Author| Dr. Maureen O’Keefe, DPT pelvic health, pregnancy and postpartum specialist
Why does my c-section scar hurt years later?
Here at Purple Mountain PT in Grand Rapids, MI, we routinely help people who have c-section scars that hurt. Our clinical specialization in pregnancy, postpartum recovery and pelvic floor physical therapy gives us unique insights into those pesky c-sections scars that hurt. We work with individuals in person in our clinic and online via telehealth. Our patients comes to us throughout the lifespan and some of our patients, whose kids are no longer babies, still have C-section scars that hurt. After your healing is complete following your cesarean delivery, your scar should not hurt you, but the truth is that anywhere between 7-18% of women develop chronic scar pain from their c-section. The good news is that you are not stuck with this painful scar tissue. We are licensed physical therapists who specialize in postpartum recovery, scar tissue mobilization and developing treatment plans that optimize your healing process, calm down your pain and enhance your scar mobility. Our specialty in pelvic health, pregnancy and postpartum care, c-section recovery, visceral mobilization, bladder, bowel and pelvic organ prolapse gives us unique insights into c-section scars that hurt. If you would like to learn more about our treatment methods to alleviate scar pain, contact us here.
What can you do for a cesarean scar that hurts years later?
Cesarean scars that hurt for years can still benefit from physical therapy that provides specialized scar tissue treatments and abdominal wall and pelvic floor recovery care. We commonly work with women who have developed scar adhesions and can recollect pain in their scar for years. Our clinical experience, patient feedback, and published research have all found that using advanced fascial and visceral release techniques to old, painful cesarean scars (and any other scar) can help resolve pain, improve function and optimize bladder, bowel and pelvic organ function. We provide physical therapy for women following cesarean and vaginal delivery to optimize postpartum recovery, even if you gave birth years ago. Our treatment plans include scar tissue and fascial recovery, to facilitate improved movement of your scar, viscera and muscles. While we all expect that a cesarean delivery is a painful medical procedure, none of us are expecting to have chronic c-section scar pain; if you fall into the 7-18% of women who do experience chronic c-section scar pain, please reach out to us. To inquire about cost and availability of our services, contact us here or call 616-516-4334 to learn more.
If you experience challenges with your c-section recovery, our licensed physical therapists are here for you! We provide you a treatment plan that includes pelvic floor PT and helps resolve your chronic scar tissue pain.
We have found that our patients tell us that the care they’ve received with us has improved their healing process, even when their cesarean delivery was decades ago. Improving the trigger points and fascial restrictions in and around the scar and also in areas far away from the scar can alleviate your pain and improve your function. Our licensed physical therapists have post-graduate training specific to chronic abdominal and pelvic pain, chronic c-section and other surgical scar treatment and pelvic floor dysfunction. We offer treatments, such as visceral mobilization, scar mobilization, trigger point release, pelvic floor dysfunction recovery, diastasis recti abdominis rehabilitation and more to help overcome the pain that a c-section scar can cause. To learn more about these treatments, contact us here or call 616-516-4334.
How many women experience C-section scar pain?
One paper examined the prevalence of c-section scar pain found the following:
18.3% of women at 3 months post-birth
11.3% at 6 months postpartum
6.8% at 12 months postpartum.
That’s a lot of people! Nearly 7 women out of 100 who have a cesarean delivery will have pain a year later! Flip these numbers and you’ll notice that nearly 82% of women have NO PAIN by 3 months after giving birth.
We recommend starting physical therapy before 3 months postpartum, especially if you are having pain. But, it is never too late to start! Some of our moms have adult children and are grateful to finally get the care they have needed for decades.
Our treatment plan for every patient, regardless of the age of their scars and adhesions, includes scar tissue work. We work with scars that are decades old and are able to meaningful improve these so there is less pain, adhesions and symptoms, like bladder urgency, related to scar issues. If you are reading this and wondering “should my c-section scar still hurt?”, chances are that, no, you should not be having ongoing pain and that physical therapy can help you. To learn more about cost and availability of our licensed physical therapists to help you during your old c-section scar that still hurts, contact us here or call 616-516-4334.
