How Scar Tissue Leads to Chronic Stiffness: Causes, Symptoms & Relief

A twisted ankle years ago. A knee surgery in your twenties. A healed scar that never quite softened. While the surface may look fine, the aftereffects of injury often linger silently beneath the skin. Scar tissue, a by-product of your body’s natural healing process, can stiffen joints, restrict movement, and reintroduce pain long after recovery seems complete.

This blog examines how scar tissue develops, why it becomes problematic over time, and what you can do if chronic stiffness from an old injury is currently affecting your mobility.

What Exactly Is Scar Tissue?

Scar tissue forms when the body rushes to repair an injury, whether it’s a muscle tear, surgical incision, or skin wound. To close the gap and rejoin damaged areas, your body sends out collagen fibres. But here’s the catch: the collagen in scar tissue is organised differently than in healthy tissue.

Normal muscle or skin has collagen woven in multiple directions to allow stretch and flexibility.
Scar tissue, by contrast, is laid down in tight, parallel strands—more like tape than a net.

This structural difference makes scar tissue:

Less elastic
Thicker and denser
More prone to adhesions and mechanical stiffness

It’s functional enough to close the wound, but not adaptable enough to move freely.

Why Scar Tissue Leads to Long-Term Stiffness

1. Reduced Elasticity Limits Motion

Scar tissue doesn’t stretch like muscle. If it forms near a joint or within muscle fibres, the restricted flexibility can limit your range of motion and affect joint mechanics, especially if the original injury involved the knees or spine, which are structurally linked.

2. Adhesions Bind Tissues Abnormally

Sometimes, scar tissue extends beyond the original injury. It may bind muscles to fascia, tendons to bone, or skin to deeper layers. These are called adhesions, and they can cause tissues that should glide smoothly to begin pulling and resisting motion.

Over time, adhesions can:

Reduce joint mobility
Cause compensatory movement patterns
Create referred discomfort away from the original injury site

3. Nerve Entrapment and Hypersensitivity

Scar tissue can envelop or trap small nerve endings, particularly after surgeries or lacerations. The result? Sharp, localised pain or a burning sensation when the area is touched or stretched. This can discourage movement, leading to a downward spiral of reduced mobility and worsening stiffness.

4. Internal Scarring After Surgery

Scars aren’t always visible. Fibrosis, or internal scar formation, commonly occurs after abdominal, spinal, or joint surgeries. For example:

After a knee arthroscopy, fibrosis can tighten the joint space.
Post-spinal surgery, scar tissue around the nerves may irritate them and limit spinal extension.

This often results in long-term stiffness, particularly if rehabilitation wasn’t comprehensive.

Symptoms to Watch Out For

Even years after an injury, you might notice signs that scar tissue is restricting your movement. These include:

A feeling of tightness or pulling when you stretch
Limited flexibility or range of motion in the old injury site
Localised pain, tingling, or sensitivity
"Creaky" joints or audible clicks when moving
Inflammation, swelling, or tenderness that flares up with activity

Why Does Stiffness Appear Years Later?

Scar tissue isn’t static—it remodels slowly over time. Many people only start noticing problems years after the initial injury because of:

Nerve regeneration: As nerves grow back into the area, they may become hypersensitive or entangled within the scar.
Tissue thickening: With use (or disuse), scar tissue can contract and become more fibrotic.
Repetitive strain: Everyday movements may slowly irritate the scarred region, particularly in areas like the ankles, where restricted mobility can change your posture and walking mechanics.
Ageing: As natural elasticity declines, older scar tissue becomes more noticeable.

In short, your body may have compensated for the injury for years, until it couldn’t anymore.

Areas Most Commonly Affected

While scar tissue can form anywhere, stiffness is particularly common in areas with complex joint or muscle systems:

Shoulders – Post-surgery or rotator cuff injury scars can limit arm elevation
Knees – After ligament tears or operations like meniscus repair
Ankles – Especially after repeated sprains
Spine and back – Internal scar tissue after disc surgery or muscle injury
Abdomen or pelvis – Post-appendectomy or C-section scarring can lead to organ adhesions that limit movement or digestion

Managing Chronic Stiffness from Scar Tissue

Scar tissue cannot be erased, but it can be mobilised and managed to reduce its impact on your daily life.

1. Massage and Myofascial Release

Deep tissue massage and manual therapy techniques, such as myofascial release, can help break down adhesions, improve circulation, and soften scar tissue. Regular sessions may reduce tightness and improve range of motion.

2. Targeted Physical Therapy

A good physiotherapist will:

Assess the mechanical restrictions
Design a stretching and strengthening plan
Re-train your body’s movement patterns to reduce compensation

Techniques may include:

Proprioceptive neuromuscular facilitation (PNF)
Active release therapy
Functional mobility drills

3. Home-Based Stretching and Movement

Consistency is key. Gentle daily exercises that lengthen the affected area can maintain gains from therapy, especially when combined with spinal mobility work to support flexibility and coordination.

Try:

Slow, controlled stretches
Foam rolling
Dynamic warm-ups before activity

However, be cautious: an overly aggressive approach may irritate the scar further.

4. Topical and Hydration Therapies

Silicone-based gels, vitamin E creams, and regular moisturising may improve skin pliability. Well-hydrated tissue is less prone to stiffness and friction.

5. Medical Interventions (If Needed)

In more persistent cases, your doctor may suggest:

Steroid injections to reduce inflammation
Laser therapy to stimulate collagen remodelling
Fat grafting or needling to break down thickened scar
Scar revision surgery, only in severe cases that do not respond to conservative care

Preventing Scar Tissue Stiffness After Injury

While you cannot always prevent scarring, early care goes a long way in avoiding long-term stiffness.

Start gentle movement early (as guided by your clinician)
Attend follow-up physiotherapy after surgery or injury
Avoid prolonged immobility and stay active within limits
Hydrate adequately to support tissue repair
Don’t skip rehab even if you feel “fine”—many issues are subclinical until later

When to Seek Professional Help

Don’t ignore persistent tightness or discomfort near an old injury. A healthcare provider can evaluate:

Whether adhesions are limiting your motion
If nerve entrapment or inflammation is present
Whether imaging, manual therapy, or surgical review is needed

Early assessment can prevent long-term functional loss and unnecessary pain.

Conclusion

Scar tissue tells the story of survival, but it can also become a barrier to comfort and mobility. Whether it formed after surgery, trauma, or years of micro-injury, its impact on your movement can be significant, especially when left unaddressed.

The good news? You’re not stuck with stiffness. With the right interventions—such as physical therapy, soft tissue work, and medical guidance—you can reclaim freedom in your movement. Recognising scar tissue’s role in chronic stiffness is the first step toward lasting relief.

References

How Scar Tissue from Old Injuries Causes Chronic Stiffness

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