Q&A with Tom: Scar Tissue Work After Open Heart Surgery

One of our students writes to Tom with the following question:

I have a question for you about scar tissue work for a relative who had open heart surgery. I want to help him with some scar tissue work. Could you give me your best advice on the timing, the frequency and any other info you have about it? Thank you! 

Tom replies:

While there might be some superficial adhesions in the fascia outside the sternum, the major and limiting adhesion come on the deep side of the sternum between it, the transversus thoracis, and the pericardium they had to cut to get in there.


In an email, this is the best I can do:
Sit beside him as he lies supine. Put your whole hand centered on his chest, your middle finger pointing to his nose, and sink in, so that when you move, you are not moving the skin on the bone (much), but moving the bone inside his body. Try a small move, an indication really, with a firm enough engagement to move the bone a bit, in each of the eight directions, seeing where it gives a little, and in which directions it doesn’t.

Focusing in the directions that seem stuck, hold your move into that direction and get him to breathe, and feel for the release. If it is restricted to the left, hold the bone left through several breath cycles, maybe many, until you feel it give way and the movement normalise.

Everyone has a different capacity for scarring, and it depends on how the surgery was done – some things might have been sewn together, especially if it was an emergency not an elective – but these gluey adhesions can be persuaded to ease up, given the right direction of stretch. If you stay within bodywork bounds (don’t do CPR!), you are unlikely to do anything negative.

Here are a couple of extra tips:

• One had on the chest and the other hand under his thoracic spine behind, and feel him through your hands, between your hands. Feel several breath cycles – where is it stuck? The use your spider sense to sim your hand energy / movement at where the restriction is. This is subtle feeling, but can get at deeper restrictions.

• You can also reach the heart through the neck, essentially from longus wapitis and colli on the front of the neck, again using the breath and your sense through your hands – untwist the rotation that will usually be palpable on the inbreath.

Hope this helps,