Our licensed physical therapists perform fascial release techniques that have been shown to help alleviate cesarean scar pain
One study provided fascial release techniques and scar tissue manual therapy to women who had chronic cesarean scar pain for 6-9 years following their cesarean delivery. In this study, the women reported high pain levels in the premenstrual period, with bowel movements and with any pressure on their scar. One woman also reported pain when she was trying to move around in her bed. Our physical therapists have advanced training in manual therapy methods, including fascial release techniques, to treat scars. The women in this study experienced resolution of their pain! This is huge. Their pain rating scale was 0 out of 10 after they completed treatment. Using these fascial release techniques, the scars were measured and their mobility and tolerance to pressure both improved. If you are interested in learning more about our treatment plan that comprehensively helps address old c-section scars that hurt, call our office at 616-516-4334 or contact us here.
In one study about c-section scar pain, women reported it hurt when:
*At Rest: Most women reported mild pain when at rest.
*They move: Moderate to severe pain with movement was present at 3 months and tended to decrease for some, but not all women, by 12 months.
*With Activities of Daily Living: Because your c-section scar hurts, this study found your activities of daily living were compromised.
Characteristics of chronic C-section scar pain
The women we work with who have chronic cesarean scar pain describe to us a lengthy list of what it feels like to have c-section scar pain. While this is by no means a complete list, any pain you experience in or around your cesarean scar is a valid experience. Some things our patients report vary and include:
- My c-section scar feels tight
- My c-section scar feels pinched
- I don’t like to touch my abdominal muscles or cesarean scar
- My c-section scar hurts, it can throb, when something comes in contact with it, like my pants
- I can’t have a baby or child in my lap, because I may experience sharp pain in my lower abdomen and scar.
- My cesarean incision always hurt, from day one! It was a really painful medical procedure, a major surgery! I feel like my healing process was not right from the very beginning.
- Sometimes I have pain with bowel movements; it can feel sharp in my abdomen.
- Sometimes when I reach behind me, twist or roll in bed I get a catching feeling, sharp pain or something that says “nope, you shouldn’t move that way.”
- My cesarean scar looks asymmetric, puckers and pinches.
- When I try to pull it up or to the side, it just won’t go. It feels very tight and can feel throbby.
- My c-section scar burns or feels like there’s nerve pain.
Adhesions, tension and stiffness causes chronic c-section scar pain?
As your incision site heals, it goes through 3 stages of developing scar tissue.
- The first stage is the inflammatory stage, when beneficial inflammatory factors flood the tissue for the purpose of cleaning up the wound and beginning the process of scar tissue development.
- The second stage is the proliferative stage, when collagen and other cells begin to fill in the defect caused by the incision site.
- The final stage is remodeling and, in this stage, your new collagen scar tissue becomes more organized and structured, so it is stronger.
When someone experiences chronic pain from a cesarean section or any other surgery, often we find that their healing process may have led to scar tissue that is contracted and stuck to surrounding structures.
In many cases, the person sustained an infection in their postoperative days, but this is not always the case. If you are wondering why does my c-section scar hurt years later, come to an appointment with our licensed physical therapists and you will receive answers. We help you uncover what’s going on and also find a path forward to resolve your c-section scar pain. We find that chronic c-section scar pain has myofascial layers (abdominal muscles, connective tissue, nerves, blood vessels) that often have adhesions and are not able to slide and glide properly. The result is tension and stiffness in the scar tissue and nearby structures. If you have tension and stiffness in nerves and tissues that should be able to easily move when you are going about your daily activities, it is likely you will experience scar pain. In our postpartum recovery physical therapy, we provide skilled treatment to all types of scars, including adhesions, c-section scars, laparotomy scars, robotic scars, perineal tears, episiotomies, keloids and scars that had prior infections.
