Updated: Sep 15, 2020
There are 1.3 million C-sections performed annually and 7-18% of women have cesarean scar pain after 1 year of their surgery. Chronic cesarean scar pain is more common that people realize. A study by Wasserman showed that soft tissue mobilization (similar to massage) helped chronic discomfort including premenstrual pain, pain upon pressure to the lower abdomen and pain during bowel movements. With 4 30-minute treatment sessions over 2 weeks, they had improved pain and 0/10 premenstrual pain. (Wasserman) Another study found similar results with 4 sessions lasting 30-minutes-- improved scar pain and abdominal pressure sensitivity (Ryan).
Moms who have had a cesarean scar should start mobilizing their scar once it has fully healed, usually around 6-weeks after surgery. We see only the "skin" layer, but there are 7 layers between the skin -- what we see (skin, fascia, muscle, organ) --and the uterus scar. We help not only the skin layer slide and glide, but also the organs (small intestine, bladder, uterus, colon) slide and glide.
Cesarean scars can cause the "layers" to be stuck resulting in:
1) Period pain and cramping: the uterus doubles in size with menstruation and when stuck by scar tissue, moms can experience increased cramping
2) Low back pain: the uterosacral ligaments attach to the sacrum
3) Bladder urgency or frequency: the bladder needs to expand and scar tissue sometimes restricts the bladder's ability to expand
4) Painful sex (especially with deep thrusting)
5) Digestive issues (SIBO, constipation, diarrhea)
6) Difficulty healing a diastasis: pulling on the fascia or muscle layers (causing a pulling apart)
7) Pain with bowel movements
We assess and treat the cesarean scar through the abdominal wall. It is surprisingly gentle and effective and many moms are shocked that their "old" cesarean scar of 10+ years ago is causing them some of the issues they are having today such as back pain, painful sex, bladder issues or abdominal pain and bloating.
If you are struggling with cesarean scar pain, reach out for an appointment locally in Richmond, Virginia or via telehealth in the state of Virginia-- specially trained pelvic health physical therapists are trained to help with cesarean scar pain, low back pain, pelvic health issues and adhesions. Call us at 804-372-0291