Scar tissue on deltoid

Hi I've a patient with a 4cm mass of scar tissue on her L) medial deltoid from a weight training accident. Injury is approx 5 years old. She is wanting it treated for cosmetic reasons as there is quite a noticable lump on her deltoid. I've used friction techniques in the past for scar tissue breakdown, but not on injuries as large or old. Would frictioning be the first choice of treatment? Any thoughts on whether LLLT could be used for this?

There is no chance that a lump of scar tissue that large and that old is going to be significantly changed with frictions or any other manual technique. The scar tissue is well passed its remodeling stage and is now static. If she's really that serious about it she'd probably have to see a plastic surgeon to remove it. I suppose it's possible some injection agents might be able to break some of it down (e.g. - steroid's effect on connective tissue) but I believe her best option is surgical removal given the length of time since onset.

Ok.. update on this. I decided to treat with friction technique and have performed 3 seperate sessions of 10 min cross fibre frictions followed by icing the area (ice massage 10 mins).

The result is the scar tissue mass has is now reduced to the size of a bean. Patient is very pleased. Will continue this treatment to reduce it further :)

Excellent update.

Highlights the importance of Physio's believing and applying the tools within their rehab kit to solve problems!

What may appear to be 'scar' tissue, may be no more than myo-fascia that is capable of being remodelled through time and hard work.

Obvious case in point.

Thanks for sharing