The physical therapy treatment plans that we provide for individuals who have any abdominal or pelvic pain, especially if it is pain that is related to a cesarean delivery scar, always includes a variety of manual therapy methods, such as visceral mobilization, trigger point release, fascial release to the scar, joint mobilization and massage. Our licensed physical therapists also incorporate exercise, postural correction, movement, stretching and core and gluteal strengthening into a recovery plan for anyone with chronic abdominal and pelvic pain. If you are interested in learning more about our treatment plans to help resolve abdominal, pelvic, back or hip pain, you can call our office at 616-516-4334 or contact us here.
What are some of the predictors that your C-section scar is going to hurt?
If you have chronic c-section scar pain, please know that you have not done anything wrong. We don’t always know why one person’s c-section scar hurts years later whereas another person experiences no pain. Some of us simply lay down more scar tissue, develop adhesions and experience more nerve pain than others. Our licensed physical therapists are able to help you navigate the complexity of chronic abdominal and pelvic pain. If you are wondering “why is this happening to me?”, we do have some research that investigated risk factors for chronic c-section scar pain.
The risk factors for chronic c-section scar pain:
*How did it feel those first 24 hours? Higher pain intensity with movement within 24 hours of giving birth. This is an important indicator for women because this continued to be the associated with higher pain levels at your baby’s first birthday.
*Did you experience low mood before your C-section? Depression present before the operation was a risk factor for ongoing C-section scar pain.
*Did your operation take a long time? Longer duration of surgery was found to be a predictor of ongoing c-section scar pain.
Could my bladder, bowel or prolapse symptoms be related to my c-section scar tissue?
Because your cesarean scar and incision site penetrates all the layers of tissue in your entire abdominal wall, it can affect how your entire abdominal and pelvic region function. Scar tissue that is altering the ability of your abdominal muscles and pelvic floor to work optimally might contribute to back pain, hip pain, pelvic pain or abdominal pain. Scar tissue might cause non-optimal forces through the abdomen and pelvis, resulting in worsening of pelvic organ prolapse symptoms. Scar tissue might cause pinching or pulling when your bladder or bowel fill up. It is common that our patients have urinary urgency, frequency or incontinence. We also find our patients experience painful bowel movements and sometimes difficulty emptying their bowels. In our work as pelvic health specialists, this is why we examine and treat every scar, even if you don’t have any scar pain. Our experience with providing fascial release and visceral mobilization to all types of scars is because our licensed physical therapists have advanced training in these manual therapies and cesarean recovery. Because we specialize in pelvic pain, we have written a variety of articles, you may be interested to read this. To get your questions answered, you may contact us here or call our office at 616-516-4334.
About Purple Mountain PT’s Treatment for Chronic Pain in C-section Scars
Purple Mountain Physical Therapy is a specialty pelvic health clinic that serves women, men and children in Grand Rapids Michigan. We help kids and adults overcome pelvic conditions, including chronic abdominal and pelvic pain related to old c-section scars that still hurt. If you are looking for solutions for why does your c-section scar still hurt years later, we are here to help you. Our c-section recovery program helps women who are newly postpartum and women who have old c-section scars that still hurt. Our physical therapists focus exclusively on pelvic physical therapy and we’ve written before about chronic c-section scar pain. The treatment plans we provide for c-section scars and other scars that are adhered and cause pain, are comprehensive, effective and offer whole-body care. We have training and techniques specific to ongoing c-section scar pain, pelvic floor rehabilitation and abdominal wall recovery. If your c-section scar still hurts and you know that something doesn’t seem right, give us a call to get help. Our doctors of physical therapy are here to help you feel like yourself again. Give us a call at 616-516-4334 to learn more about cost and availability or contact us here.
Peace,
Dr. Maureen O’Keefe, DPT specializing in pelvic floor physical therapy, pregnancy and postpartum recovery for 25 years.
