After a Caesarean birth, the scar can cause discomfort for many women, even once the incision has healed and looks normal. It is also possible to feel pain when something touches the scar. The cause of this can be restrictions in the flexibility of the scar tissue.
Scar tissue can form after any type of surgery. It consists partially of collagen. Scars can heal in many different ways. Sometimes they will heal straight and cause minimal changes, however, scar tissue can also heal unevenly. Apart from raised scar tissue and redness, your wound can worsen the flexibility of surrounding skin and tissues. Adhesions can form in the abdomen and muscle layers. This can cause pain during ovulation or any kind of strenuous activity.
It can take up to a year for nerve fibers to regrow and heal
It is normal for scars from a Caesarean birth to be red and sore at first. It is also perfectly normal to experience pins and needles or numbness in the scar area. Even if the healing process begins early it can take up to a year for the nerve fibers to regrow and heal completely; this will affect how the scar will look and feel.
How can scar massage be helpful?
Massaging is a great way to reduce the extent of cesarean section scarring. Massaging improves blood circulation and mechanically breaks down the scar tissue. This helps to aid the scar tissue healing process and can lead to a flatter looking scar. This can be done daily once you have been cleared by your healthcare provider. Massaging the scar tissue can decrease the pain and improve the flexibility of the skin as well as the abdominal wall. As a result you experience less discomfort and pain surrounding the scar as well as reduced visibility of the scar tissue. The general guidelines usually instruct you to begin with a gentle stretch of both skin and scar.
Two techniques for scar massage after Caesarean birth:
- Stretching the skin around the scar
- Massage the scar directly
Stretching the skin
- Place two fingers 1–2 centimeters (around half an inch) away from the scar and begin either from above or below, then switch.
- Stretch the skin around the scar area by moving your fingers up and down. - Continue this movement along the entire length of the scar.
- Then stretch the skin around the scar area by moving your fingers from side to side. Continue this movement along the entire length of the scar.
- Finish by stretching the skin by making circles above and underneath the scar both clockwise and counterclockwise.
Do/Perform the massage around the scar 5 - 10 times daily.
Massage the scar directly
This is a technique that you can begin using about 12 weeks after a Caesarean birth.
- Apply pressure gently using 1 or 2 fingers directly onto the scar.
- Massage the scar by pulling your fingers 1 - 2 cm (about half an inch) across the scar, hold 5-10 seconds,
- Repeat along the entire length of the scar and stretch in all directions (up, down, side to side, and rotate).
You can end the massage by “rolling” the scar, between your index finger and thumb. Simply lift the scar and roll along the entire length of the scar for 5-15 seconds.
If you experience any areas with decreased flexibility or roughness, spend more time massaging these areas. It should not be painful when you perform the massage but it is normal to experience some discomfort or a prickly sensation.
There is limited research but those published have shown many benefits to massaging the scar tissue when it is started six weeks after birth. Few have even shown some benefit up until 2 years after your Caesarean birth. Massaging is not mandatory, but for some, it can provide aid.
Sources: - Arung W, Meurisse M, Detry O. Pathophysiology and prevention of postoperative peritoneal adhesions. World J Gastroenterol. 2011; 17(41): 4545-4553. - Wallace K. Massage for your abdominal scar. (2014). https://rotunda.ie/rotunda-pdfs/PIL/Physiotherapy%20-Abdominal_Scar_Massage.pdf?_t=1586259203 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7578190/ - https://www.tommys.org/pregnancy-information/giving-birth/caesarean-section/recovering-home-after-c-section