Belly Birth Scar Care And Core Activations

/ Eastridge Chiropractic Co./

Let’s talk about scar tissue

Scar tissue needs to be addressed to prevent loss of mobility and to ensure normal strength and range of motion. Sources say scar tissue can continue to grow and change for 12-18 months after it’s formation. It is not a permanent fixture in the body, and can be remodeled and reduced to allow it to tolerate the stresses and forces the body encounters. Taking care of your scar is not only important for aesthetics, but also for the function of your core!

Scarring can commonly cause:

  • Pain, itchiness and sensitivity around the scar

  • Low back, pelvic and sacral pain

  • Discomfort with bending and lifting

  • Bladder urgency and frequency

  • Trigger points with referral to the urethra and clitoris

  • Pain with sex

  • “Shelfing” look or lack of tone in the lower belly

Before working directly on your scar, make sure:

  • You are 6 weeks post-surgical

  • No severe incision pain

  • No bleeding

  • No stitches or staples

  • No infection, redness, pus or fever

Prior to 6 weeks

  1. Scar Care

Goals:

  • Bring nervous system connection to the belly 

  • Bring blood flow to the belly

  • Activate deep core & pelvic floor

What to do

  • Light massage with circular pressure around the scar along the abdomen/belly, changing from clockwise to counterclockwise

  • Gradually increase the amount of pressure every day. Do not cause pain.

  • Spend 2-5 minutes massaging in the morning and evening daily to establish good mind body connection, bring blood flow and encourage healing.

2. Deep core activations

Transverse Abdominal Activation Cues

  1. Imagine a wire between your front pelvic bones (ASISs) and generate a force to pull the bones together.

  2. Imagine the front of the pelvis is like an open book with each cover on a pelvic bone (ASIS). Now close the book covers.

  3. Pull lower belly away from the pelvic bone.

Multifidus Activation Cues

  1. Imagine a wire between your SI joints and generate a force to pull the SI joints together.

  2. Imagine the back of the pelvis is like an open book with each cover on a SI joint. Now close the book covers.

Perform 3 sets of 10 reps (or as many to 10 as possible), and 3 sets of 30 second holds (or as close to 30 seconds as possible)

3. Pelvic floor activations

These cues help to activate all the layers if the pelvic floor muscles, which is the goal when doing pelvic floor muscle training.

  1. Imagine you are drinking a milkshake through a straw up through your vagina. The goal is to hold this for 30 seconds. How long can you hold it?

  2. Imagine you are picking up a blueberry with your vagina. The goal is to pick up 10. How many can you pick up?

  3. Activate your anus as if holding in a toot. Now, pull the anus up, and towards your pubic bone. Can you do this 10 times?

  4. Imagine the vagina as an elevator and you are slowly pulling up to the top floor. The goal is to take 5 seconds from top to bottom, and perform 10 times.

When performing these pelvic floor exercises, put your hands on your belly, medial to your iliums.

4. Diaphragmatic breathing

Place both hands on the side of your rib cage. Take a deep breath, driving the breath into your hands. You should feel your rib cage go up with the inhale, and down with the exhale. Next, place one hand on the front of your chest, and the other on your midback. You will feel the belly “go along for the ride” meaning it will come up and down slightly. It is important not to drive the breath into the belly, and into your ribcage and diaphragm instead. Finally, place one hand on your upper shoulder, and the other hand on the side of your neck, right above your collarbone. Take a deep breath. Do you feel this area contract or your shoulders go up and down? We don’t want this! These muscles are considered the secondary muscles of breathing, and we want the primary muscle, your diaphragm to be doing the majority of the work.

Take 2-5 minutes and practice diaphragmatic breathing

Now, do it ACTIVE:

Inhale through the nose into your ribcage (front, back, and into sides). As you do this, your diaphragm will come down, your lungs will fill, and your belly will expand slightly. Exhale though your mouth and allow the air to exit while engaging your pelvic floor and transverse abdominis.

Scar Care Post 6 Weeks

Why Massage?

Massaging helps to mobilize the scar, and to allow the fibres within the scar tissue to align properly allowing proper mobility and reducing pain. Massaging prevents the scar tissue from pulling on the surrounding tissues such as the skin, muscle and organs affecting functions of the bladder, sex, pelvis, etc.

How to massage

  1. Continue with the circular massage around the scar with light pressure. This light pressure allows us to address the more superficial layer, the skin. Bring this massage over the scar as well, changing from clockwise to counterclockwise. Make sure to mobilize and pull the tissue in every direction.

  2. Repeat the circular massage along the abdomen and scar with medium pressure. This allows us to address the deeper muscular layer.

  3. Repeat the circular massage a third time along the abdomen and scar with firm pressure. Make sure to avoid any pain. This deeper pressure allows us to address the deep visceral layer.

  4. Finish up with “skin-tugging” and “skin pulling” along the scar. With firm pressure pull the skin, stretching it in all directions. Think of creating *asterisks* in 5 spots along the scar. You may feel like the skin is stretching, and stuck in some areas more than others. Give these areas extra attention.

  5. Perform this for 5 minutes, twice daily.

At 2 weeks, we recommend a postpartum evaluation with your chiropractor. At this point, we can evaluate the scar, assess the function of the core, pelvic floor and diaphragm!

A specific postpartum rehab and return to fitness plan will be made to advance you from the basic core and pelvic floor exercises and diaphragmatic breathing, to something more fun, dynamic and functional.