While giving massage therapy, I often come across scars. They are usually results of operations of all sorts. Scars are similar in the sense that once they are healed, they must be tended to – be it the result of laminectomy, arthroscopic knee surgery, appendicitis removal, hip replacement or C-section. You have all reasons to ask: why is it necessary when it is healed anyway? Simple. Adhesions might form in between fibrous tissues, which are connected to other soft tissues, so they might be impacted. At first, this might not be noticeable at all; it can take years for the first symptoms to appear. In this article, I would like to present to you by the example of post-C-section scars why you should tend to them, how they affect the rest of our body and what changes they might bring upon us.
I focus on these types of scars, because very high percentage of births result in C-sections in Hungary. While only 29% of births were delivered via C-section in 2006, it rose to 35% by 2010 and 40% in 2018. Given the ever-rising tendency, it is very likely that someone in our family or circle of friends will have a scar related to caesarean delivery. According to the WHO, the ratio of C-sections should not exceed 15 percent to ensure quality care and recovery.
A 2014 study revealed that adhesions are responsible for the frequency of the subsequent obstetrical and gynaecological operations in 51%. Adhesions are also believed to be one of the main causes of endometriosis. They can often cause chronic pain at the scars as well, which may radiate to other parts of the body. As tissues are connected, this may effect our movement patterns, which may cause even further issues along the way. A study which spanned from 2005 all the way across 2011, 41% of C-sections are succeeded by post-operational adhesions. These adhesions lead to symptoms of all sorts, including chronic stomach pain, the clogging of small intestines, unsystematic menstrual cycles and infertility.
You can avoid all of these provided that you tend to them in time. Soft tissue scar treatment can reduce pain and pressure sensitivity, increase scar resiliency as well as improve the aesthetic look of the scar. (Creams recommended for scar can only help in only whether the scar appears at all.)
In the research which I share with you today, two women with scars received treatment. The first woman was 35 years old who had two C-sections in 2005 and 2007. The second was 33 years old who also had caesarean delivery in 2008 and 2012. They both suffered from constant pain during bowel movements as well as when pressure was applied to the lower part of their stomach. The first woman experienced acute pain when she changed position in bed, and she said it was about 4-7-level pain.
(On the pain index, 1 is the sense of pain you hardly feel at all, while 10 equals excruciating pain)
Both women experienced an increased level of pain two weeks prior to ther period. The second woman had no significant pain in general scenarios, but she did experience a sense of burning discomfort upon touch. Prior to the research, neither of them sought treatment for their pain.
They underwent treatment every two weeks and they received 4 massages per person during the time of the study. Treatments lasted 30 minutes so they could fit them easily into their daily schedule. The massage therapies first started with a myofascial release technique applied to the pelvis and the stomach – this eased tissue mobility in certain layers. In addition, they also received deep tissue massages and stretching exercises. What’s more, they did not have to do any related exercise at home at all, yet, the condition of both women improved a great deal by the end of the treatments.
While the first woman suffered from level 4-7 pain, it completely ceased to exist after the last treatment. This held true for the second woman as well, although she claimed to have experienced only level 1 pain. The sensibility upon touch had decreased significantly, however, and the sense of burning discomfort also passed. In addition, the mobility of scars had also improved. Both women claimed that they experienced a huge change during treatment.
The study shows that a few well-targeted treatments may bring around significant change in our lives. As far as I am concerned, it helps a lot if we tend to our scars at home as well, be it massages, exercise or any other preferred techniques. The actual time spent on it is less important, just make a daily or weekly regular habit. It is completely natural, if it feels like a hassle at first to tend to our scars. We might even feel the scar being alien in a way, that is, not belonging to us at all. You must be patient with yourself and your body as well. Perseverance will bring around gradual change and in time, it won’t be difficult for you to touch you scar(s). We don’t have to live side by side this pain unless we want to. There are no scars which cannot be treated.
As a farewell gift, here is a video to assist you during your self-massages at home. It can help you treat you post-C-section scars. (It is only 13 minutes long)
Source: Chronic caesarian section scar pain treated with fascial scar release techniques: A caseseries
Jennifer B. Wasserman, DPT, MSc, Jessica L. Steele-Thornborrow, DPT, Jeremy S. Yuen, DPT, Melissa Halkiotis, DPT, Elizabeth M. Riggins, DPT
