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Home > Blog  > Traumatic Scar Management: An Interview with Nancy Keeney Smith

Nancy-Keeney-SmithHealwell is honored to be presenting Traumatic Scar Management with Nancy Keeney Smith at the Teal Center, January 8-10, 2016. She was gracious enough to spend some time talking with us about her work, the class, and her soon-to-be-released textbook.

Healwell: How did you get involved in this kind of work? What drew you to it?

Nancy Keeney Smith: I was looking for an alternative to surgery and medication for my own issues with scarring and lymphatic issues. A friend was a student at the Florida School of Massage and needed a journal entry. The impact on my scarring and health was immediate. Several years later I decided to go to massage school to help those like myself with traumatic scarring.

Healwell: Talk a little about why you use the term “traumatic scar tissue.” Isn’t all scar tissue evidence of trauma?

NKS: It’s true trauma is in the eye of the one with scar tissue. Scars are not obligated to be problematic – where would we be without our body’s natural ability to heal itself following a wound? However, normal physiological processes can be altered in a variety of ways and, when altered, this constitutes what is termed pathophysiology.

Abnormal or pathophysiological scars can impact function within and beyond their physical borders and present considerations outside of the physical/physiological aspect of the scar.

Problematic scarring following planned and unplanned trauma can be accompanied by serious physiological and psychological considerations and, as such, led me to co-author a book with Cathy Ryan, RMT entitled TRAUMATIC SCAR TISSUE MANAGEMENT.

Traumatic scars can occur as a result of accidents, acts of violence and other catastrophic events (e.g. disease, burn accident and surgery).

 Healwell:What motivated you to offer this class with Healwell? How does Healwell’s mission connect to the work you do?

NKS: Healwell is an industry leader in presenting cutting edge therapies that are relevant to today’s professional body worker. I am honored to present the class to the Healwell community.

I offer my services to the burn survivor and cancer communities in my area. I offer a sliding scale and pro bono work for those that can’t afford a session. Healwell’s mission statement of demonstrating the ability of hands-on integrative therapies to measurably improve outcomes for patients through clinically sound, replicable methods is what I strive for in my teaching.

Healwell: What’s your favorite thing about teaching this work?

NKS: The “ah-ha” moments in a student during lecture and hands-on demonstrations; assisting students to recognize they can do this type of work with the skill set they have; and to hear from former students about how the information and work has enhanced their practice.

Healwell: Do you have a teaching moment of which you are particularly proud?

NKS: Just one? I have several students that have started their own journey with teaching and opening clinics for traumatic scar clients that include burns, cancer survivors, and returning veterans. I’m so proud of them and how they are opening doors for others to experience the work.

Healwell: You mentioned that you have a book coming out soon (January 2016). Tell us a little about that.SMITH-Front-cover-website-1-Sep-15

NKS: I was honored to be a presenter at the International Massage Therapy Foundation research conference in Boston, Massachusetts in April of 2013. After my presentation, I was introduced to Mary Law of Handspring Publications (Check out their stable of authors! Very humbling.) and Cathy Ryan, the chair of the College of Massage Therapists in British Columbia.

Cathy and I found a common bond in our approach to traumatic scar tissue and noticed a lack of published information for body workers. We recognized the management of scar tissue is a growing problem for massage and manual therapists. In our teachings, we have found many are afraid to deal with it in their practice. This book shares research that shows appropriate massage treatment can have significant results both physically and psychologically. Existing books may dedicate one chapter on the problem but there is no practical manual available on the subject which instructs the therapist what to do and how to do it. TRAUMATIC SCAR TISSUE MANAGEMENT fills the gap, explaining the physiological and pathophysiological background and provides practical guidance on how to help our clients and patients.

Healwell: What makes Traumatic Scar Management different from other scar tissue massage courses?

NKS: Traumatic Scar Tissue Management builds a foundation of knowledge from the anatomy and physiology of scar tissue and research on scar tissue and manual therapy. This course includes exploring the important role the lymphatic and nervous system plays in scar healing, interviewing techniques and clinical decision-making for working with all types of traumatic scarring including cancer, surgery, and burns. Therapists will put their knowledge to use during a hands-on clinic with volunteer traumatic scar clients.

Therapists are encouraged to bring their own experiences and questions to the classroom. I make no claim on having the only way or the best way-just presenting data and clinical observations to assist the therapist in working safely and confidently with all types of traumatic scarring.

Whether the client’s scar tissue was brought on by a burn, surgery, auto accident, injury or cancer recovery, scar management treatment can help with range of motion and improve their quality of life. I enjoy combining years of research with my clinical experience of scar clients to develop a protocol that combines gentle hands-on techniques to facilitate the best healing environment.

Healwell: What’s a common mistake/misconception that you encounter when teaching massage therapists about working with scar tissue?

NKS: That you will cause the client pain when you are doing the work. This is where the knowledge acquired in class eases the fear and instills confidence in the therapist.

Another is the need to go deep and hard on the scar tissue. We learn why this is not the best idea for lasting effects.

Healwell: Is there anything else you’d like to share with our community?

In the developed world alone, a total of 100 million people develop scars each year as a result of 55 million elective operations and 25 million operations after trauma. Current statistics estimate that over 50% of postsurgical patients will experience scar-related complications.

Millions of people, world-wide, are inflicted with non-fatal burn injuries. Although mortality and morbidity from burns have diminished significantly over the past several decades, these statistics do not reflect the overall impact on the burn survivor and how well they carry on with life and manage post-burn deformities, contractures and other disabilities that collectively present with aesthetic and functional considerations.

The prevalence of occurrence, complications and sequelae associated with problematic scars, of varying etiology, present important clinical, economic and social considerations.

My hope is the therapists that sign up for the class will be ready to open their clinic doors and help the traumatic scar population regain their quality of life.

Healwell: Thank you so much for sharing your time and knowledge, Nancy. We are so grateful and excited to bring your class to the Healwell community.

There is still time to enroll in Nancy’s Traumatic Scar Management class at the Teal Center in Arlington, January 8-10, 2016. Register today!

Nancy Keeney Smith is a Board Certified Licensed Massage Therapist, Certified Lymph Drainage Therapist, and a Florida and NCTMB Provider of Scar Management Workshops.  Nancy’s Scar Management Workshops have been taught internationally to students, LMT’s, PT’s and OT’s.  Nancy is a member of the Associate Research Team at the Florida School of Massage in Gainesville, Florida, former 1st VP of the AMTA Florida Chapter, member of the American Burn Association, the National Lymphedema Network, and the Phoenix Society for Burn Survivors. She has a private practice in Gainesville, Florida. You can learn more about Nancy at You can order a copy of her text book from Handspring Publishing.