C-Birth (C-Section) Scar Movement

Y’all! There is something we have to talk about. 

For all you mommas that have had a Cesarean Section, there is a really simple, easy thing that you should be doing and it is one of the most important things you should be doing for yourself  (but your doctor may not tell you about it).

We tend to think that C-Births are just another “routine” surgery that we can bounce back from in just 6 short weeks. Yes, C-Births are performed every single day. But just because it is routine, does not mean it is simple. A C-Birth is still a major abdominal surgery that can have negative long-term consequences if we do not manage it well.

Why do I need to mobilize my scar?

We want good scar mobility- aka scar movement. This is because if the abdominal tissues (like 9 whole layers worth of tissues from your outer skin to your uterus) are allowed to stick together long-term, there could be certain issues down the road. 

Low back pain

The sacrum is an important part of your pelvis, and the pelvis is the basis for most functional movement in the body- think: getting up from a chair, picking up your baby, going for a walk. With almost every movement we do, the tailbone rotates forward and backward. There is fascia that runs from different parts of our pelvis to hold in our organs as well as connecting to a bunch of different muscles. The restricted tissue “tightens down” the sacrum, decreasing its ability to rotate. This lack of mobility is a common cause of back pain. 

Frequent Urination

Another issue that can come from C-section scarring a significant increase in going to the restroom. This is a longer term problem, sometimes up to 10 to 15 years after surgery. The scar tissue prevents your bladder from being able to fully expand, which means you have to go more often. 

Pelvic Pain and Pain During Intercourse

Two of the most common C-section scar-related issues are pelvic floor pain and pain during sex. If the scar sticks to the fascia that supports your organs, this can create a lot of pain. During sex, the uterus and vagina needs to be able to move upward with thrusting. If the scar blocks this motion, sex can be very painful. This same concept applies for things like running- no movement of the organs equals pain during running.

Benefits of Scar Mobilization

There are so many benefits to massaging your C-section scar. And the research says so! A study in the Journal of Women’s Health Physical Therapy, found that both superficial and deep scar massage help prevent the issues we listed above.1 Another study found strong evidence for the benefits of massage acutely and chronic scars.

So How Do I Do It?

First let’s talk anatomy! Collagen fibers are the major building block of all the connective tissues in our body. Think skin, muscle, bone, fascia. Collagen lays in every direction like a spider web. 

When collagen is damaged (like surgery) it heals back at 70% of its original tensile strength. This means that it is less flexible and is more likely to want to “stick” to the tissue around it. This may cause scar tissue to grow in unwanted places, like on muscle and fascia. When you massage your scar, you help that collagen learn where it is allowed to go. 

The first thing to talk about is timing. You want to make sure that your scar is fully closed without any redness or bleeding (usually ~6 weeks). Most scars are fully healed between 8 and 12 weeks postpartum. 

Next, there are a couple of different ways that you can perform scar massage and it is all about finding what works for you. If you learn better through video/visual instruction- head over to our Instagram page and check out this video —> https://www.instagram.com/tv/CLoxE2VjQno/?utm_source=ig_web_copy_link

Instructions for 3 ways to perform Scar Mobilization:

You can put your fingers directly on the scar and gently push/pull it in any direction to really work those collagen fibers. The skin is directly connected to all the layers of fascia and muscle below it, so by moving the skin, you’re moving the deeper layers too. 

You can also try sinking your fingers into the area around the scar to work on the collagen from a different direction. By sinking the pads of your fingers into the skin (gently!), you can more directly access the deeper layers. Experiment with the amount of “give” under your fingers. Does going one direction feel easier than another? If so, it is generally easier to get the tissue to release going in the “looser” direction first. This encourages the “tighter” direction to loosen up. Sometimes, it may feel good to gently hold the tissue in that direction at end-range for between 3 and 5 minutes. You may experience a form of tissue release that feels like butter or taffy melting. This is normal!

 A third way is called skin rolling, where you (gently) pinch the skin between your fingers and thumb and roll the skin gently in every direction. This may be a bit odd and uncomfortable, so work your way up to it. It is always good to work on an area bigger than the scar itself, because sometimes the “stickiness” of the collagen fibers extends out in a larger area within the deeper layers under the skin. Going up as far as your ribs or down towards your hip bones is a good idea depending on your sensitivity. 

There should never be any bleeding, redness lasting more than a few hours, or open incision site after self-treatment.

How Long Do I Do It For?

A good rule of thumb is 3-5 minutes a day. Easy. But sometimes, it can be difficult to do because the massage may be weird and uncomfortable at first. 

Eventually, when the skin feels loose in all directions, you can step back to a “maintenance” phase every few days or once a week. 

Women undergo C-Births every single day. Remember, just because it is a routine surgery does not mean it is a simple one. You deserve the best care after growing a human being for 9 months! C-Birth scar massage is a simple gift you can give yourself on the journey to postpartum recovery!

ALSO- IF YOU ARE STRUGGLING WITH PAIN, YOU NEED TO GET SEEN BY A PELVIC FLOOR PHYSICAL THERAPIST. WE ARE TRAINED SPECIFICALLY FOR THINGS LIKE THIS AND CAN CHANGE YOUR PAIN IN 1 SESSION.

If you have any questions- don’t hesitate to reach out to us! And don’t forget to follow us on FB and Instagram @RechargedPerformanceTherapy!!

<3 Recharged Performance Therapy Team

References

Wasserman, J. B., Abraham, K., Massery, M., Chu, J., Farrow, A., & Marcoux, B. C. (2018). Soft tissue mobilization techniques are effective in treating chronic pain following cesarean section: a multicenter randomized clinical trial. Journal of Women’s Health Physical Therapy, 42(3), 111-119.
Wasserman, J. B., Copeland, M., Upp, M., & Abraham, K. (2019). Effect of soft tissue mobilization techniques on adhesion-related pain and function in the abdomen: a systematic review. Journal of bodywork and movement therapies, 23(2), 262-269.