When any damage occurs to the soft tissue (muscles, tendons, ligaments), the body immediately goes into a process of repair. Where the individual fibres rupture, or tear, the body begins to bind the damaged fibres together using a fibrous protein called collagen. Or, as it's more commonly known, scar tissue!

When a tendon is torn or strained, you would expect that the body would repair that damage with new tendon. In reality, this doesn't happen. The tear or rupture, repairs itself with scar tissue.

Now this might not sound like a big deal, but if you have ever suffered an Achilles tendon injury, (or any soft tissue injury) you'll know how annoying it is to keep re-injuring that same old injury, over and over again.

Very brittle, inflexible fibrous material makes up scar tissue. This fibrous material binds itself to the damaged tendon in an effort to draw the damaged fibres back together. What results is a bulky mass of fibrous scar tissue surrounding the injury site. In some cases, it's even possible to see and feel this bulky mass under the skin.

When scar tissue forms around an injury site, it is never as strong as the tissue it replaces. It also has a tendency to contract and deform the surrounding tissues, so not only does this diminish the strength of the tissue, but compromises flexibility of the tissue.

So, how do we get rid of that annoying formation of scar tissue associated with an Achilles tendon injury or any other type of soft tissue injury?

Firstly, you must keep active! Don't listen to anyone who tells you to do nothing. Now is the time to start active rehabilitation. Most of the swelling will have subsided after the first 48 to 72 hours and you are now ready to start light activity.

Light activity will not only promote blood circulation, but also activates the lymphatic system. The lymphatic system plays a vital role in clearing the body of toxins and waste products, which accumulate in the body following a sports injury. Activity is the only way to activate the lymphatic system.

Before we move on, a quick word of warning. Never, Never, Never do any activity that hurts the injured area. Of course you may feel some discomfort, but NEVER, NEVER push yourself to the point where you're feeling pain. Listen to your body. Don't over do it at this stage of the recovery, you've come too far to blow it now.

To remove most of the unwanted scar tissue, you now need to start two vital treatments. The first is commonly used by physical therapists (or physiotherapists), and primarily involves increasing the blood supply to the injured area. The aim is to increase the amount of oxygen and nutrients to the damaged tissues.

You see, the Achilles tendon receives very little blood supply, as compared to a muscle for example. So it's vitally important to increase the blood flow to the injured area. This helps supply the tendon with the oxygen and nutrients needed for a speedy recovery.

Physical Therapists accomplish this aim using a number of activities to stimulate the injured area. The most common methods used are ultrasound and heat.

Ultrasound, or TENS (Transcutaneous Electrical Nerve Stimulation) simply uses a light electrical pulse to stimulate the affected area. While heat, in the form of a ray lamp or hot water bottle, is very effective in stimulating blood flow to the damaged tissues.

Secondly, to remove the unwanted scar tissue it is vital that you start to massage the injured tendon and connecting muscles. While ultrasound and heat will help the injured area, they will not remove the scar tissue. Only massage will be able to do that.

To start with, the Achilles tendon may be quite tender. So start with a light stroke and gradually increase the pressure until you're able to use firm strokes.

Concentrate your effort at the direct point of injury, and use your thumbs to get in as deep as possible to break down the scar tissue.

Just a few final points before we move on. Be sure to drink plenty of fluid during your injury rehabilitation. The extra fluid will help to flush a lot of the waste products from your body.

Also, I recommend you purchase a special ointment to use for your massage called "Arnica". This special ointment is extremely effective in treating soft tissue injuries, like sprains and tears. You can purchase this ointment at most health food shops and pharmacies.

As usual, I've gone on way too long, and I'm not finished with this topic yet. I still need to cover the rehabilitation and conditioning exercises needed to get your Achilles tendon back to 100%. This final part of the rehabilitation process for an Achilles tendon injury is vitally important, and I’ll discuss it over the next couple of topics.

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