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C-Section Scar Massage
C-section scar massage is probably the biggest thing you can do to help your recovery that you're NOT doing. In fact, most women have never even heard of it. And a lot of women won't dare to touch their scar, even years after giving birth.
After other types of surgery, physios often encourage patients to get moving early on, and will perform some scar tissue massage, we know that it can really help the healing process and prevent complications later down the line.
Lots of women report numbness, sensitivity, soreness, swelling or pain in the area, years after their c-section(s). Starting some massage early on can help prevent these sorts of issues.
Why does it help?
What happens is all the layers of tissues, when healthy, are supposed to slide and glide over one another. After having surgery, they form adhesions - or kind of stick together in places. Massage helps mitigate this, but also helps the scar tissue become more supple.
It can also encourage the removal of waste products from the area, further aiding recovery of the tissues
When should you start?
You need to wait until the incision has healed completely.
I consulted with physio colleagues about it after mine and they got me doing some gentle massage 3-4 weeks post-birth, but this will vary a little for everyone.
How do you do it?
You have to be very gentle and careful in the beginning, you can place an index finger either side of the scar and wiggle it around a little, without putting any pressure directly on the scar. You should work your way along the entire length of the scar. It may feel a little uncomfortable, but it shouldn't hurt.
You may want to start off by doing it while lying in bed, or standing in front of the bathroom mirror - whatever feels more comfortable for you.
In the early stages, it may also be a good idea to gently massage the surrounding tissues, especially the stomach, as this can help to circulate lymph. Fluid can build up in the stomach area and massage can help to clear it out. (It definitely won't make your tummy "ping" back into place, but it may help bring the swelling down a bit).
Once everything is completely healed, it's a lot easier to incorporate it into your weekly routine as you don't have to be careful and you can just do it in the shower with soap. You can go over the scar itself and apply much more pressure.
(It's worth noting here that when I got my bandages removed after a couple of days, I was told to wash the area with soapy water twice a day - while you won't want to massage the area at this stage, you might think of it as the prelude to massage, by gently touching the scar).
Why haven't I heard of this before? Why does no-one talk about this?
Physios use scar tissue massage with other types of surgery, but no-one talks about it with c-sections! It's bonkers!
It's like all the early recovery stuff... I talked a lot about what do do from day 1 after a c-section, how to slowly incorporate movement into your daily routine to prevent aches and pains. After any other surgery, physios get involved immediately to get you moving, even though it hurts. We know that not moving at all is a great way to get stiff, that movement, even with injury, is important for getting blood and lymph flowing and preventing aches and pains.
But when I discussed these things online, I literally got hate mail from someone that my message is damaging to women, that I shouldn't be telling them to do anything other than remain completely still in bed - this idea is so ingrained in us, but it's not how we approach recovery from other events like injuries, illness or surgery. We certainly encourage people to rest, and we don't encourage them to exercise, but gentle movement can absolutely be part of the rest and recovery phase.
I assume it's to do with the sheer numbers of women giving birth, logistically we can't give them all individual attention postpartum from physiotherapists, so we just tell them to rest.
It's also likely to do with people's inability to see the grey area. Most people have a binary approach to information, a kind of all-or-nothing attitude. They are either on a diet, or going bananas. They are either exercising every day, or doing no exercise whatsoever. It's very hard for most people to compute "just do a little bit of gentle movement". It gets interpreted as "go to a bootcamp, do some sprints and burpees".
The psychological side
It can be difficult for some women to touch, or even look at their scar, especially, but not only if they had a traumatic birth experience or if they didn't want a c-section.
It is important to internalize it, and to integrate it - both the experience and the physical scar. Denying it, avoiding it and shoving it to one side doesn't ever help. Touching, massaging and exploring the scar can really help process the experience and accept the scar as part of your body. It can bring up emotions for some, and for almost everyone it's difficult to look at in the beginning, but physically touching it with your own hands can help you own both the experience and the physical scar.