A C-Section is a major surgery, 7 layers of fascia and muscle are cut to birth the baby and postpartum healing is essential. But healing doesn’t commence once the incision has closed.
Adhesions and scar tissue are present in each of the 7 layers. Clients typically bring up their scar for aesthetic reasons and before coming to us were unaware of how many of their current pelvic floor dysfunctions are rooted in that scar tissue.
This is how I explain it to my clients. Imagine you are wearing a one piece bathing suit that fits you perfectly, then you cut it at the same place as the c-section and stitch it up tight. You’ll start to feel it ride up and the shoulder straps will start to feel like they’re pulling you forward. That’s what happens when we have scar tissue present in the abdominal wall. Even small surgeries like appendectomy or even laparoscopic surgeries can leave scar tissue that can affect our core function. Over time the adhesions and scar tissue becomes more dense and your body will start to compensate because of the reduced core function which causes strain on other parts of the body.
So common symptoms we see in postpartum clients that had a c-section
Pelvic floor tightness
Pain with intimacy
Low Back Pain
Hip Pain
Knee Pain
Numbness at and around the scar
A “weak” core
Feeling like you can’t engage your lower ab muscles
Aesthetically clients refer to stubborn lower belly fat or a “mom pooch” and a raised noticeable scar.
It’s a common belief that if you don’t birth your baby vaginally your pelvic floor has been spared but the pelvic floor is affected by pregnancy regardless and many clients who have had a c-section spent time pushing prior to the surgery. All postpartum clients need internal manual therapy to address pelvic floor tightness and c-section clients get external treatment of their scar to break it down. Recently we started offering Shockwave Therapy which has had some amazing results when treating c-section scars. It not only treats the scar aesthetically but actually penetrates the layers of muscles and fascia to help restore blood flow and build collagen.
About the author
Dr. Allison Feldt, PT, DPT
Allison is a pelvic floor physical therapist and the founder of Body Motion PT in Edmonds. A mom who knows the aftermath of pregnancy and birth firsthand, she's on a mission to help women restore their core and pelvic floor at every stage of life.
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