Long-Term C-Section Scar Management: Insights from Bea, Pilates Instructor at Drakes Gym
Hi everyone, Bea here! As a Pilates instructor—and a mum who had a C-section myself—I know firsthand how often women are left in the dark when it comes to managing their scar after surgery. In the days and months following my own C-section, the only advice I was given was to “take it easy for six weeks.” I was shocked to learn that hospitals rarely mention the long-term impact of scar adhesions or the importance of keeping the tissue flexible and mobile. Many women I’ve talked or worked with simply don’t realise how scar management can affect movement, flexibility, and even alignment throughout the entire body years after surgery.
When scar tissue goes unmanaged, it can form adhesions—rigid bands that bind tissue together and restrict movement. These adhesions can go unnoticed for years but may lead to discomfort and pain, even affecting areas as far as your hips, lower back, shoulders and knees. For many of us, staying active and pain-free is a priority, so it’s essential to understand how to care for your scar well beyond the initial healing phase. Here’s what I’ve found helpful both personally and with my clients, based on solid evidence and practical techniques.
Why Most Women Miss Out on Scar Management Guidance
Most healthcare professionals focus on wound healing and tend to overlook long-term C-section scar care, leaving many women without the knowledge they need. Unfortunately, this lack of guidance means we often have to be our own advocates, figuring out how to support our recovery and long-term health. Adhesions may go asymptomatic for years, silently impacting the way we move. When issues do arise—whether it’s tightness, hip pain, knee or even shoulder discomfort—it’s often surprising to learn it’s connected to the scar.
Long-term care can make a world of difference, not only for the scar itself but for our whole body. Through my own experience, I’ve put together this guide to help other women understand the benefits of scar tissue massage, targeted mobility, and strengthening exercises that support lasting comfort and movement.
Scar Tissue Massage: Restoring Flexibility and Comfort
Why Massage Matters for Older C-Section Scars
Over time, scar tissue can become rigid, binding to deeper muscle layers and causing a pull on the surrounding area. Regular scar tissue massage can help reduce this rigidity, releasing adhesions and improving flexibility. Research in the Journal of Bodywork and Movement Therapies shows that massage techniques for scar mobilisation can be effective even years after surgery, breaking down adhesions and improving tissue quality. This can ease discomfort and prevent the pull that causes compensations in movement, which is something I’ve seen make a real difference for myself and my clients.
To get started, try these techniques:
- Start with Gentle Circles: Warm up the area around the scar with light, circular movements to increase blood flow.
- Multi-Directional Movements: Use small vertical, horizontal, and diagonal motions across the scar to reduce stiffness and encourage flexibility in multiple directions.
- Consistency is Key: Like anything in fitness, regular practice is what delivers results. A few minutes of scar mobilisation a couple of times a week goes a long way in keeping the area flexible.
A session with a physiotherapist trained in scar tissue massage is a great investment if you want to take it further, as they can help personalise the approach for your unique needs (Did you know cupping can help too?).
Mobility Exercises to Restore Posture and Movement
How Scar Tissue Affects Movement Over Time
When we don’t address scar mobility, adhesions can eventually restrict movement and cause subtle shifts in posture, affecting areas like the lower back, hips, knees and shoulders. For example, the core might lose flexibility, creating tightness in the hip flexors or leading to pelvic tilt. UK-based physiotherapists recommend that women recovering from a C-section incorporate movement exercises that restore flexibility and keep the surrounding muscles mobile.
Here are a few effective exercises to help:
- Hip Flexor Stretch: Begin in a lunge position with one knee on the floor and the opposite foot forward. Gently shift forward to stretch the hip flexors. Hold for 20–30 seconds on each side.
- Thoracic Twists: While seated, gently twist the upper body from side to side. This helps counteract stiffness that develops around the core.
- Pelvic Tilts: Lie on your back with your knees bent, pressing the lower back into the floor and releasing. This simple move eases lower back tension and gently engages the core.
I incorporate these regularly and recommend them to clients with C-section scars; they’re easy to add to any routine and help maintain mobility around the scar, which is key to preventing compensations elsewhere in the body.
Building Strength to Support Core and Overall Stability
Why Core and Hip Strength Matter for Long-Term Recovery
Strengthening the core and hip areas is essential, especially for those of us with C-section scars. Scar rigidity often impacts core strength, causing other areas—such as the lower back or glutes—to take on extra work, which can lead to compensatory pain. A study in the British Journal of Sports Medicine showed that core strengthening for women with abdominal scars improves functionality and reduces discomfort associated with postural imbalances.
The following exercises are gentle and effective ways to build core and hip strength:
- Standing Core Stability Exercises: Light resistance bands are great for these. Try standing side reaches with a resistance band, which engage the obliques and improve stability.
- Glute Bridges: Lie on your back with knees bent, lifting the hips and engaging the glutes. This strengthens the lower back and glutes, helping stabilise areas that can be affected by a weaker core.
- Modified Planks: Start with a side plank on your knees or a full plank if you’re comfortable. This engages the obliques and helps strengthen the core without too much direct pressure on the scar area.
These gentle exercises can help ease any lingering stiffness and prevent compensation issues that can arise as we move through daily life.
Embracing Low-Impact Cardio for Long-Term Health: Walking as Therapy
Why Walking Is a Perfect Post-C-Section Exercise
Walking remains one of the most accessible and effective ways to support scar healing and long-term fitness. Research shows that regular, gentle walking boosts circulation and keeps the core engaged in a low-impact way. Walking not only enhances cardiovascular health but also improves alignment and mental well-being. It’s an exercise I always recommend, especially for women returning to fitness after a C-section.
For best results, aim for 20–30 minutes of daily walking. Remember to keep your posture aligned, engaging your core slightly to support your lower back as you walk. Walking is also a wonderful way to release stress—important for both physical and mental health!
Bridging the Information Gap for Women’s Health
The gap in C-section scar management is significant. Scar tissue management isn’t widely discussed, and too often, we’re left to figure it out on our own. If hospitals and doctors shared more on scar mobility, massage, and strengthening, many of us could avoid the surprises of pain or discomfort years down the line. I hope that by sharing my experience, I can help other women feel empowered to manage their C-section recovery and avoid the discomfort that can arise if scars are left unmanaged.
If you have questions or want guidance on your own recovery, e-mail me at bea@drakesgym.com. Whether you’re months or years post-C-section, it’s never too late to take charge of your long-term health and movement!
References
- British Medical Journal. “Scar adhesion and long-term effects on movement.” BMJ, 2018.
- Journal of Bodywork and Movement Therapies. “Effective scar mobilisation techniques.” JBMT, 2020.
- British Journal of Sports Medicine. “The role of core strength in post-surgical abdominal recovery.” BJSM, 2021.
- Chartered Society of Physiotherapy. “Mobilisation exercises for post-surgical scar recovery.” CSP, 2019.
- Physical Therapy in Sport. “Impact of low-impact cardio on post-surgical recovery.” PTIS, 2020.