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A caesarean section is a major abdominal procedure in which several layers of the abdomen are cut. Any break in tissue continuity can lead to postoperative adhesions.

Adhesions are, in a way, a side effect of the tissue healing process. It also happens that the body itself is prone to adhesions.

So how should a properly healed scar and its surrounding area behave after a caesarean section procedure?

  • It should be mobile,
  • tissues relative to each other should move,
  • it shouldn’t look like something is pulling it from the inside,
  • it should not cause symptoms such as a „pulling sensation” or pain
  • it should not be sensitive to changes in the weather

An untreated scar and so-called “leaving it alone”, can lead in a further stage to:

  • increased tension in the pelvic area and includes: pain during intercourse (which was not present before pregnancy), urgency, urethral pain, and increased painful menstruation),
  • pain in the abdomen and the entire pelvic area
  • pain in the lumbosacral spine
  • pains in the groin area
  • a pulling sensation in the groin and towards the thigh
  • neuromuscular irritation
  • limitations in mobility
  • changes in body posture, its deterioration


If there is pain in or around the scar, a gynaecological consultation will always be the basis. Once gynaecologic factors are ruled out, it is possible to work with the scar.

The basis of scar physiotherapy is a thorough interview with the patient. We then perform a thorough analysis of the patient’s postpartum body movement from postural assessment, including body posture assessment, range of motion tests, and functional tests. This is followed by a palpation evaluation to determine the degree of tissue tension, its mobility, and possible pain on touch in other surrounding parts of the body.

After evaluation, the therapy consists of mobilization, manual therapy of the scar and the areas closer to or further away from the scar, depending on the needs. The patient receives thorough guidance on preventive care and ergonomics of everyday life. At the same time, in order to make the process of scar therapy more effective, the patient always receives a homework assignment which is individually tailored to the patient’s needs (it can be exercises or independent work with the scar).

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