Painful C-Section Scar, Diastasis and Adductor (Inner Thigh Muscle) Tension…A Fascinating Tale!

I saw a client recently regarding her Diastasis and painful C-Section scar and felt compelled to share this story with you with her kind permission.  As the title of the blog says, it's about C-Section scar pain, Diastasis and randomly the Adductor muscles (inner thighs).  A perfect demonstration of how IT'S ALL CONNECTED.  And we always have to look at the bigger/wider/holistic picture when working with this client population...ALWAYS!  Here goes.....

A potential client contacts me to request C-Section Scar Release Massage/Therapy after being passed a link from her Pilates teacher for a blog on Holistic C-Section Healing I wrote HERE....

And yes indeed,  just below and above the actual scar was adhered and 'stuck' and causing quite a lot of discomfort.  Also, on further investigation, an area where removal of suturing had been less than perfect was also causing discomfort. For all of these areas, I performed a  gentle, hand and soft tissue/myofascial tool assisted massage which helped immensely and had almost immediate effect (reported by client after session - see below).

But rarely in the world of bodywork is THE ISSUE that brings the client to the treatment room soley THE ISSUE.   Try this for size (NOT if you are still healing your C-Section). Place your fingers just above your pubic hair line and your thumbs just under your belly button and hold the flesh that you can trap quite firmly so that your movement feels restricted.  Now, lean back and LISTEN to where else 'speaks', lean to the sides (into the frontal plane) and LISTEN  to where else 'speaks'.  Try to rotate and also LISTEN to where else 'speaks'.  Can you feel the repercussions of the entrapment caused by your fingers holding your flesh lower down in your thighs at the front and also possibly in the adductors?  Can you feel a restricting tension at the sides of your hips (technical language: TFL, top of IT Band and possibly into Glute Max fascia?)  Can you feel the tension in your pubic mound?  Do you get a sense of restriction in your obliques?   Amazing isn't it?  The effects of the restriction can be felt quite a distance away from the actual 'problem'.

Ultimately, when the client presents with an achy scar, the therapist has to look wider than the actual C-Section scar.  We need to be looking above and below on the kinetic chain and also examine possible links within the Myofascial Lines that traverse the 'target area'.  In this case I feel both the Front Myofascial Functional Line and and the Superficial Front Line (as described by Thomas Myers) are very much a part of solving this puzzle and even if we just think about the Front Functional Line and implications for both the healing of the C-Section and also the healing of the clients' Rectus Diastasis (stretch of the abdominal wall at the midline) we immediately start to get  a better idea of how we can help this client to heal and rid herself of pain.

 

Front & Back Functional Lines

 

On palpation, it was highly visible that even the most gentle drawing downward on the flesh of the Adductors and thigh muscles, there was a highly evident pulling down of the C-Section Scar.  And indeed when you look at the journey of the Front Functional Line you can see exactly why.  I used a normal hand massage using transverse strokes and a very small myofascial foam roller to release both areas.

Next, I also though about the typical clamping/use of instruments during the C-Section procedure and how this too could create 'binding' adhesions around the width of the pelvis that too would cause discomfort.   So as well as massaging directly above and below the scar we also have to go wider and work on the sides of the pelvis and the upper abdomen and time permitting, I would even go right around to the buttock and the top of the IT Band (it inserts into Glute Max).

The public mound is also often overlooked as an area in need of massage, but it too can hold a lot of tension/adhesion that's liable to 'pull' on a C-Section scar.  Obviously, the pubic mount is an incredibly personal place so I always use a small Polycarbone IAM Tool for this and this work is performed over a thin sheet or over the client's underwear.

There are two more pieces to the puzzle with this client that I unfortunately didn't have time to explore but will at our next session....the Front Functional Line is seen as a continuation of the arm lines, it begins with the pectorals and connects to the lower ribs, where it has myofascial continuity with the Rectus Abdominis then on to the pubic bone and down to the thigh muscles.  So there is a continuity and communication between all these constituent parts of this Front Functional Line during activity.

The Anterior & Posterior Arm Lines

 

This is a new mom, plainly and typically showed signs of  Upper Crossed Syndrome (below).  Could possibly the lack of functional length at the arm lines including pectorals (chest muscles) be increasing pressure in the abdominal wall, having a negative effect on her healing Diastasis?  And could any potential tension within the intercostals from rib-flaring during pregnancy (the client is very small in stature) still be residing and also contributing to poor Diastasis closure?  Note:  the Internal Obliques (side abdominal muscles)  interdigitate the ribs too and hypertonicity there also has the potential to pull away from the midline tissues.

Upper Crossed Syndrome

If you are working with women and have no idea of what happens during a C-Section, just Google and check out a video!  Preferably before a large meal 🙂  There's a lot of disruption to the entire abdominal wall.  So during the 'recovery period' a great idea would be to either offer (if you are a therapist) or seek out (if you are a mom) a true remedial/recovery massage for not only your abdominal area with emphasis on releasing scar tissue but also your legs, hips, upper abdomen, intercostals (in between your ribs), back, shoulders neck, face and head - IT'S ALL CONNECTED and ALL IMPORTANT for a truly holistic and long lasting recovery.

Ultimately, the trauma experience at the abdominal wall is utterly reflected throughout the entire body because of the intrinsic link between muscle, fascia, nerves, blood vessels, lymph etc., and in your journey back to full function - inside-out - viewing the bigger picture is ESSENTIAL.

So I guess, this blog will be completed after the next therapy session when we take a look at the Intercostals and Pectorals but here is what the client reported after the first session.....

"Wow - I honestly didn't expect to feel such a difference. The minute I started walking home I noticed the whole area feeling so much 'lighter' and freer - almost texted you in my excitement!  It is only now that it has been relieved that I realise how much tightness and 'pulling' I was experiencing. It also feels better to the touch. Just hope I can keep it that way!"

To be continued................

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If you're a fitness/wellness professional without therapy skills you'll love the content of the On-Line Advanced Post Natal Exercise & Core Restore Certification.
 In this course you will be taught both hands-on and hands-off solutions to the issues raised above......

 

 

 

 

 

3 Responses to Painful C-Section Scar, Diastasis and Adductor (Inner Thigh Muscle) Tension…A Fascinating Tale!

  1. Lindsay June 28, 2015 at 12:55 pm #

    Oh how I wish that you were in the US! There is a huge lack of care and education here for us Moms who had to have c sections. Thanks for all your great information!!

  2. Tanya March 10, 2018 at 6:59 am #

    Hello
    Not sure if you are UK based?
    I’m really struggling with so much you have written about here. Can you help??

    • jenny March 29, 2018 at 11:58 am #

      Hi Tanya, yes, I’m in the UK. Whereabouts are you? For sure, I can find someone to help you…..

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