Inspiration

SCAR MASSAGE - POST OP AND POST NATAL RECOVERY

Megan Vickers

Scar Massage - Why this is an essential part of your post -op and post-natal recovery

What is scar tissue?

Scars are a normal process of wound healing. Healing takes place in four sequential, overlapping phases; Haemostasis, Inflammation, proliferation and remodelling. It is the remodelling phase where scar massage can be of huge benefit. 

phases-of-wound-healing
  • Haemostasis: The very first stage of wound healing, in the formation of a blood clot, bridging the sides of the wound. 
  • Inflammation: Essential for tissue healing as the “inflammatory soup” contains all we need to repair. During this time the scar will be swollen, tender and red. This resolves within 1-2 weeks.
  • Proliferation: This is the process of depositing scar tissue within the wound. This phase lasts up to six weeks, the scar will become raised and hard as large amounts of collagen are being laid down in a haphazard fashion. The body “over-heals” in this phase with more scar tissue than we need in preparation for re-modelling. This phase is characterized by the three R’s: red, raised and rigid and we should wait for this phase to settle before we begin massage.
  • Remodeling: The body works on reorganising the collagen along the lines of stress, softening and flattening the scar. This phase can last twelve to eighteen months. Remodelling is when exercise and massage is most important as the scar matures and some of the collagen is re-absorbed.

 

Why Scar Massage? 

  • Promotes collagen remodeling; softening and flattening the scar
  • Reduces pain and itching
  • Improves numbest and altered sensation
  • Reduces muscle guarding and imbalances

Scar massage is beneficial for any surgical incision, anywhere in the body.  Scars can be painful, cause poor muscle recruitment and adhesions that prevent healthy movement of the organs and tissues below. 

“Normal” tissue fibres are organised in neat lines along the direction of muscle pull (B).  Scar tissue forms itself in a mesh like fashion (A), and if left alone, can be restrictive and uncomfortable.  

Screen Shot 2019-05-15 at 22.10.16

Scar massage can prevent this, mobilising the healing tissue so that it can be re-organised along the lines of stress. Even in the presence of adhesions, massage can help to mobilise individual layers of tissue and restore normal muscle function. 

When & How to scar massage?

Level 1:

This can begin daily 3-6 weeks following surgery/C-section, as long as incision is well healed and there are no signs of infection.

  • Start with no oils or lotions, just your hand against your skin.
  • Using a flat hand make large circles around the area, avoiding directly pressing on the scar. 
  • For abdominal wounds always work in a clockwise direction to follow your bowel. 
  • Your goal is to move the top layer of skin and fascia to gently pull on the healing tissues and re-organise the collagen along their normal lines of stress. 
  • It is normal to experience a pulling sensation around the scar. This is part of the remodelling process. If you feel an area that does not move as easily, spend a little extra time here. 
  • Spend 5-10 minutes on this every day. 
  • Finish with the same motion, applying a lotion or oil to the whole area to nourish the skin and aid tissue mobility. 
  • Progress to Level  2 after 6 weeks. 

 

Level 2:

This can begin daily 6 weeks following surgery/C-section, or as soon as the scar has fully healed.

  1. Always start with Level 1 to desensitise the area and loosen the skin and fascial layer. 
  2. Start with no oils or lotions, just your hand against your skin.
  3. North-South: Using the pads of 2 fingers work just above the scar. Apply firm pressure into your tummy then pull upwards until you feel a tightness, then pull downwards, maintaining your deep pressure. Repeat several times until the tightness begins to ease, then move along, staying just above the scar. Repeat in both directions; left to right and right to left.
  4. Repeat North-South just below the scar and directly on top of the scar.
  5. Circles: Using the pads of 2 fingers work just above the scar. Apply firm pressure into your tummy then draw circles, stretching the tissues in all directions. You’re aiming to move the layers in a circular direction rather than draw circles on the surface of the skin. Repeat moving along the scar left to right and right to left. 
  6. Repeat Circles just below the scar and directly on top of the scar.
  7. Finish by massaging an oil or lotion directly into the scar using the same circular motion. 

Spend 5-10 minutes on this as part of your daily routine.

Megan demonstrates how to do scar Caesarean scar massage here: https://www.youtube.com/watch?v=DXeWlxPrC8k

Level 3: EXERCISE

Specific to the recovering muscles. This should be taken as soon as you feel able to. Contracting the muscles around the scar is an essential part of the remodelling process. As you contract the muscles you will pull along the lines of stress, restoring the muscles natural movement and rhythm. 

Lotions and potions: 

To aid healing and elasticity of the scar at the end of your massage we have tried and loved the following: 

  • Vitamin E oil
  • Silicone Strips or gel – worn 12 hours every day for 6 months

 

If you have pain when massaging or are struggling with technique we can help you. In our Post-natal MOT’s and Physiotherapy appointments, scar massage and release is a normal and essential part of the rehabilitation process. 

Megan