Surgery closes the incision. What often stays is adhesion — layers stuck where they should slide. It is quiet, it does not show up as pain at first, and it turns up months later as range that never quite came back. Sessions at Fit Body Therapy in Los Altos are one-on-one with Angelo dela Cruz, practicing since 1996.
The Scar You See Is Not the Problem
The visible line on the skin is the smallest part of it. Healing lays down collagen through every layer the procedure passed through — skin, fascia, muscle, sometimes deeper — and that collagen is deposited without the organised alignment of the tissue it replaces.
Where that happens between two layers that are supposed to move independently, they tether. The medical term is adhesion. Functionally it means one structure now drags another along with it.
Which is why the complaint frequently has nothing to do with the scar’s location. A shoulder that will not reach overhead a year after a repair. Hip range that stalled after a replacement. A C-section scar that shows up as low back pain because the abdominal wall stopped participating.
Why It Surfaces Late
Immediately after surgery, everything is limited, so the restriction is invisible against the general recovery. Physical therapy restores the range the protocol targets, discharge happens when the functional goals are met, and the residual tethering sits under the threshold anyone was measuring.
Then the body compensates around it, quietly, for months. The complaint that eventually arrives is usually somewhere adjacent — and by then the connection back to the procedure is not obvious to anyone.
Old restriction takes longer to change than recent restriction. It does not stop being modifiable.
How It Is Treated
Assessment first, and the useful question is not whether the scar looks good but which movements it is participating in. Tissue that should glide is tested for glide, layer by layer.
Treatment combines direct manual work on the layers with instrument assisted soft tissue mobilization, which locates restriction that fingertips cannot feel and treats it precisely. Where swelling is still a factor, lighter fluid work comes first, because firm treatment on a swollen area mostly produces guarding.
The scar is not forced. Aggressive work on healing tissue produces more collagen, which is the opposite of the goal.
Who Books This
- Post-joint-replacement range that stalled short of where it should be
- Rotator cuff or shoulder repair with overhead reach that never fully returned
- Abdominal or C-section scars with low back pain or a core that will not engage
- Old injuries — scar tissue is not exclusive to surgery
- Anyone discharged from PT who met the goals and still does not feel right
Timing: the incision must be fully closed and cleared by your surgeon. If you are early in a post-operative protocol, check with them before booking — timelines vary considerably by procedure.
Frequently Asked Questions
Is it too late if my surgery was years ago?
No. Long-standing adhesion takes longer to change than recent adhesion, and the tissue remains modifiable. Duration affects the timeline, not whether it is worth starting.
Will this make the scar less visible?
Appearance is not the goal and not what is promised. The aim is restoring glide between layers so the area participates in movement again. Some people notice the scar softening; that is a side effect, not the objective.
Does it hurt?
It should not. Forcing healing tissue provokes more collagen deposition, which works against the outcome. The work is specific rather than aggressive.
How soon after surgery can I come in?
Once the incision is fully closed and your surgeon has cleared soft tissue work. That varies by procedure, so ask them rather than going by a general rule.
Book a session at Fit Body Therapy in Los Altos and let’s find out whether an old procedure is still shaping how you move. Serving Los Altos, Mountain View, Palo Alto and Sunnyvale.