C-section adhesions & the shelf

Thirty-seven percent of births in the US are via c-section. That’s a lot of moms with c-section scars.

C-sections are performed by a surgeon by traversing the skin, fascia and muscles. The main myofacial structures affected include the abdominal fascia, rectus abdominis, transverse abdominis, and the internal and external obliques. After incising these structures, the surgeon enters the abdominal cavity and of course, the uterus.

A c-section is deemed very safe and often is vital for the health of baby and mom. But it results in a scar that is made up of tighter, less flexible tissue. After the incision heals, the fascia hardens and can produce myofascial adhesions. These can feel tight and knotted and can even cause pain or restricted movement.

What are scar adhesions and how they contribute to the c-section shelf

A c-section shelf is also known as an overhang or section pooch. These names are used because of the shelf like appearance that results from tissue restrictions and excess fat accumulation and/or loose skin that hang over the scar. Shelves are due to layers of the healing tissue along the incision adhering to one another creating an indented, stuck scar. During the healing the process, collagen is deposited along the incision to build tissue strength. This collagen can be laid down in a very chaotic pattern forming adhesions between the layers of abdominal tissue and pinning them down. The most visible of these layers is the skin but there are also deeper layers that you can’t see. Restrictions at any layer can cause a C-section shelf to occur.

Not just the aesthetics

The hip bone is indeed connected to the back bone and EVERYTHING else. Our muscles, organs, nerves, blood vessels, and skin are all attached to one another via our fascia. When one area of fascia is disturbed, as occurs with a c-section, ripple effects are felt throughout the entire body. A C-section scar sits on top of the bladder and extends all the way past the abdominal muscles. This means scar restrictions at these deeper levels can cause issues beyond the visible c-section shelf.

These issues can include: Diastasis Recti, Urinary incontinence, Urination frequency, Decreased bladder sensation, SI joint or Low back pain, Constipation, Restricted body movement, Scar sensitivity / pain and Pain with intercourse.

Treatment

Diet and exercise will not make a shelf go away. Surgery will work but not everyone wants to go to that extreme route. So where does that leave you?

Treatments options to minimize a c-section shelf include: Myfascial Release (MFR), Scar mobilization, Cupping, Microcurrent Point Stimulation (MPS), Dry Needling (DN).

These manual therapy techniques encourage realignment and lengthening of the scar tissue layers. This helps the tissue in each layer to orientate in a more favorable fashion so that there is more movement and less restrictions thus decreasing the c-section shelf.

You don’t have to just live with scar adhesions or your c-section shelf!