These days many women have distended and dysfunctional abdominal muscles years after having children.

It can be caused by:

• having more than one pregnancy in less than two years, before the body can heal

• putting on too much weight during pregnancy

• damage to the pelvic floor during birth

• c-section.

If untreated, it may lead to back pain but also to orthopedic and visceral injuries.

While performing a c-section doctors cut through three layers of muscles and an organ, uterus. It also disrupts the fascia.

Fascia is a connective tissue that envelopes and separates muscles. It covers the entire body. It’s under the skin and houses fat, nerves, blood vessels and other connective tissues as well as surrounds whole muscle, muscle sections, fibers and even individual muscle cells[1].

When fascia gets disrupted, it makes it impossible for muscles to glide easily while we’re moving. This weakens muscles even more and leads to faulty muscle recruitment patterns destabilising the back and the whole body (indirectly)[2].

Unattended scar tissues can grow, forming more adhesion which can affect circulation, organ placement and even posture.

Movement and heat can help to dissolute the scar tissue. With blood, lymph and hydration our body is able to carry away the collagen fibers that are no longer needed, replacing them with healthy, new structures, making scars more elastic and pliable[3].

Scar tissue massage, together with postnatal abdominal fix exercises will help restore function and strength in your abdominals as well as decrease the risk of back pain and injuries.

Performing scar massage is easy and can take less than 5 minutes. Scar tissue massage can only be done when the scar FULLY HEALS. I would recommend waiting at least 6 weeks (if there were no complications/infections) and check with your doctor if you’re ready to start working on your scar.

When you start, I would recommend doing it while lying down in your bed. Be very gentle and use coconut oil (or any other extra virgin, organic oil) to allow your hands to glide easily and decrease the scar formation.

1. Phase one (from 6 weeks after surgery, after consulting your doctor)

• Don’t work directly on the scar

• Place your fingers above the incision (2-5 cm)

• With gentle pression start moving your fingers up and down, gently stretching your skin around the entire incision, move left to right and right to left

• Move your fingers side to side, in horizontal motion

• Move your fingers in circular motion both clockwise and counter clockwise

• Repeat the massage below the scar

• Perform each motion 4-10 times

It is normal to experience gentle pull around the scar but any pain indicates that it is still to early and you may need to wait few more weeks.

2. Phase two (direct scar massage, when the wound fully healed)

• Each motion will be performed on the scar itself

• With gentle pression start moving your fingers up and down, gently massaging your scar and skin around it, move left to right and right to left

• Move your fingers side to side, in horizontal motion

• Move your fingers in circular motion both clockwise and counterclockwise

• Perform each motion 4-10 times

• To make it more effective, gently pull the skin (do it in all directions: up & down, side to side and diagonal) and hold the stretch for 10-15 seconds.

• Finally, gently lift your scar with your thumb and index finger and roll the scar between your fingers for 10-15 seconds.

Do these stretches daily. When there is a decrease in pain and an improvement in mobility you may start doing it less frequently, but it will never completely stop.  

Note: After my traumatic birth experience I could not even look at my scar for about 8 weeks after giving birth (I didn’t touch it until months after giving birth). After my midwife took off my wound-dressing, I didn’t notice that my underwear (that was specific post c-section underwear) was rubbing on the scar, rubbing the skin and making it bleed again. That lead to thicker scar tissue in the middle. Pay attention to your clothes and keep your incision well protected until it fully heals. Avoid shaving directly on the scar (I did that).

To make it easier for you to learn how to perform a scar tissue massage I have recorded a video that you can get by clicking on the button below.

BONUS: In addition to scar massage, using castor oil packs is effective in “reorganising” scar tissue.

Saturate organic cotton flannel strips with castor oil and place them over the affected area. Place the hot water bottle over the soaked strips and let it sit for about 20 minutes. Perform your massage afterwards, massaging the oil into the scar. Do it daily for a min of 3 weeks[4].

Daily scar tissue massage may sound overwhelming or even boring. But it is necessary. Untreated scar tissue can lead to pain even years after delivery, so don’t put it off. After a while it becomes a habit and you will just do it automatically, especially that later it can be done standing as well. Yet at first set up a reminder on your phone or stick a post it note on your bathroom mirror or night lamp. Soon it will be as easy as brushing your teeth.

With love,

Karo

[1] “The trigger point therapy workbook” by Claire Davies, NCTMB and Amber Davies, CMTPT, LMT

[2] “How to eat, move and be healthy!” by Paul Chek

[3] “The fourth trimester” Kimberly Ann Johnson

[4] “The fourth trimester” Kimberly Ann Johnson