Scar Tissue and What the Brain Believes
–by Julie Beem In early October I fell and broke my left knee cap (annihilated it into pieces is a more accurate description). The skillful surgeon put Humpty Dumpty back together again, but I was ordered to remain immobile for six weeks while my old bones decided to knit back together. Right before Thanksgiving, the “do not put any weight on it or attempt to bend” orders became “move as much as you can.” The change was abrupt, and overwhelming. In the first week, progress was quick. I went from hobbling with one crutch to hobbling with a cane. The new-found ability to actually stand on two legs in the shower made me giddy. The physical therapist was thrilled and gave me some stretches and tips on how to use the cane. She said, “no more stairs on your bottom” and taught me how to safely go up and down. The next week, however, was about reckoning with scar tissue. The ligaments and tendons around my knee were stiff and the muscles had been inactive. Part of every PT appointment involved “massaging” the knee joint, which feels a great deal like being placed on a medieval torture device. Afterwards the increased mobility is obvious, but so is the fatigue and swelling. And so it is with scar tissue…including the emotional scars of our early trauma wounds. Healing comes with doing the deep “massage” work of therapies and interventions, allowing for fatigue and rest. Then the stiffness sets in, and then repeat…and repeat…and repeat. Persistence through the hard work and patience through the need for rest are critical if we’re going to heal. “Your quad muscle is shut down,” the PT explained. It is apparently the typical response to a knee injury. “It’s not that the muscle itself can’t function. It’s that the brain is telling it not to let you move your knee. We’ll have to work on overriding and retraining your brain.” Hmmm…the parallel to early childhood trauma was immediate for me. When you injure your knee, the quad protects further knee damage by not working well– this explains why I couldn’t force myself to my feet after the accident. When children are injured by trauma – abuse, neglect, other traumas –their brains become very protective. Behaviors that don’t make sense in a “safe” world make total sense when you needed that protection for survival. And our brains can get stuck in that protection mode. The next exercises included electro-stimulation of the muscle and lots of stretching and strengthening, consciously trying to override the way I’d been taking each step. Slowly, over time and with therapy sessions, we’ll “convince” my brain that it’s safe to trust that my knee won’t give out and that I can move again. Will I fully recover? I think it depends on what your mean by “recover.” Just like living with the scars of early trauma, I think there will always be residual scars…potential weakness there. But with persistence to do the hard work of digging into the scar tissue and patience and grace to allow myself rest and time, I know that I will heal, just as we all can heal.