Mobilizing your incision is beneficial for a multitude of reasons:

• Improves aesthetic appearance, decreasing the shelf or puckering

• Decreases pain and sensitivity

• Decreases symptoms of pelvic pain and/or urinary frequency

• Improved firing and mind-muscle connection with the lower abdominals for increased efficacy of strengthening exercises

Your incision needs to be completely healed before starting scar massage. It should be a light pink color with no scabbing or peeling at all. This usually occurs by the 6 week mark, but can sometimes take longer, especially if there were complications of infection, debridement, or delayed healing. If it is not healed yet, you need to wait to perform direct scar mobilization.

Start on your back and expose the scar. Without lotion, start to lightly touch the scar to get used to this sensation. The reason to do massage without the lotion is to get more friction/tension behind your fingertips so the tissue doesn’t slide as much. You can add in abdominal massage with lotion.

As you get used to touch, you can gradually increase the tension and pressure. This can be over the course of weeks to months. I recommend scar massage at least 4 days/week for about 5-10 minutes per day. If you are able to do it most days, that is beneficial.

With your finger tips, move the scar:

• vertically, up and down

• horizontally, side to side

• clockwise circles

• counter clockwise circles

• pin and pull - pin the tissue down below, sink fingers down and gently pull the tissue to opposite direction

• pinching and lifting the scar

You may feel more tightness, soreness, or restriction on one side - this is common. This is an area that you may spend a bit more time on.

You should not be in a lot of pain doing this. Your pressure and tension are very gradual. If you feel sharp or intense pain, you need to decrease the intensity. If you feel okay during but feel a significant soreness or notice bruising the next day, you need to lighten the intensity.

As you progress mobilizing the scar, you can try different positions: sidelying, sitting, standing, kneeling, etc. If you notice more of a shelf in standing, that would be a good position to also do scar massage in.

The goal through all of this is to allow all of the layers of tissues to move independently over each other. You want skin, fat, fascia, muscle, to be able to slide, stretch and move without pulling on the layers above and below. Scar tissue is laid down in an unorganized matrix (think of the game ‘pick-up sticks’). During the first year, the scar tissue is still in the remodeling phase and can be influenced and reorganized with mobilization. As you continue this over the course of the first year, you should see an improvement in the mobility, decreased pain/pulling, as well as less puckering and adhesions.

If you are over a year postpartum, it is definitely not too late to see advantages of scar massage, but it may take much longer bouts of consistency.