Cross-Fibering
Start by using a cream, lotion, or oil (I personally recommend Lotus Touch cream, available from http://www.lotustouch.com) and use it on the area you want to work. Skinstore.com also sells a few creams and gels, which have been reported to help considerably to diminish the tightness and the overall thickness of scar tissue. Remember that you are using the massage cream to allow your hands or a tool to more easily move across the skin, so if the skin soaks all of it up, you may need to reapply. You will then want to work across the muscle fibers. In the case of the muscles around the knee: as you are standing, most of the muscle fibers go up and down, so you will want to work across the leg. You can use massage tools and/or implements to get into the muscle deeply and work across the muscle, or you can use your hands. One good hand position is to bend the middle and ring fingers and use the second knuckle (closest knuckle to the hand-but not the knuckle joining the hand) on the middle and ring fingers, to get into the muscle fibers of the quads/calves, while the second and pinky fingers are straight and glide across the leg. Move up and down the muscle, making sure to focus on areas where it feels like there is more binding of the tissues. You can finish by doing a gentle massage on the area to calm it down. This is one possibility for cross-fibering.
Whatever hand position or tool you use with cross-fibering, remember that your goal is to break up the scar tissue by going across the muscle, and remember that this isn’t going to happen overnight. By using cross-fibering, you are actually causing minor traumas to an area which promote the healing in that area. You don’t want to re-injure the area to the point where more scar tissue develops because of your working on it. A generally good way to know how much pressure is enough is that it should be on the level between uncomfortable and painful. So it should be uncomfortable, but not overly painful. As far as the time it takes for healing, a good general guideline is that you should give the scar tissue as long to break up (if you’re working on it daily) as it did for it to be created. In other words, if you had surgery two years ago, and you just started working with the scar tissue yesterday, large improvements could take up to two years from yesterday. Healing doesn’t have to take this long, but this should give you an idea of how patient you should be.
In summary:
Work with the scar as often as you think about it.
It is possible to overwork an area, but not likely that you will with the scar tissue.
Use heat to bring blood to an area, cold to take blood away from an area.
Generally speaking, you will want to take the blood away from an area before you work with scar tissue so that it will hurt less to work with it (the cold of ice will also numb the nerves so you can work with the scar tissue). You will then want to work with the tissue that is deeper in the muscle, using cross-fibering, while it is cold. When you are done, you will want to heat the area to bring blood in and carry away the toxins which are released as you break up the scar tissue and open up the area. (Too much time with the heat can cause an abundance of blood in an area, which can cause swelling and a different kind of pain. Generally, 20-30 minutes with the heat is a safe bet.) You will want to use moist heat if possible (i.e. a wet washcloth warmed up in the microwave or something comparable), as it will draw more fluids to the area and encourage the muscle to return to its natural state. (Don’t get the heat so hot that it burns you.)
Working with the scar tissue may hurt initially.
Pain should decrease over time, but may not fully go away. Be prepared for this, but don’t psyche yourself out. It does get better.
You can do the work yourself
You can have great results just from working on the scar tissue yourself. You will be most successful if you will work on it yourself because you are the only one who is with you 24 hours a day, so you can be there all the time to work on it. However, just like it feels better to get a massage from someone else than it does to give yourself one, you may experience good results from someone else working on you as well. Just make sure that you communicate with them (and that they are willing to listen) when there is too much pain, or not enough pressure, etc. Also, there may be cases where you can not reach the scar tissue (i.e. back surgery. If this is the case, have someone else work with you, and get into a regular stretching program). Caveat: Make sure you say thank you to the person who is helping take care of you. They’re much more likely to help again.
Nutrition is important.
Eating well can have a huge impact on how quickly the body will heal. With regard to scar tissue, nutrition plays an important role in how quickly the body will be able to develop feeling in an area and breakdown the scar tissue. It needs the vitamins and minerals to build tissue, create chemical connections, and carry away toxins.