The Process of Fibrosis and How to Prevent Stiffness
Scar tissue, the thick fibrous scarring that forms following surgery on an injury, is found on the surface of the skin. Fibrosis, similar to scar tissue but not an interchangeable term, is a buildup of scar-like tissue that can happen inside the body as well.
Fibrosis, also known as fibrotic scarring, can occur within any solid organ or tissue in the body. It can manifest inside structures such as the lungs, liver, heart, joints, and muscles – predisposing their tissues to thickness, stiffness, and dysfunction.
As scary as that sounds, fibrosis is actually part of the body’s natural healing process. With that said, excessive amounts of it can cause chronic stiffness and pain. If left untreated for too long, it can even lead to organ damage.
Is there anything that can be done to treat fibrosis-related stiffness? Yes, there is! Let’s dive deeper into what fibrosis is and how it can be prevented.
What Is Fibrosis?
Fibrosis is the formation of connective tissue that has become scarred, hardened, or overgrown. It is most often triggered by:
- Chronic inflammatory processes
- Repeated injury
- Inadequate circulation
- Overactive immune system
- Poor healing
In response to tissue damage, the body sends messages to repair cells such as fibroblasts – connective tissue cells that synthesize extracellular matrix and collagen – to rebuild it. When functioning properly, this process commences once the tissue heals. In the case of fibrosis, the process continues. This causes the affected tissue to become thick, inflexible, and dysfunctional. When found in muscular tissue and fascia, fibrosis can feel like a tight knot that won’t subside.
What Causes Fibrosis to Linger?
What can cause fibrosis to become a chronic problem?
- Healing process is interrupted
- This can be a result of repeated physical injury or emotional stress.
- Continued inflammation
- If inflammation doesn’t resolve itself or receive treatment, it will keep activating fibroblasts. The fibroblasts will try to repair what has already healed, causing the tissue to become dense.
- Limited range of motion
- Healthy movement maintains tissue pliability and hydration by promoting the collagen turnover process. When motion is restricted, fibroblasts create excessive collagen which causes the tissue to stiffen.
Essentially, each of these factors hinder the signal to the fibroblasts to stop working. Thus, the connective tissue continues to rebuild unnecessarily.
How Fibrosis Leads to Stiffness
Fibrotic scarring is thick, disorganized, and lacks elasticity. These characteristics make it less responsive to movement, stretching, and hydration.
With fibrosis, fascial and muscular tissue is bound together and has trouble gliding freely. This restriction leads to tightness, discomfort, and limited range of motion. If left untreated for a long period of time, the pain and mobility restrictions can become a chronic issue. It can also alter one’s posture, as well as damage nerves and blood circulation.
How to Prevent and Manage Fibrosis-Related Stiffness
Active Lifestyle
- Exercise – or just movement in general – improves blood flow, which hydrates bodily tissues and is crucial for both the healing process and rebuilding collagen.
- Avoid a prolonged sedentary period following an injury or surgery, unless a medical professional advises otherwise.
Mobility Training
- This is more than just stretching. Mobility training involves:
- Controlled movement through full joint range of motion
- Dynamic stretching – a type of stretching that warms the body up for activity or sports-specific movement
- Activates muscular tissue while lengthening the fibers
- Proprioceptive neuromuscular facilitation (PNF)
- A type of stretching that stimulates proprioceptors to enhance contraction of a targeted muscle group
Incorporating mobility training into your wellness routine can help break up muscular adhesions and reorganize collagen to improve flexibility and decrease stiffness.
Massage Therapy
- Massage therapy, especially modalities that target fascia such as myofascial release and deep tissue massage
- Cupping, a holistic approach that uses suction to recreate space between fascia and muscle, is commonly paired with massage therapy
- At-home self-care such as foam rolling can also offer relief
Anti-Inflammatory Diet
- Supplements or foods high in antioxidants, omega-3s and micronutrients promote tissue healing and reduce inflammation.
- Lean meat, fatty fish, whole grains, fruit, vegetables, low-fat dairy, turmeric, ginger, etc.
- Avoid foods with high sodium content, added sugars, and saturated or trans fats.
Adequate Hydration
- Dehydrated tissue is stiff tissue
- Sip water throughout the day
- Aim for 64 oz unless advised a different amount by a medical professional
- Consider adding powders or tablets containing electrolytes, amino acids, or Vitamin C
- Incorporating bone broth into diet can be helpful as it supports collagen synthesis
Find a Movement Specialist
Physical therapists, occupational therapists, chiropractors, massage therapists, or other types of bodyworkers trained in myofascial health are able to assess the following:
- Joint range of motion
- Muscular imbalance
- Restriction patterns
A movement specialist can assist you with progressive mobility and strength training to prevent or treat stiffness caused by fibrosis.
Can Fibrosis Be Reversed?
If fibrotic scarring has become advanced, the condition might be permanent. However, if caught early, fibrosis is often at least partially reversible. This is usually the case when it’s located in the muscles or fascia.
What needs to happen to increase the chances of partial reversal?
- Motion restoration
- Inflammation reduction
- Healthy movement pattern retraining
Now You Know!
The onset of fibrosis begins with the intent of healing the body. But if it lingers and goes unchecked, fibrotic scarring can lead to stiffness, pain, and mobility restrictions.
Mobility training, physical activity, manual therapy, and balanced diet can help prevent stiffness brought on by fibrosis. Let your tissues restore their health and functionality – your body was made to move and scarring shouldn’t put a stop to that.
Katrina Jenkins
Author, Licensed Massage Therapist
Katrina Jenkins graduated from Towson University in 2013 with a Bachelor’s Degree in Health Science and worked as a nurse’s aide briefly before pursuing her true passion. She graduated from the Massage Therapy Institute of Colorado in April 2016 with honors and completed the Touch of Healers Scholarship Program the following summer. She has been a part of the Moyer Total Wellness Team since the summer of 2017.
Resources
Cleveland Clinic. “Dynamic vs. Static Stretching: Is One Better?” Cleveland Clinic, 29 Aug. 2024, health.clevelandclinic.org/dynamic-stretching-vs-static-stretching.
Huang, Enyu, et al. “The Roles of Immune Cells in the Pathogenesis of Fibrosis.” International Journal of Molecular Sciences, vol. 21, no. 15, 22 July 2020, p. 5203, https://doi.org/10.3390/ijms21155203.
News-Medical. “What Is Fibrosis?” News-Medical.net, 18 Jan. 2011, www.news-medical.net/health/What-is-Fibrosis.aspx.
Nicholas, Catherine. “A Quick Guide to Understanding Fibrosis.” IAA, 21 June 2024, www.arthrofibrosis.info/post/a-quick-guide-to-understanding-fibrosis.
Physiopedia. “Proprioceptive Neuromuscular Facilitation.” Physiopedia, 2023, www.physio-pedia.com/Proprioceptive_Neuromuscular_Facilitation.
“The Dynamic Link between Exercise and Boosting Scar Healing.” Scar Healing and Treatment Institute in Los Angeles, California | SHI, 26 Mar. 2024, shi.org/scar-healing-scar-recovery-the-dynamic-link-between-exercise-and-scar-healing/.
Wynn, Thomas A, and Thirumalai R Ramalingam. “Mechanisms of Fibrosis: Therapeutic Translation for Fibrotic Disease.” Nature Medicine, vol. 18, no. 7, July 2012, pp. 1028–1040, pmc.ncbi.nlm.nih.gov/articles/PMC3405917/, https://doi.org/10.1038/nm.2807.
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