Your C-section scar.

So Physio is your holistic physiotherapy clinic in Albany, North Shore and Auckland City Central. Our team is experienced in pre and post natal care & pelvic floor health.

Yes, you read that right. Your C-section scar might be causing you pain. Ladies, this is one to read and take note.

This is one of my favourite things to treat in the clinic because no one would gather that their c-section scar is causing their symptoms. It is also amazing to see what a quick effect it would make on the client’s pain and discomfort.

Some of the symptoms that I have seen caused by C-section scars are:

• Bilateral hip and neck pain

• Lower back pain

• Upper Trapezius pain/tightness

• Sacral pain

• Anterior shoulder pain

• Upper back tightness/discomfort

• Pelvic Floor symptoms

• etc, etc, etc….

So the question is WHY? and HOW?

First - we talk about motor control.

Motor control is the regulatory system in the body which allows execution of human movement via the integration of the signals and information from the nervous system network. These signals and information are collected from our muscles spindles and Golgi tendon which gives us proprioception (the ability to sense where you are in space). These inputs are then channelled through the nervous system network up to the cerebellum. The cerebellum is the center of motor coordination. It then coordinates all the body parts/joints/muscles that are part of the movement pattern and then sends signal to them to execute the movement. For example, you are trying to reach for your cup of water. Sounds simple? Yes, in a certain way it is simple because it is something you have learnt to do when you are a toddler and that movement pattern has been stored and saved in your brain. In reality, however, lifting a cup of water requires movement from many joints and muscles in your body (Core stabilisers, Thoracic extends and rotates, Scapulae stabilisers, Shoulder girdle flexes etc etc…). Each part of your body that has to help you do the job has to switch on and off at the right place and the right time. That’s what we call motor coordination. However, some times they can become dysfunctional.

C-section Scars & Dysfunctional Movement

Many things can cause dysfunctional movements. One of the main ones is scars. The skin is an organ. The skin and fascia are home to nerve endings that sends information to your brain. Alteration to the skin and fascia can change the information being relayed to the brain causing a change in movement output.

The reason why a C-section scar can cause so many symptoms is because it cuts through some of the lower abdominal musculatures and affects the person’s ability to build intra-abdominal pressure (IAP). C-section scars are commonly done transversely above the pubic bone. The incision slices through many important structures like the transverse abdominals, conjoint tendon, iliopsoas fascia and abdominal aponeurosis. These structures are part of your inner core connection which allows for stability at your center of gravity and transfer of stability throughout the whole body. These structures function together like the engine of the car - everything needs to do their own job and create pressure together to prevent any problems.

Many people don’t realise it, but the scar causes a fascial restriction in the area itself which results in the poor building of IAP. I like to tell clients that it’s almost like a leaky balloon, that there is a ‘spot’ that is causing the inability to build proper pressure around the abdominal region.

These tend to lead to compensation in movement and inhibition in some of the other important stabilisers in the body. Most commonly causes back pain because proper IAP pressure cues the core muscles (Transverse Abdominals, Internal Obliques, External Obliques, Multifidus, Lumbar Erectors) to do their job. It can cause pelvic floor dysfunctions because the pelvic floor is a group of tonic muscles and its response is dependent on the diaphragm, transverse abdominals and Internal Obliques. IAP loss can also cause shoulder and neck issues because of the secondary breathing muscles like Sternocladomastoid, Scalenes, Serratus Anterior around the ribs and thorax that kicks in to help with breathing. The list goes on….

Next time you shrug off your nagging back pain that never really went away, that tight hip flexor that is ‘always there’, that uncomfortable feeling in your pubic region, or that bit of stress incontinence you get. Maybe its time to think that it is not normal and potentially your c-section scar is causing all this havoc in your body. Or your episiotomy scar…..

Something to think about. As always I am happy to help.

For more information on the connection with skin, fascia and scars - here’s a good read.

If this sounds like you, don’t wait now. Book in for an appointment now at both of our locations.