Guidelines for Practice
By Bernie Clark
April 1, 2026
“Can yoga get rid of my scar tissue?” There seems to be a widespread idea that yoga, foam rolling, fascia blasting, or some forms of physical therapy can lessen or completely remove scar tissue. Can scar tissue be broken down or broken apart? Not quite. We do not break scar tissue, but it is true that there are ways to help reduce its effects and, over time, remodel the fibers so that it becomes less of a problem. To understand how to do this, let’s first look at what scar tissue actually is, how it develops, its consequences, and the options for dealing with it, starting right from the time of injury onward.
An Injury Response
Let’s suppose you cut your finger, say with a small paper cut, nothing dramatic. The body will go through a sequence of responses. The process is often described in three overlapping phases.
The first phase is the inflammatory stage. The body first seals the wound opening by forming a blood clot, which contains filaments called fibrin which forms a fibrous mesh, and a glue-like substance called fibronectin, which helps bind the provisional matrix together. These form a scaffold upon which other cells can gather. Blood platelets release chemical messengers called cytokines that attract white blood cells such as neutrophils and, later, macrophages, which destroy and dispose of microbes and cellular debris. Growth factors are also released that attract endothelial cells, which help restore blood vessels. Fibroblasts arrive and lay down an initial extracellular matrix consisting largely of type III collagen. This process, which occurs over several days, creates granulation tissue.
The next phase is called the proliferative stage and takes a few weeks. This includes building new blood vessels inside the wounded area, which provide the nutrients needed for fibroblasts to multiply and, in some cases, evolve into myofibroblasts, which are fibroblasts that can contract. By contracting, they help to close the wound by pulling the edges toward each other and eventually replace the initial scaffold with something that more closely resembles the original connective tissue.
In the final stage, which can last for months, the remodeling, maturation, or scar phase, the tissues are remodeled. The initial collagen is gradually replaced by the stiffer type I collagen, the number of cells is reduced, and the whole extracellular matrix is reorganized into a smaller but stronger scar. Unfortunately, while some stretchy elastin fibers may reappear, they are fewer in number. Thus, the newly reconstructed tissue is not quite like the original tissue.
Why do we become stiffer?
At the end of the healing process, we may have lost some range of motion. In a simple finger cut, this will not be noticeable, but if the damage was done to deeper tissues, perhaps due to an appendix removal or a C-section, the changes may be more apparent. Scarred tissues may feel stiff for several reasons. Adjacent tissue layers may not glide as freely; this is often called adhesion. The watery extracellular matrix may be less well hydrated. Collagen fibers may be denser and more highly cross-linked (tied together). There may also be fewer stretchy elastin fibers, which reduces the tissue’s ability to stretch. The nervous system may also add protective muscle tension around the area called muscle guarding.
Yoga and other physical therapies do not dissolve scar tissue, but they may improve how these tissues function. Movement can encourage sliding between layers, support fluid exchange, guide collagen remodeling, and reduce guarding. The result may be better mobility even though the scar itself remains.
Adhesions reduce gliding
After surgery or injury, the layers of our tissues can become stuck together. This can occur between the skin and underlying superficial fascia, within and around muscles, around tendons and ligaments, and even within the tissues surrounding joints. When these interfaces do not glide well, movement can feel restricted. We feel stuck or stiff.
Fortunately, yoga and other physical therapies, through repeated movement, may revive gentle shearing, gliding, and sliding between tissue layers. Twists, side bends, stretches, and movements in multiple planes can be effective because they load tissues in a variety of directions. Slow movements synchronized with the breath may also help reduce muscle guarding by retraining the nervous system.
These methods are not tearing adhesions apart. Rather, they help restore tolerance, glide, and movement coordination over time.
Reduced Hydration or Altered Ground Substance
Our fascia needs fluid exchange to remain pliable. Immobilization or chronic underuse may reduce normal fluid movement through the extracellular matrix. Fortunately, yoga may help here too. Alternating stretch with release, and compression with decompression, may support fluid flow. Tissues often feel more supple when they are better hydrated.
Anything that gets you moving may help increase mobility in and around scar tissue: walking, resistance training, and the normal activities of daily life. Movement may improve the internal fluid environment of connective tissues, which can help them feel less stiff even without changing the scar tissue itself.
