical messengers that communicate between other cells. In response, cells begin to manufacture “glycoproteins” which are molecules that form the support structure, similar to bricks and mortar.

Fibrous bands of collagen form with a glue-like gel matrix, as the protein molecules combine with oxygen, acids and minerals in the body.

Together they become scar tissue and provide a temporary framework to fill in the damaged spaces, bind tissues together and hold the injured area intact, while the body attempts to grow normal tissue back.  

In other instances it becomes the permanent replacement to normal tissue but is always inferior to regeneration.

There are 2 interesting traits about scar tissue that impact the dog and determine what physical therapy treatment will be needed:

1. Proliferation

Scar tissue grows in various amounts per individual animal or human. Some bodies seem to grow scar tissue in overabundance, compared to others. This may be related to the particular patient’s natural immune response to trauma. For animals that grow more scar tissue than others, extra time and attention to treatment may be needed.

2. Random arrangement

Scar tissue is rather tough and inflexible. As it forms, it does not arrange itself in consistent patterns.  It is laid down in mixed, random arrangements. This makes it less resistant to tension and therefore can be broken down through stretching, deep massage, pulsed ultrasound, extracorporeal shock wave therapy and laser.

In particular, stretching is the key component of scar tissue removal. If massage and other physical modalities are used, they must be followed with stretching.

If your dog has sustained an injury, scar tissue will form in varying amounts.  

If the injury is at or near a joint or in a large muscle belly, the scar tissue may be “too much of a good thing “and cause impairment in function with restricted range of motion.

In these cases, your veterinarian will show you how to stretch the area or refer you to an animal-trained physical therapist or chiropractor for additional expertise in the best way to break the adhesions.

You may be concerned that this sounds painful for the animal, but with proper use of physical agents to pre-soften (such as ultrasound, laser or shock wave), skilled manual techniques, comfortable body positioning and gentle soothing assurances to the pet, it can be well tolerated.  

Conversely, there are instances when scar tissue is good and better left alone! 

In situations where there is instability, scar tissue can provide some protection and support.  A few examples are:

1. Partial cranial cruciate ligament tear

Surgery may not be necessary or desirable, and scar tissue helps tighten the residual portion of the ligament that remains attached.  Scar tissue now becomes your dog’s friend!

2. FHO surgery

When the ball of the femur is surgically removed, it is blood callous and scar tissue that fills in the void and forms a “pseudo arthrosis” or artificial soft cushion. Scar tissue is desirable in this case!

3. Medial shoulder instability

Some sporting and agility dogs may develop this condition, similar to a dislocated joint. It often requires surgery and is followed by a long healing phase where activity and motion are restricted.  Stretching is absolutely contraindicated as it will break apart or tear the desired scar tissue.  

Understanding the basics of scar tissue can be important when faced with an unexpected injury to your dog!  

Your veterinarian and physical therapist can help you determine when scar tissue should be left alone or when treatment is needed because it’s just too much of a good thing!

Further reading:
The Biology of Scar Formation
Cranial Cruciate Ligament Injury in Agility Dogs (Part 1)


*** 

Susan E. Davis (Sue) is a licensed Physical Therapist with over 30 years of practice in the human field, who transitioned into the animal world after taking courses at the UT Canine Rehabilitation program.  She is located in Red Bank, New Jersey.

She has been providing PT services to dogs and other animals through her entity Joycare Onsite, LLC in pet’s homes and in vet clinics since 2008.

She also provides pro bono services at the Monmouth County SPCA in Eatontown, NJ.  Sue is the proud “dog mommy” to Penelope, a miniature Dachshund with “attitude”.  For more information see her website www.joycareonsite.com , or follow on Twitter @animalPTsue.


Sue is also the author of a fantastic book on physical therapy, Physical Therapy And Rehabilitation For Animals: A Guide For The Consumer.  

Physical therapy can do so many great things for your dog. Understanding all the possibilities physical therapy can offer will change your dog's life. This book definitely belongs on the shelf of every dog lover.


Articles by Susan E. Davis:
Functional Strengthening Exercises: the What, Why and How
One Thing Leads To Another: Why The Second ACL Often Goes Too
Compensation: An Attempt To Restore Harmony
Paring Down to the Canine Core
Canine Massage: Every Dog ‘Kneads’ It”
Photon Power: Can Laser Therapy Help Your Dog?  
Physical Therapy in the Veterinary World  
Reiki: Is it real? 
Dog Lessons: Cooper  
The Essentials Of Canine Injury Prevention: 7 Tips For Keeping Your Dog Safer 
It's Not Just Walking, It's Therapy! 
Treatment And Prevention Of Canine Intervertebral Disc Disease (Part I)
Treatment And Prevention Of Canine Intervertebral Disc Disease (Part II Physical Therapy)
Range Of Motion: It’s A Matter Of Degree…
The Weight Of Water And How It Helps Dogs 
By Land or By Sea? A Comparison of Canine Treadmills 
Unraveling The Mystery Of Fascia And Myofascial Trigger Points (Part I)
Unraveling The Mystery Of Fascia And Myofascial Trigger Points (Part II) 
Scar Tissue: Is it Too Much of a Good Thing? 
Physical Therapy Tip Of The Month: Ramps! 
Physical Therapy Tip Of The Month: Indoor Duo Dog Exercises!
Physical Therapy Tip Of The Month: Best Practices After Your Dog’s Surgery

6 comments

  1. This is a very good article. I've heard that coconut oil can help heal scar tissues in dogs. Thanks for sharing your tips.

    ReplyDelete
    Replies
    1. Not aware of that particular benefit but coconut oil certainly is great.

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    2. Coco Butter, as well as Coconut Oil can help smooth out and heal surface scars from surgical incisions, wounds or with keloid formations on deep scars.

      Delete
    3. Ah, awesome, good to know. Thank you!

      Delete
  2. My dog has internal scarring and suggestions? He's taken steroids but of course that's just causing him discomfort with bloating and gas. Wanted a more natural remedies??

    ReplyDelete
    Replies
    1. Scarring where and what from? Muscles? Organs?

      Delete

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