Think of the scar tissue formation like the game of pick-up sticks, with different fibers going in many different directions whereas the fibers in the tissue it is replacing are all oriented in the same direction.
For some mothers, the scar tissue formation may not affect them. They may notice some decreased sensation around their cesarean scar and some light pulling while it is healing.
For others, however, the cesarean scar tissue can have lasting and negative impacts such as: reduced skin mobility; nerve irritation in the scar tissue or skin surrounding the scar; pain or increased sensitivity in the skin around the scar; feeling of tugging or pulling around the scar.
This could then also impact posture and alignment and lead to other muscular pain; increased tension in the muscles (and fascia) around the scar and increased urinary
As pelvic health physiotherapists, we usually don't start treatment until the patient is about six weeks postpartum, and the scar looks like it is well healed, and there are no signs of infection.
If the scar does not look like it is healing properly, there is still significant inflammation in the scar or around it or if it is unusually tender we have the person check back with their doctor.
If the person’s pain or dysfunction is coming from scar tissue formation, scar tissue mobilisation can be a great way to improve function and decrease pain. The massage/ mobilisation technique encourages realignment and lengthening of the scar tissue fibers so that they are not obstructive to the normal tissue.
Thus, each layer of skin moves independently from another. This allows the scar tissue in each layer to be oriented more favorably so that there is more skin movement and less restriction.
As a physiotherapist, we might also utilise other modalities such as dry needling and other soft tissue mobilisation techniques to address the scar tissue restriction. Another important part of the scar tissue massage is the desensitisation of the nerve fibers around the scar.
Often after a surgery, injury, or trauma, nerves in the surrounding area become more sensitive than the nerves in the un-injured tissue.
Our sensory nerves function in our body like pain “alarms” letting us know when something is dangerous and could cause us harm. Oftentimes, after an injury has occurred our nerves can become a little too sensitive.
I like to think of this like your fire alarm going off when you have burnt toast. Yes, there is a little bit of smoke, but there is no real danger from burnt toast. Thus, we need to “recalibrate” our pain alarms. Scar massage can be a great way to do this.
Ms Yusa is a physical therapist at Chiropractic & Physiotherapy Health Centre in Nairobi
PAYE Tax Calculator
Note: The results are not exact but very close to the actual.
