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Evidence-Based Article
Scar Tissue in Muscles: What Athletes Should Actually Do About It
Evidence-Based Insights for Performance, Recovery & Long-Term Health
Scar tissue—or fibrosis—is a natural part of healing after a muscle injury. But for athletes, excessive scar tissue can limit flexibility, reduce muscle power, restrict movement, and increase the likelihood of reinjury.
This article breaks down what scar tissue really is, what current research says about treatment options, and what athletes can realistically do to manage it.
What Exactly Is Scar Tissue in Muscles?
Muscle scar tissue forms when the body repairs damaged fibers by creating a dense collagen network. This process is normal—but not perfect.
Why it becomes a problem:
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Excess collagen disrupts normal muscle structure (Mahdy, 2018)
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Fibrosis reduces elasticity and increases stiffness (Gardner et al., 2020)
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It interferes with muscle stem cell function, slowing proper regeneration (Stearns-Reider et al., 2022)
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Imbalance between collagen production and breakdown restricts mobility (Yoseph & Soker, 2015)
When fibrosis develops, the muscle becomes less efficient, less responsive, and more vulnerable.
Can You Break Up or Remove Scar Tissue?
Not entirely — but you can influence how it behaves.
Most treatments do not eliminate scar tissue. Instead, they aim to:
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Improve tissue mobility
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Reduce symptoms
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Enhance range of motion
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Help the muscle function more normally
Here’s what the research actually supports.
Evidence on Common Scar Tissue Treatments
1. Graston Technique (Instrument-Assisted Soft Tissue Mobilization)
Research shows short-term improvements in:
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Pain levels
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Flexibility
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Range of motion
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Symptoms of tendonitis or strains
(Karmali et al., 2019; Moon et al., 2017; Palmer et al., 2017)
Best evidence: hamstring flexibility improvements (Cheatham et al., 2016).
Limitations: does not “break up” scar tissue; results vary and may not be permanent.
2. Massage & Stretching
Useful for:
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Reducing stiffness
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Improving comfort
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Improving mobility
But no strong evidence shows they remove scar tissue (Papadopoulos & Mani, 2020).
Still valuable as supportive techniques.
3. Dry Needling
May help reduce tightness and improve mobility.
Evidence is promising but inconsistent — not a definitive treatment for fibrosis.
4. Ultrasound Therapy & Laser Therapy
Research is mixed:
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Some studies show small effects
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Many show no significant benefit
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Methodology varies widely
These should be considered optional—not primary interventions.
What Athletes Should Actually Do
Managing scar tissue is about function, not “breaking it up.”
✔ Combine mobility & strengthening
Scar tissue remodels based on load. Progressive strengthening and controlled movement help tissues align more functionally.
✔ Use manual therapy as an adjunct
Techniques like Graston or massage improve short-term mobility so you can train better.
✔ Prioritize tissue health through nutrition
Collagen-supportive nutrients:
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Vitamin C
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Zinc
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Adequate protein
These support tissue repair and remodeling.
✔ Stay consistent with mobility work
Foam rolling, dynamic stretching, and joint mobility help maintain tissue glide and reduce stiffness.
✔ Work with qualified professionals
A PT or sports clinician can tailor treatments based on the injury’s severity, chronicity, and functional demands.
< Recommendation by Our Experts>
✔ Combine Treatments
Use a mix of interventions—Graston Technique, stretching, mobility drills, and foam rolling—to improve tissue mobility and reduce stiffness.
✔ Prioritize Nutrition
Support recovery with adequate protein, vitamin C, and zinc, which assist collagen repair and healthy tissue remodeling.
✔ Consult Experts
Work with skilled PTs or trainers who can assess scar tissue severity and build a personalized strengthening and mobility plan to reduce reinjury risk.
< Reference >
- Mahdy, Mohamed A. A. “Skeletal Muscle Fibrosis: An Overview.” Cell and Tissue Research 375, no. 3 (March 2019): 575–88. https://doi.org/10.1007/s00441-018-2955-2.
- Gardner, Tyler, Keith Kenter, and Yong Li. “Fibrosis Following Acute Skeletal Muscle Injury: Mitigation and Reversal Potential in the Clinic.” Journal of Sports Medicine 2020 (September 1, 2020): 1–7. https://doi.org/10.1155/2020/7059057.
- Yoseph, Benyam. “Redefining the Satellite Cell as the Motor of Skeletal Muscle Regeneration, BioMedicine Journal of Science and Applications, 2015 5, no. 1 (July 26th): 76–82.
- Stearns-Reider, Kristen M., Michael R. Hicks, Katherine G. Hammond, Joseph C. Reynolds, Alok Maity, Yerbol Z. Kurmangaliyev, Jesse Chin, et al. “Myoscaffolds Reveal Laminin Scarring Is Detrimental for Stem Cell Function While Sarcospan Induces Compensatory Fibrosis.” Npj Regenerative Medicine 8, no. 1 (March 15, 2023): 16. https://doi.org/10.1038/s41536-023-00287-2.
- Moon, Jong Hoon, Jin-Hwa Jung, Young Sik Won, and Hwi-Young Cho. “Immediate Effects of Graston Technique on Hamstring Muscle Extensibility and Pain Intensity in Patients with Nonspecific Low Back Pain.” Journal of Physical Therapy Science 29, no. 2 (2017): 224–27. https://doi.org/10.1589/jpts.29.224.
- “Withdrawn: Influence of Instrument Assisted Soft Tissue Techniques versus Active Soft Tissue Therapies on Latent Trigger Point of Upper Trapezius Muscle: Randomized Clinical Study.” Physiotherapy Research International 28, no. 2 (April 2023): e1859. https://doi.org/10.1002/pri.1859.
- Kang, Ho-Seong, and Jung-Hoon Lee. “The Immediate Effects of Graston Instrument-Assisted Soft-Tissue Mobilization and Self-Stretching on the Muscular Properties of the Gastrocnemius in Athletes.” Journal of The Korean Society of Physical Medicine 15, no. 4 (November 30, 2020): 29–35. https://doi.org/10.13066/kspm.2020.15.4.29.
- Papadopoulos, Emmanuel S., and Raj Mani. “The Role of Ultrasound Therapy in the Management of Musculoskeletal Soft Tissue Pain.” The International Journal of Lower Extremity Wounds 19, no. 4 (December 2020): 350–58. https://doi.org/10.1177/1534734620948343.
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