Our bodies have the beautiful and amazing ability to heal after a trauma. However if the cut or tear is deep enough, we do not heal with the exact same tissues as before. Instead, we put down scar tissue to heal the damage.
Scar tissue is made of collagen fibers that are typically not as elastic or strong as our original skin.
Scar tissue is laid down in accordance with the amount of pressure and forces we place on it. This is why it's important to start mobilizing your c-section scar (once it is fully healed of course), to tell the body where and how to place the scar tissue.
Let's talk C-Section Scars
Many people, including healthcare providers, associate a Cesarean Birth with better long term outcomes for pelvic floor dysfunction. There is a false assumption that because the pelvic floor muscles are spared from tearing or trauma, that the risk of prolapse and incontinence is less following a C-Section.
But this is incorrect. The abdominal wall and healthy abdominal muscle activation are essential components to staying continent and supporting the organs in the body. The pelvic floor certainly does not perform this task in isolation.
A C-Section injures the abdominal wall and interrupts its ability to activate, often requiring rehabilitation.
Scar tissue from a c-section is intense. It is far more extensive than what is visible from the outside. A C-Section requires cutting through 7 layers of muscle and tissue. Scar tissue is often found all the way up to the navel. Scar tissue in the abdominal cavity can create problems for our organs.
Our GI system needs to be free to move around in our abdominal cavity in order to digest food. Scar tissue can sometimes wrap itself around our organs and restrict movement, and in the worst case scenario, result in a GI obstruction.
I saw this happen to a 95-year-old woman who had a c-section in her 30's!
Mobilization of the scar tissue itself is essential for healing the c-section, but so is regular abdominal massage or visceral manipulation of the organs to keep everything moving and flowing as it should.
C-section moms also have a higher risk of lingering Diastasis Recti, and can have challenges restoring hip and pelvic mobility due to tight C-section scarring.
Check out the videos below for self GI massage and C-Section scar tissue massage at home!
Let's talk Perineal Tearing and Episiotomies
Yes, it's true. Tearing vaginally puts us at the highest risk of developing pelvic floor dysfunction. It most commonly occurs during mom's first birth.
This is because an injury has occurred to the muscles that directly control support of the pelvic organs and sphincteral function.
Scar tissue will form along the tear or surgical incision (episiotomy). Once the scar is fully healed, I recommend doing scar tissue massage and pelvic floor muscle rehabilitation.
It's important the scar tissue along the vagina is smooth and moves well, especially for sexual function and subsequent births. The vaginal canal is elastic and meant to stretch, if a chunk of tissue is adhered due to scarring, pain and inflammation of the tissues will result.
Not all moms will need strengthening of the pelvic floor muscles following tears, but it's important to find out. Asymmetrical pelvic floor musculature can create a dysfunctional pelvic floor.
Most moms need to rehabilitate supporting musculature to the pelvic floor such as the abdominal wall and hip stabilizers in order to prevent incontinence and prolapse.
Make sure you get the help you need to heal.
If you are experiencing any of these issues or just want to learn more, book a session here today!
Handa, V. L., Blomquist, J. L., Knoepp, L. R., Hoskey, K. A., McDermott, K. C., & Muñoz, A. (2011). Pelvic floor disorders 5-10 years after vaginal or cesarean childbirth. Obstetrics and gynecology, 118(4), 777–784. https://doi.org/10.1097/AOG.0b013e3182267f2f