february 2022

C-section Scar Massage: A Step-by-step Guide

A post c-section massage is one of the most important things for a women’s health after having a c-section. This step-by-step guide will provide you with the best knowledge you can use to massage your scar and help it heal.

15 min read Cathy Tabner birth recovery Recommended Products
C-section Scar Massage: A Step-by-step Guide
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A post c-section massage is one of the most important things you can do after having a c-section to care for and help your scar to heal. Initially, the scar can be painful, and if left alone, scar tissue can be problematic, causing problems in your pelvic floor muscles and the abdominal wall. A scar massage can prevent these complications and help heal your scar.

How can massage help with c-section scars?

A massage is beneficial for your caesarean section scar as you help the scar tissue from growing in unwanted places, help smooth out thick scars and increase blood flow which is beneficial for c-section scar healing. The healing process takes time and occurs in 4 stages:

  • The first stage is haemostasis, where clotting factors in your blood stop the bleeding
  • The second phase (inflammation stage) is scabbing over and clearing away toxins and infections
  • The third phase (proliferation stage) is the rebuilding stage, and this is when you can benefit the most from massaging your scar. Once healed and formed, it can feel itchy and sensitive as the nerve endings within the tissue are actively healing. It may feel numb in places or tingly to the touch, or even painful if pressed on. It still looks red at this point but does fade over time to normal skin tone
  • The fourth phase (maturation stage) is when the scar strengthens. Your scar tissue can form for more than a year after your C-Section. When the body no longer produces scar tissue, the scar is mature. Massage can still be beneficial

How to massage the C-section scar?

Use gentle oil for e.g. coconut oil or vitamin E oil to massage your scar. Our Fantastic Skin Elastic is great for minimising scar appearances and soothing scar tissue. When you’re ready, coat your index fingers in serum, use the thumb and fingers, and start massaging using small circular motions. Use comfortable pressure so that the scar can move but is not painful. After massaging the scar itself, massage the area around the scar by gently pushing the skin while applying pressure. In other words, give yourself a gentle abdominal massage. The aim is to loosen the scar from the tissue.

What is the best way to massage a C-section scar?

You will want to be gentle when massaging your scar in its initial stages until it becomes less red and painful.

Stage 1 - the skin

You can begin gentle massage after your 6-week check-up, or sooner if the scar is considered well healed. Initially, the scar may be quite tender, red, and painful, and it may be best to work around the actual scar itself, working the tissues above and below it, depending on the length of the scar. As the scar becomes less tender, you can follow this procedure with your fingers directly on top of the scar itself:

  • Wear loose comfy clothes with easy access to the scar area and have your legs out straight and relaxed
  • First, massage the skin gently around the scar with the oil
  • Place your fingertips lightly on the skin above the scar and see how mobile the skin is by moving it up and down
  • If it moves down more than it does up, that’s normal; try to move it more upward. Does it move more quickly on one side than the other? Are you sore on one side? This is also normal. Discomfort is okay but not too much pain, be conscious about trying to relax, too
  • If you find a stiff or tight zone, maintain your hold there and breathe – you may feel a release or the tissues relaxing
  • Use your fingers to move your skin up and down, side to side, and in little circles. Start by working the tissues around the scar and, later, including those on top of the scar as much as your pain and tenderness allows. Eventually, you will be able to pick the skin of the scar up and roll it between your fingertips

Stage 2 - muscle layer

Just below the skin and fat is the muscular layer, and you may or may not feel your abdominal muscles, but they are there. It is ok to feel slightly uncomfortable during this massage, but it should not be painful.

  • Allow your fingers to melt deeper into your abdomen and check to see how this layer of tissues move
  • If one side moves less than the other side, this is normal. Most people find one side of the scar is more restricted than the other side. It may be that the knot from the stitches finished on that side or that some nerves have been compressed, but there usually is a side which is more sore
  • Do the same movements as with the skin, keeping fingers deep and embedded in the flesh, moving them up, down, side-to-side, and small circles around the scar
  • Have your fingers on top of the scar as much as any tenderness allows. Adhesions where the scar tissue attaches to your bowel can occur so you can work further out and around the scar as you would like to
  • Focus on any area of tightness to encourage movement in that direction by moving the tissues to where they don’t want to go and then gently holding them there for a few seconds
  • You may feel a slight burning sensation, which is normal for stretching in the tissues. Hold until you feel a softening or melting of the tissues or the feeling that the scar tissue is releasing a little under your fingers
  • Do not be too heavy-handed with the massage. Go at your own pace - until you feel some softening and improvement in the area under your fingers

Do not use extreme force as this can cause tissue tightening, where it will refuse to release. Most importantly, relax, breathe, and massage to the point of tenderness, not extreme pain.

Stage 3 - deep muscle

In the last stage, you are working down at quite a deep level. If you’ve ever been checked for appendicitis or had kidney problems, a doctor would have felt your abdomen this way - it is a massage which is firmly moving the deeper tissues.

  • Bend your knees to slacken your lower abdominal tissues. This helps you to massage the deepest layer
  • Remember, your fingers need to sink deeper into the tissues around your scar area
  • Massage at your scar level on the surface and lower near the pubic bone. Try to sink further into the muscles and see if you can move these deeper tissues side-to-side up and down
  • This deeper level massage can prevent you from developing lower back pain or frequency of urination in years to come
  • Make sure both sides are massaged well and feel equally mobile. If one side is tighter, take the massage in the direction it doesn’t want to move in until you can’t move it any further. Gently hold it there until you feel the tissues melting and releasing under your fingers
  • Relax and breathe deeply, then recheck the tissue’s mobility to see if it feels the same from side-to-side

How long should I massage my c-section scar?

Develop a routine that feels comfortable for you. Once you are ready to start in the first few weeks after the birth, begin with 5 minutes daily until your tissues are freely moving in all directions with all three layers. This may take a few weeks or longer- everyone is different. Then reduce to a weekly massage, notice any stiff or tight areas, and work with them. Then you may want to massage the area every so often. The week after your period finishes is a good time, as you won’t have any additional tenderness or irritation. This massage routine is good to do monthly to 6-weekly, up until the 2-year mark from birth. If you find the tissues getting tight again, slip back into a more regular weekly massaging pattern. You can also use our Soak for Bits which contains Epsom salts to help relax the deep muscle fibres before your massage.

Whether your scar is new or a few months old, massaging your scar frequently is good for preventing problems such as releasing scar tissue and increasing mobility. If you are experiencing any issues with your scar, a postnatal massage, or postpartum massage, may help with healing. It is a full body massage performed after the first 12 weeks after giving birth. If you require more information, contact your doctor or a pelvic physical therapist for more individual guidance.