Scar Tissue Onion

Scar tissue accumulates in the body whenever tissue undergoes excessive stress and strain. Scar tissue is like the body’s duct tape; it is meant as a short term patch to help support tissue. Most of the time the body replaces scar tissue patches, but sometimes it forgets.


The next time a scar tissue patch undergoes stress and strain it becomes aggravated and flares up. This process causes more scar tissue to be added to the outside of the patch. This process can repeat itself over and over, leading to larger patches.

I like to describe scar tissue patches as “onions.” Scar tissue ends up growing in layers around the initial injury. Stress to the area aggravates the outside layers and triggers another layer to be formed. The layers further from the center are easier to aggravate than inside layers, which is why the onion continues to grows in size without causing the inside area to properly repair.

Many people experience this concept with chronic neck and shoulder pain. People come into the office complaining of knots in their muscles that cause them pain and never go away. A massage helps decrease the pain but the knots never disappear. Their neck and shoulder pain always begins in the exact same spots and becomes easier to aggravate over time. What once was a little pain after five long days at the computer eventually turns into constant dull pain with average workloads. The spots are always tender to the touch but feel better when rubbed.

graston technique on shoulder

These knots are scar tissue onions that have grown in size over time. Stress and strain from daily activities begin to overwhelm the scar tissue onions, leading to pain, discomfort, and muscle spasms. Holding your head up makes the neck muscles work throughout the day, which places strain on the onions. Slouching makes the muscles work even harder. Slouching with your shoulders rounded and reaching toward the computer really strains the neck muscles, placing more strain on the scar tissue

Scar tissue patches are not able to handle the workload that is placed upon the muscles, which causes the outer layers to become chronically aggravated.

Treatment comes down to some basic concepts. Reduce the stress and strain to the injured areas. Tear up scar tissue patches and allow the body to replace it with proper tissue. Home therapies are recommended to limit further scar tissue formation, encourage proper healing, and speed up recovery.

Graston Technique works by stretching the outer layer of the onion and breaking it into several pieces. The broken ends trigger healing mechanisms to build proper tissue. Ice helps limit additional scar tissue formation and pain. On the following visit we break up the next layer of scar tissue, working toward the center of the onion. The goal is to get to the center of the onion so the body fixes the original problem.

Graston Technique is not meant to be painful and should be performed at a comfortably tolerable level to break up scar tissue. Trying to be too aggressive with Graston or massage causes excessive pain and actually slows the repair process by flooding the area with inflammation. Most people notice a significant difference after 4-6 visits. Larger onions may require much more treatment, and everyone recovers at different rates. Some people have very small onions that create a lot of pain and can resolve quickly.