Scar mobilization and postpartum care after C-section

This post was written by Esther Axle, DPT, PT, LAT, Parkview Bryan Hospital.

Postpartum care is vital for all new mothers, especially for those recuperating from a Cesarean or C-section. While the excitement of welcoming a newborn often takes center stage, a crucial yet often overlooked aspect of maternal self-care during this 6-8-week period is scar tissue maintenance. Below, we’ll outline the significance of scar mobilization and how it enhances postpartum recovery.
 

What is scar mobilization?

Scar mobilization is a manual therapy performed by a licensed professional and taught to patients and family members to improve the flexibility and mobility of scars and the underlying tissues. Physical therapists or patients can perform this technique using special tools or simply by hand.
 

Why is scar mobilization necessary?

Scar tissue develops as the body's natural response to a wound or surgical incision, eventually transforming into normal, healthy tissue. However, after an injury, the new tissue forms in a haphazard pattern instead of a regular, aligned one. When left unmanaged, cesarean scar tissue, even years later, can cause a range of pelvic health complications, such as:

• Adhesion

• Back pain

• Hip pain

• Pelvic pain

• Urinary issues

• Bowel obstruction

• Constipation
   

How is scar mobilization performed?

Scar mobilization techniques can vary. My preferred methods involve applying a small amount of lubrication such as coconut oil, vitamin E oil, massage cream or lotion and using 2-3 fingers to massage either cross-friction (perpendicular to the scar) or in small circles over the scar. I advise my patients to do this 1-2 times daily, for up to 5 minutes, depending on their tolerance. Other effective methods of scar mobilization therapy incorporate myofascial release, cupping, general stretching and instrument-assisted scar tissue massage.
 

Who can benefit from scar mobilization?

While some women may not develop excessive scar tissue or experience adverse symptoms, maintaining mobility in this tissue is advantageous for all, as it promotes healing and a smoother recovery process.

I personally have experienced the benefits of scar mobilization. I noticed a huge difference after my second and third C-sections compared to my first because I incorporated scar mobilization into my recovery.

Patients often see an improvement in their pelvic pain or constipation in as short as 1-2 weeks after beginning scar mobilization. Some additional perks associated with scar mobilization include:

• Flattening the scar

• Improving the mobility of the surrounding tissue

• Improving blood flow

• Normalizing tissue sensitivity

• Mitigating the onset of adverse symptoms
   

What is the recommended timeframe for scar mobilization following a C-section?

Generally, tissue requires approximately eight weeks to heal fully, but scar mobilization can begin as early as 2-4 weeks post-operation. At this point, touching or massaging the skin around the incision is appropriate. Be sure the applied pressure is light and not directly over the scar. Mild manipulation will facilitate blood flow to the area without putting excess stretch on the healing tissue. Between 4-8 weeks, light touch can progress to gentle pressure and massage to the tissue around the scar. Around 8-12 weeks, pressure can increase to a firmer touch directly on the scar and surrounding tissue. During this phase, it is also vital to address the different tissue depths, including superficial, middle and deep layers.
 

Final thoughts

Incorporating this practical therapy into your care regimen can facilitate improved healing speed, mobility and overall comfort following a C-section. If you're navigating postpartum recovery and aren't sure how to get started with scar tissue mobilization or need guidance on which therapies are most suitable to your unique journey, don't hesitate to seek the care of a licensed professional.

Pelvic Physical Therapy, at Parkview comprises a multidisciplinary team of physicians working together to ensure you receive the right treatment for your specific pelvic floor problem. To find a provider near you, visit our website here for a current list of locations.