Today let’s go through a few questions regarding scar tissue. I hear a lot of misconceptions regarding this topic, and today would just like to clarify things a bit more. I hear a lot of recommendations of “oh, just wait 8 weeks, and see how it goes.” I just want to clarify that this is not correct, it will take much longer for scar tissue to mature, and 8 weeks is not enough time.
Let’s talk about the mechanics of the knee. The front of the knee is composed of 2 main bumps, the patella and the tibial tuberosity. The tibial tuberosity is on the Tibia bone, and above this sits our menisci. Then we have the femur bone above, with the patella. When we have a CCL tear, the bottom bone, or tibia, will thrust forward, causing abnormal movement in the knee. This is called Tibial Thrust. This is what your veterinarian will check for in the clinic. It may also be called a drawer sign.
So, scar tissue starts forming immediately , once the body has an injury to a ligament, to stop this movement. Basically, with conservative management, we are externally supporting that joint, allowing scar tissue to form, until we get to a point where there is no longer any movement.
Scar tissue takes 6 months to form to the juvenile state, and 9-12 months to fully mature. We suggest using the brace during any active times, to help this scar tissue heal. Any movement without the brace could lead to a re-injury of the scar tissue, and this could set us back a bit.
So, with a tear, we commonly see a lot of re-injury initially, before bracing. This can be a cycle until we get a brace on the knee to stabilize things. A re-injury is easy to do during the juvenile state. If this happens, just keep rested for 1 week, and resume our Physical Therapy schedule along with bracing. Too much too soon is not a good thing, this is not a race.
This is why it is so important to include Physical Therapy with our bracing, so that this scar tissue forms in the pattern we want it to. Range of motion allows the scar tissue to form in a healthy manor, and be more flexible. We do not want hard/stiff scar tissue to form, as this will decrease our mobility down the road. Please let me know if you have any questions!