Why should you massage your C-Section incision?
Having a C-Section delivery, whether planned or an emergency is invasive and causes trauma and edema to the surrounding tissue. A caesarean birth can harbour a wide range of emotions because of its location on the vulnerable part of the body; and its link to a woman's image of herself as a woman and mother.
It is very important to keep the incision clean and dry to avoid irritation and infection. Itching is a common sensation; either pubic hair regrowth, or a normal part of the healing process. Holding a cloth or towel over the scar can help to reduce this itching sensation, whilst learning how to gently massage the area will also increase blood flow and encourage healing.
Symptoms of redness, swelling, extreme or worsening pain suggests you should see your GP. Any oozing or weeping of the incision suggests there may be an infection and needs prompt care.
Other symptoms experienced after a C-section can be sensations specific to the scar itself, but can be more globally experienced in the body. Sensations around the body that might be related to the surgery and recovery, and let us know the scar and surrounding areas could use treatment are:
o pain, burning, or discomfort during intercourse or penetration
o clitoral, vulvar, or labial pain
o numbness or highly sensitive sensations around the scar
o lumpy or hard spots over or around the scar
o feeling of tightness or rigidity around the scar
o pelvic pain, lower back pain, pain in the groin
When can you begin your C-Section massage?
The general guidelines are that C-section scar massage can be started after the scar has fully healed. You should get the 'all clear' at your 6-week postnatal checkup with your GP if there is no infection and the scar has closed over. But it is never too late to start scar massage. Even if it has been years or decades since you had a C-section, you may experience benefits from starting now.
It is important to begin slowly, building confidence in touching your own scar, becoming more familiar with how your body feels, and getting the tissues moving with your own hands on your body. If wanted, you can use any natural, non-abrasive oil (coconut, almond, olive, etc) on your fingers and skin to help the tissues move more easily. That said, it can sometimes be useful to have some ‘grip’ on the skin. Start with gentle pressure applied to the skin and progressively increase the pressure used as comfort level increases. You do NOT need to use extremely hard touch to experience results.
There should not be pain with these techniques.
There might be sensations of pulling, stretching, burning, or some discomfort. I want to acknowledge that it can be unnerving and highly emotional to touch the scar directly - or even look at it - for some. I recommend starting to massage the belly well above and below the scar, if that is more comfortable, and moving closer to the scar itself when/if you feel ready.
How often should I do my C-Section massage?
Massage can facilitate increased blood flow which is beneficial for healing the area. Scar tissue forms during recovery and is less pliable/flexible than the original tissues. Myofascial stretching and massage or mobilisation work can help the tissues move with less restriction. Additionally, regular massage can help re-train the sensory nerves which may have switched off, or they might be on high alert. Massage provides some calm with touch and pressure.
There is evidence to suggest that the appearance of scarring can be reduced with mobilization techniques. While someone could practice scar massage daily, it is not likely to be necessary to experience benefits, or will not be possible for most mothers to find the time!
You might want to aim to practice the routine 3-4 times per week.
The best time of day to do the scar massage? When you remember to do it!
For many, this will be when they get into bed at night. I encourage my clients to set a timer on your phone and follow the directions for the 4-minute routine from there. You might want to test out the massage routine for 2-4 weeks to see if you notice any change or shifts in the sensations or symptoms, and continue only if you enjoy the process, or if you are experiencing benefits.
Gayle Hulme, BScPT. Founder and Physiotherapist at Lakeview Physiotherapy in Calgary, Alberta.
Jessie Mundell, BPHE, MHK, P.Kin 4 Minute Caesarean Scar Massage
Wasserman, Jennifer B. DPT, PhD; Abraham, Karen PT, PhD; Massery, Mary DPT, DSC; Chu, Jennifer PT, MS, WCS; Farrow, Alicia DPT; Marcoux, Beth C. DPT. (2018). Soft Tissue Mobilization Techniques Are Effective in Treating Chronic Pain Following Cesarean Section: A Multicenter Randomized Clinical Trial. Journal of Women's Health Physical Therapy, 42(3). 111-119. doi: 10.1097/JWH.0000000000000103
Kathe Wallace, PT, BCB-PMD. Retrieved from: https:// kathewallace.com/resources/abdominal-scar-massage/Cesarean Scar Massage - A Closer Look. Leah Milne. MsCPT, Pelvic Health Physiotherapist. Retrieved from: https://lakeviewphysio.ca/blog/cesarean-section-scar- mobilization-a-closer-look