Some might consider a C-section scar a badge of honor. Others, a symbol of motherhood and love. And some — let’s be honest — would just like the cesarean section scar to heal and fade as soon as possible. Wherever you fall on that spectrum, you are not alone. About one in three women in the United States gives birth via C-section every year. That means there are more than a million new moms who, like you, are contemplating their surgery souvenirs. 

Love it or not, your C-section scar is there to stay. But there are techniques you can use — including scar tissue massage and desensitization therapy — that can help it look and feel better.

Benefits of C-Section Scar Massage

When scar tissue forms near an incision site, tissue fibers arrange themselves in all directions. Bands of scar tissue can sometimes adhere to nearby connective tissue, muscle layers, or organs. 

“Think of normal tissue like two layers of saran wrap with oil in the middle, allowing for an easy glide,” explains Amanda Welter, DPT, and Hinge Health pelvic floor physical therapist. “But when scar tissue and adhesions form, the oil is instead like honey, which creates stickiness and restriction with the layers of tissue.” This can lead to problems with your pelvic floor muscles and abdominal wall. It may also cause bladder symptoms, pelvic pain and back pain, and even complicate future pregnancies.

Some studies suggest scar tissue massage may help. Also called soft tissue mobilization, the technique has been shown to help loosen scar tissue, reduce pain, and increase blood flow to the area to help the scar heal faster.

Scar massage also helps flatten and soften the scar over time and decreases pigmentation at the incision site, so it becomes less noticeable. Another benefit: massage improves skin tightness and elasticity. This can help prevent overhang or “shelf” belly, which is when your tummy hangs over your C-section scar.

How to Massage Your C-Section Scar

In most cases, you can start scar massage as soon as the incision line has completely closed, with no signs of redness or infection. “It’s important to note that ‘closed’ is not the same as healed,” says Dr. Welter. “Gentle massage before the scar is fully healed helps facilitate optimal healing.” Before you begin, check with your healthcare provider. 

A cesarean birth involves cutting through several layers of tissue. C-section scar massage should gradually target these layers, starting with the outermost skin. As scar tissue becomes less tender, you can begin mobilizing the muscle layer beneath, and with time, deeper tissue. Here is a guide:

2 to 4 weeks postpartum

Wash your hands well with soap and water. Then, using just your fingertips, lightly touch the skin above and below the scar line.

4 to 8 weeks postpartum

As the tissue becomes less tender, use slight pressure to massage around the scar. Pinch and lift the skin around the scar gently between your fingertips and roll it in different directions. Try moving it up and down, side to side, and diagonally.

8 to 12 weeks postpartum

To target the muscle layer, apply a little more pressure into your abdomen — above, below and directly on top of the scar.

12 weeks postpartum and beyond

To mobilize the deepest layers of tissue, apply firm pressure without causing pain. (Think of the force you’d use to knead bread dough, erase pencil marks with a pencil eraser, or scrub stubborn stains off of a surface.) 

How often should you massage your scar? Get into a routine that feels comfortable for you. At first, aim for five to 10 minutes, twice a day. As the tissue layers move more freely in all directions, you may reduce the frequency to a weekly massage.  At about 12 to 18 months, a surgical scar is considered fully mature. After that, C-section scar massage won’t provide the same healing benefits.

Scar Desensitization: Turn Down the Pain Volume

Sensory nerves function like pain alarms in our body, alerting you to injury. Your C-section incision disrupts sensory nerves in the surrounding skin, causing numbness around the incision. The lack of sensation can be permanent, or it may fade during the months after surgery. But for some, as the nerves regrow around the incision site, they can become hypersensitive (or too sensitive) to stimulation. That can mean even the slightest touch or pressure causes extreme discomfort and pain. 

Desensitization therapy essentially recalibrates those nerves. It helps change how your nervous system interprets the sensation of touch in a hypersensitive area, retraining the brain to turn down the pain volume. Over time, your scar area should have the same level of sensitivity as the skin around it when it rubs against underwear, for example, or stretches when you stand up.

How to Perform C-Section Scar Desensitization

This technique builds your tolerance for touch by practicing with a variety of fabrics and textures. Similar to C-section massage, you can begin desensitization as soon as the incision line has completely closed. Some guidelines to help you get started:

• Start soft and build slowly. Begin by gently rubbing your scar with a very soft fabric, such as a cotton ball or silk. Once that material no longer irritates you, gradually transition to rougher fabrics, such as towels, then paper towels or soft Velcro, and eventually something more abrasive, such as jeans or corduroy.

• Keep it short and frequent. Practice desensitization for short periods — three to five minutes at a time — several times a day.

• Concentrate and relax. To help retrain your brain, pay close attention to the sensations you’re experiencing. Look at your scar as you rub the materials against it and think about what you are feeling. Practice relaxation techniques during desensitization, such as deep breathing, to help your brain associate touch with relaxation instead of pain.

Pelvic Floor Physical Therapy for C-Section Healing

If your C-section surgery causes symptoms such as low back or pelvic pain, urinary urgency and frequency, constipation, or pain with sex — or you aren’t seeing improvements after a month or so of C-section scar massage — a pelvic floor physical therapist (PT) can help. A PT can help mobilize scar tissue with manual therapy to help ease symptoms and encourage healing and provide pelvic floor exercises and other interventions to help improve pelvic health.   

Pelvic floor physical therapy is a comprehensive treatment that also includes education, behavioral and lifestyle strategies. 

You can see a physical therapist in person or use a program like Hinge Health to access a PT who specializes in pelvic health via telehealth/video visit.

PT Tip: ‘It’s Never Too Late’

“For hypersensitive scars, starting desensitization sooner rather than later (after your incision is closed) can save you years of discomfort,” says Amanda Welter, PT, DPT, a Hinge Health pelvic floor physical therapist. “But it’s never too late to reap the benefits. You can improve hypersensitivity even for scars that are fully healed.”

How Hinge Health Can Help You

If you have pelvic pain or symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

 References

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3. Deflorin, C., Hohenauer, E., Stoop, R., van Daele, U., Clijsen, R., & Taeymans, J. (2020). Physical Management of Scar Tissue: A Systematic Review and Meta-Analysis. Journal of Alternative and Complementary Medicine, 26(10), 854–865. doi:10.1089/acm.2020.0109

4. Garg, S., Dahiya, N., & Gupta, S. (2014). Surgical Scar Revision: An Overview. Journal of Cutaneous and Aesthetic Surgery, 7(1), 3–13. doi:10.4103/0974-2077.129959

5. Gilbert, I., Gaudreault, N., & Gaboury, I. (2022). Exploring the Effects of Standardized Soft Tissue Mobilization on the Viscoelastic Properties, Pressure Pain Thresholds, and Tactile Pressure Thresholds of the Cesarean Section Scar. Journal of Integrative and Complementary Medicine, 28(4), 355–362. doi:10.1089/jicm.2021.0178

6. Lubczyńska, A., Garncarczyk, A., & Wcisło‐Dziadecka, D. (2023). Effectiveness of various methods of manual scar therapy. Skin Research and Technology, 29(3). doi:10.1111/srt.13272

7. Stupak, A., Kondracka, A., Fronczek, A., & Kwaśniewska, A. (2021). Scar Tissue after a Cesarean Section-The Management of Different Complications in Pregnant Women. International Journal of Environmental Research and Public Health, 18(22), 11998. doi:10.3390/ijerph182211998

8. Wasserman, J. B., Abraham, K., Massery, M., Chu, J., Farrow, A., & Marcoux, B. C. (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