movement and nervous system
The nervous system plays a key role in maintaining musculoskeletal and scar-related pain, especially in the process of becoming chronic. After tissue injury or the healing of a surgical scar, pain often persists even when the biological damage itself has already resolved. Behind this lies the plasticity of the nervous system, i.e., the adaptation of neural pathways:
Peripheral and central sensitization: As a result of prolonged stimulation, the sensitivity of pain-sensing receptors (nociceptors) increases, and the processing centers of the spinal cord and brain enter a state of "overactivity." Because of this, the body may experience normal, non-painful stimuli as pain.
The scar as a neural and connective-tissue barrier: Scar tissue is not merely an aesthetic or superficial change; in deeper layers (fascia) it can fix tissues in place and exert mechanical tension on surrounding nerves. In addition, free nerve endings can branch densely within scars, which may send increased pain signals to the brain in response to movement of the surrounding tissues.
Proprioception and sensory integration: In painful or scarred areas, the nervous system receives imprecise information about body position and movement (proprioception). The brain often responds to uncertainty or perceived threat with increased muscle tension and protective movement patterns.
From a rehabilitation perspective, the goal is to "retrain" the nervous system: to activate the pain-gate mechanism, to release scars painlessly, and to restore correct sensory input to the brain so it can eliminate unnecessary protective tension.
Movement is fundamentally important in treating musculoskeletal complaints and pain, because it has a direct effect on tissue healing and nervous-system regulation:
Improving circulation and nutrient flow: Cartilage and scar tissue do not have a direct blood supply; they take up nutrients through the mechanical pumping effect generated by movement (compression and relaxation of tissues), which is essential for regeneration.
Restoring the elasticity of scar tissue: Targeted stretching and movement prevent pathological fibers from sticking together in one direction (adhesions, fibrosis), making the scar more able to glide over deeper layers.
Neural inhibition and pain relief: Appropriately dosed movement activates the body’s own pain-relief systems (endorphins, serotonin) and helps break the vicious cycle of "pain–fear–lack of movement."
Rewiring neural pathways: Controlled movements below the pain threshold restore the accuracy of the body map in the brain, teaching the nervous system that the given movement is safe.