–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.
The Physical and Emotional Battle with Scar Tissue
Scar tissue is often misunderstood. It doesn’t just form as a result of physical wounds but also emotional ones. My knee, surrounded by stiff ligaments and tendons after being inactive for so long, required significant physical therapy (PT) to regain its mobility. PT sessions were tough—painful massages of the knee joint were necessary to break up the scar tissue and encourage flexibility. Each session left me feeling both physically fatigued and emotionally exhausted.
This experience with physical scar tissue reminded me of how we cope with emotional scars, especially those resulting from childhood trauma. Much like my knee, the emotional scars we carry require persistent work, patience, and a willingness to endure discomfort if we are to heal. Just as my physical therapist had to “massage” the knee tissue to restore its function, so too must we address the emotional scars through deep therapeutic work.
The Parallel Between Physical and Emotional Healing
The body’s response to injury—whether physical or emotional—is similar in how it reacts to protect itself. My physical therapist explained that the muscles around my injured knee, especially my quadriceps, had “shut down” as a defense mechanism. The muscles weren’t malfunctioning but were being restricted by signals from my brain, which was essentially telling my body, “don’t move your knee to avoid further damage.” This phenomenon, though frustrating, is a natural way the brain protects the body from more harm.
This mechanism immediately brought to mind how trauma works on an emotional level, especially childhood trauma. When children experience traumatic events such as abuse, neglect, or other adverse experiences, their brains also adapt by becoming protective. Behaviors that might seem illogical or maladaptive in a “safe” environment make perfect sense in a world that requires self-preservation. This hyper-protectiveness, however, can result in behaviors and emotional responses that persist long after the trauma has passed, much like how my body continued to guard my knee even when it no longer needed to.
The Brain’s Role in Physical and Emotional Trauma
Trauma, whether physical or emotional, alters the brain’s processing. When children endure trauma, their brains become hardwired to protect them, and this pattern can persist into adulthood. Emotional trauma can become entrenched in the brain, much like scar tissue forms around physical injuries. When trauma goes unresolved, it creates emotional “scar tissue” that can manifest in various forms, such as anxiety, depression, or hypervigilance.
In my case, my brain was sending signals to my quadriceps to prevent knee movement long after my bones had started to heal. The muscle didn’t need to be inactive, but my brain was stuck in protection mode. Over time, I needed to retrain my brain to trust that it was safe to move again. The same principle applies to healing from emotional trauma: our brains often need to be retrained through therapy to understand that the original danger is no longer present.
The Hard Work of Healing
Healing from both physical injuries and emotional trauma requires persistence, patience, and grace. There is no quick fix. In physical therapy, I had to do exercises that forced me to override my brain’s protective mechanisms. Electro-stimulation helped activate my quadriceps, and stretches and strengthening exercises allowed me to consciously retrain my movements.
The same is true for emotional healing. Trauma-informed therapies such as EMDR (Eye Movement Desensitization and Reprocessing) or cognitive-behavioral therapy (CBT) help individuals retrain their brains to move beyond the protective mechanisms that no longer serve them. Just as with physical therapy, the work can be uncomfortable, requiring us to confront painful memories, fears, or deep-seated beliefs. However, over time, with persistence, we can “convince” our brains that it is safe to move beyond our trauma.
The Role of Therapy in Breaking Emotional Scar Tissue
Emotional healing often follows the same process as breaking down physical scar tissue. Emotional trauma, like scar tissue, creates rigidity in how we think, feel, and respond to life. It binds us, holding us back from emotional flexibility and full participation in life. Therapy acts as the metaphorical “massage” that stretches those emotional ligaments, increasing our emotional mobility and flexibility.
Types of Trauma Therapies That Help Break Emotional Scar Tissue:
Eye Movement Desensitization and Reprocessing (EMDR): EMDR helps individuals reprocess traumatic memories by using bilateral stimulation, such as guided eye movements, to desensitize the emotional distress associated with those memories. Over time, this form of therapy can help individuals feel less stuck in their trauma, much like how physical therapy helps break up scar tissue.
Cognitive Behavioral Therapy (CBT): CBT focuses on identifying and challenging negative thought patterns that arise from trauma. Through this therapeutic approach, individuals can learn to change the way they think and behave in response to their trauma, thus reducing the emotional scar tissue that keeps them trapped in unhelpful thought patterns.
Somatic Therapy: Somatic therapy focuses on the connection between the mind and body, helping individuals process trauma that is stored in the body through physical sensations. It recognizes that trauma can manifest physically and works to release the body from its protective patterns.
Recovery: What Does it Mean?
As I continue my journey toward physical healing, I’ve begun to ponder what it means to “fully recover.” Will I ever be the same? The truth is, physical and emotional scars may never completely fade, but that doesn’t mean we can’t heal. With persistence, patience, and the willingness to embrace both the painful work of “massaging” our scars and the grace to allow for rest, healing is always possible.
The Nature of Recovery:
Residual Scars: Just as there may be residual physical weakness in my knee, emotional scars can leave lasting marks. Trauma changes us, but it doesn’t have to define us. We may carry the scars of our experiences, but with hard work and time, those scars no longer have to hold us back.
Strength Through Vulnerability: Healing requires us to be vulnerable, to confront our pain, and to allow ourselves to trust again—whether that means trusting a body part to function after injury or trusting the world after experiencing trauma.
Grace and Patience: Recovery is not a linear process. There will be setbacks, and there will be moments when rest is necessary. The key is to approach healing with grace and patience, both with our bodies and with ourselves.
Conclusion: Healing is a Lifelong Process
Whether we are healing from physical injury or emotional trauma, the process is ongoing. Scar tissue—both physical and emotional—may always remain, but with perseverance, we can continue to work through the stiffness and limitations it imposes on us. Healing is a journey of understanding the body’s and mind’s incredible ability to protect us, while also learning to trust ourselves again.
Through this journey, we discover that while scars may remain, they do not have to define us. With the right support, time, and effort, we can heal from both physical and emotional wounds, becoming stronger and more resilient in the process.