An adhesion is an internal scar. Adhesions tend to form in all peopleat the site of tissue damage wheneverand wherever the body heals. Adhesions consist largely of tiny but powerful strands of collagen that bind to each other and to underlying surfaces, isolating injured areas to set up the process of healing. These collagen fibers can form in random patterns to form a patch or in parallel patternslike the strands of a nylon rope. Adhesions occur on the surface of our bodily structures or deep within them. Adhesions can be formidable, with a strength estimated at over 2,000 pounds per square inch (140K/cm2). Responding to inflammation, they can squeeze muscles, organsor nerves like a straitjacket, or spread to join any bodily structure to nearby, or even distant structures. When this occurs, the internal squeeze or pull can cause confusing symptoms of pain or dysfunction. Because adhesions are virtually invisible to diagnostic tests, doctors sometimes fail to consider the profound effect these internal scars can cause. Physicians may truthfully say “I don’t see anything” or “all tests are coming back as normal.” The mistake comes if they say “there’s nothing there” when powerful bonds are squeezing or joining areas that are designed to be free and mobile. Thus, the patient is confused by the diagnosisof “unexplained pain or dysfunction.”