Increased Collagen Disorder, Density, and Cross-Linking
After injury, collagen is first laid down rapidly, randomly, and chaotically. An example of this is shown in Figure 4B. This micrograph shows damaged tissues in which new collagen has been deposited randomly. Over time, as shown in Figure 4A, the tissue is remodeled. Loading is key to this process.
However, be warned: if stress is applied too soon, the weaker type III collagen fibers and the blood clot may be pulled apart, which can worsen the final scar and delay full repair.
During the early inflammatory phase, the body is trying to seal and stabilize the wound, so stretching or stressing the injured area too soon may disrupt the repair and even widen the wound. Yoga is most helpful later, first as gentle movement during the proliferative phase, and then as progressive loading during the longer remodeling phase, when the tissue is ready to adapt to stress. Eccentric and isometric strengthening programs may be especially useful for tendons and musculotendinous injuries.
Yoga for the stages of healing
1. Inflammatory phase: protect
This is the first few hours to roughly the first 2 to 5 days, depending on the injury. The tissue is fragile. The wound is being sealed with fibrin, inflammatory cells are arriving, and the repair process is just beginning. This is not the time to stretch the injured area or apply significant tensile stress. For yoga students, that means:
- avoid stressing the injured tissue
- avoid deep stretching across the wound or strain site
- avoid strong muscular contractions through the area
- gentle movement elsewhere in the body is usually fine
For a skin wound, too much tension can pull the edges apart. For a muscle or tendon injury, too much loading can re-tear the immature repair.
2. Proliferative phase: introduce gentle, graded loading
This is roughly from day 3 to day 21, though it varies. Fibroblasts are laying down collagen, granulation tissue is forming, and the tissue is starting to bridge the gap. Now some carefully dosed movement can be helpful because collagen begins to respond to mechanical stress. But the key is gentle, controlled, and progressive. In yoga terms:
- work within pain-free or near pain-free ranges of movement
- use light movement, not long intense holds (no yin yoga yet)
- emphasize circulation, ease, and low load
- avoid forcing end range of motion
This is often when very mild yoga may begin to support healing, assuming the wound is closed enough and the tissue is ready.
3. Remodeling or maturation phase: progressively load
This begins around 2 to 3 weeks and may continue for months. Now the collagen is being reorganized and strengthened along lines of stress. This is the phase in which yoga can play the biggest role, because appropriately dosed stress can help improve function, mobility, tissue organization, and reduce guarding. In this phase:
- gradually increase range of movement
- begin longer holds if tolerated
- add moderate tensile loading
- still avoid aggressive, pain-provoking stretching
This is the stage where yoga may help the tissue remodel into a more functional scar, even though it does not completely restore the original tissue.
Summary
Scarred tissues may feel stiff for several reasons. Adjacent tissue layers may not glide as freely, the extracellular ground substance may be less well hydrated, collagen fibers may be denser and more highly cross-linked, and the nervous system may add protective muscle tension around the area. Yoga and other therapies do not usually dissolve scar tissue, but they may improve how these tissues function. Movement can encourage sliding between layers, support fluid exchange, guide collagen remodeling, and reduce guarding. The result may be better mobility even when the scar itself remains.
As always, a key to successful practice is paying attention to what happens. Timing is crucial: do not do too much too early, but as time passes, add a little more effort slowly and with awareness.
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Footnotes
1Illustration is from DiIorio SE, Young B, Parker JB, Griffin MF, Longaker MT. Understanding Tendon Fibroblast Biology and Heterogeneity. Biomedicines. 2024 Apr 12;12(4):859. doi: 10.3390/biomedicines12040859. PMID: 38672213; PMCID: PMC11048404., https://www.mdpi.com/2227-9059/12/4/859
2 Images of collagen, with kind permission, are from “Organization and distribution of intramuscular connective tissue in normal and immobilized skeletal muscles” (J Muscle Res Cell Motil. 2002;23(3):245-54.) by Professor & Chief Surgeon, Tero Järvinen at the Faculty of Medicine & Health Technology, Tampere University, Finland