Scar Tissue Management  - Legacy Physical Therapy

Scar Tissue Management 

According to the international pelvic pain society, studies say up to 25% of the population is affected by pelvic pain. A lot of people don’t think of scar tissue as a common source of pelvic pain. 

Scar tissue is a normal part of healing from an injury or from surgery. Some examples of surgical procedures that can create scars include C-sections, abdominal hysterectomy or other abdominal surgeries. Scars can also form if tearing occurred during vaginal delivery or if an episiotomy was performed & stitches were done. Scar tissue responds to the amount of stress or strain applied to them and can continue to form and remodel at times 1-2 years after the initial incision. We frequently see women who are dealing with chronic pelvic pain that never had scar tissue evaluated for how well it moves which can directly contribute to pelvic pain. 

There are things that can be done early in the scar formation process to ensure your scar moves freely and heals well. Some women are scared to touch their scars or have a certain disgust, nausea or anxiety feeling when looking at or dealing with their scars.It is okay to touch your scar! We want you to be comfortable with all parts of your body, including your scars. 

The first couple weeks post-surgery, you need to leave your incision alone to make sure it fully closes and stays clean and dry. Once you have been cleared by your medical provider, you can start on the next phase of healing – Scar desensitization. 

Sometimes, scars can be really sensitive, it can be uncomfortable to have anything touching the scar, even clothing, so going through the desensitization process is important. We recommend using different materials to desensitize including cotton balls, tissues, paper towels, jeans, or soft velcro. In the early stages, don’t go directly over the scar, but move the material over the tissue near the scar. Different textures can create different sensations. If your scar is very sensitive, start with soft material, like a cotton ball or facial tissue. Gently tap or touch the area to help you get used to the feeling. Try to slowly work your way up to the more highly textured fabrics. You can do this for 5-10 minutes, a couple of times per day to desensitize the nerves in that area. This is great to do 1-2 weeks after surgery to help the abdominal scarring become less sensitive and help your nerves relearn how to react. 

Once the scar heals completely, and you have been given clearance by your medical provider, usually around 4-6 weeks, you can start to work on scar tissue mobility. The goal is the scar to be able to respond to natural stretch and stress, mobilization ensures tissue around the scar & the scar itself can move as freely as possible. 

Let’s use an abdominal hysterectomy or c-section scar as an example of how you would do this. Start by making sure you have clean, dry hands and no lotion on your skin. Use a couple of fingers to tap on the scar, and then try to move the scar up and down. Once you have done that on all parts of your scar, take your fingers and hold down the scar, moving your fingers in a circle. You can also move the scar side-to-side on all portions of the scar while holding down the scar. Try lightly plucking or lifting the scar away from your body to get the tissue underneath moving more freely. 


After performing these techniques, It is normal to feel some light burning or have some redness surrounding the area but there should not be any intense pain. Make sure you do not place a lot of pressure over the scar and be sure that the scar isn’t opening up while doing these techniques. That is an indication to stop and that your technique may be too aggressive and the tissue needs more time to heal properly. 

Scar tissue can be a source of pain for long into the future and can cause adherence to pelvic organs, affecting how the organ functions.  Scar tissue mobilization can be effective on old scars as well. We’ve met patients who had a hysterectomy years ago who have benefited from scar tissue release and mobilization to address their pain and get the tissue moving. However, it’s always best to address the scar tissue sooner rather than later. 

We can help with scar tissue that is a few weeks to years out, don’t hesitate to reach out to us to talk with one of our experienced pelvic health therapists click here.

AUTHOR

Brooke Kalisiak

Legacy Physical Therapy

"We help women who are tired of leaking, dealing with pelvic pain, and wanting to get their body back in shape after baby (even if it’s been 30 years) all without relying on medications or surgery."
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