scar mobilization

Adherent scars can significantly limit AROM and can be difficult to mobilize.  It is important to mobilize this adherent scar tissue from the underlying structures.  A technique I have found useful is to use dycem to increase the hold the therapist has of the scar tissue.  The patient can move the involved joint while pushing the scar in the opposite direction to free the scar from the underlying tissue.  For example, have the patient make a fist while the therapist uses dycem placed over the scarred tissue and pushes the scar proximally.  This can be aggressive scar management so the therapist must be careful to respect the patients response and monitor their levels of discomfort.