Massaging your scar post cesarean section is a very important step, but not often discussed. A surgical incision of any kind disrupts the fascia. Fascia is a fibrous tissue that surrounds muscles and is all throughout your body. The fibers are supposed to be smooth and run in a straight line allowing muscles and tissues to easily glide as they are moving. When the fascia becomes disrupted it grows back like a spider web and runs haphazardly, this can create adhesions to muscles and other organs. These adhesions can cause pain – think of a trigger point in your trapezius muscle. If the adhesions are not worked on, they can cause problems later in life (we will discuss these problems later in the post). Thankfully there are things you can do to decrease the adhesions.

So you had a c-section, what’s next?

Massaging your c-section scar is really easy and can take less than 5 minutes, and can make the world of difference later in life. The time to start massaging the area can vary. We would recommend waiting until you are cleared at your 6 week appointment and until the wound is fully healed before you do any work directly over the scar. If you are having a lot of pulling pain prior, you can do some of the stretches earlier, just make sure you avoid going directly over the scar. Also note that it is never too late to start doing the massages, even if you are years out from our c-section. Using coconut oil with lavender in it can be helpful in decreasing scar formation as well.

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How to do the massages

Scar Massage: Skin Stretching 

Begin about 6 weeks after surgery, as long as incision is well healed. This can be done on your own, at home, for 5 minutes/day.

1. Place fingers 2-3 inches from scar.
2. Stretch the skin by moving the fingers up and down around the entire scar.
3. Repeat step 2 by stretching side to side and clockwise/counterclockwise.
4. Massage completely around the scar, repeating each movement 5-10 times.

It is normal to experience a pulling or burning feeling when you initially are stretching the scar. If you feel an area that does not move as easily, spend a little extra time in this area stretching the scar. 

Direct Scar Massage 

Begin as soon as the incision is closed and well healed.

1. Hold the pads of two or three fingers together. The fingers should be slightly arched.
2. Place pads of fingers on the edge of the scar.
3. Stretch the scar by pushing fingers ½ inch in one direction (indicated by arrows). Hold scar stretch for 10-15 seconds.
4. Repeat step 3 by stretching the scar in the opposite direction
5. Move along the scar every ½ inch-1 inch and repeat over the entire length of the scar, stretching in all directions (up/down, side to side, and diagonal).

Scar Lift and Roll

1. Lift scar away using index finger and thumb.
2. Roll the scar between fingers for 10-15 seconds
3. Move along entire length of scar repeating every ½ inch-1 inch.

Source: https://www.foundationalconcepts.com/the-pelvic-chronicles-blog/scar-massage-c-section/

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It can be tender when you first start doing the stretches, but if you notice extreme pain with them please consult with your physician. We would recommend doing these stretches daily until you notice a decrease in pain and increase in movement. Once you are noticing these changes, you can increase to every week for a month and then increase to every other week for a month and finally every month. Scar tissue has the potential for form for up to two years after the surgery, so checking in monthly to see how it feels would be beneficial until you are two years out.

What are you preventing by doing the massage??

The fascial adhesions can have various affects on the body. Some of the most common complaints include: lower back pain, pelvic pain, and pain with intercourse. This is most likely due to fascial adhesions to various structures in the body – sacrum and organs. It can also be common for these symptoms to not appear until years later. While massaging your c-section scar may not prevent all instances of these problems, it is shown to decrease the risks and/or impact of these matters for your future health! So get started today!

Sources

Wasserman, Jennifer. “Chronic Caesarian Section Scar Pain Treated with Fascial Scar Release Techniques: A Case Series.” Journal of Bodywork and Movement Therapies, Churchill Livingstone, 10 Mar. 2016, www.sciencedirect.com/science/article/abs/pii/S136085921600022X