They say C-section recovery is the hardest. It’s major surgery after all.  And the scar that you’re left with doesn’t help matters when it comes to well-functioning abs. Read on to discover how your cesarian scar can really disrupt the function of your core.

Muscle Tissue vs. Scar Tissue

Normal muscle fibers run in nice straight lines. When you look at pictures of muscle, there are lots of little lines running in the same direction. Those are the muscle fibers all bundled together neatly.


But scar tissue is a different animal. Scar tissue lays down every which way. It’s mostly collagen and is dense. This creates the tightness you may feel on your scar.

Muscle Injury Tissue Progression. Pre-Injury, Injured, Helaed, Healthy Tissue, Strained Tissue, Scar Tissue. Scar Tissue = Risk of re-injury + range of motion. Scar tissue forms to heal injured tissue leaving the muscle weaker and less flexible. ©2012 MendMeshop ¨Ê

Muscle Injury Tissue Progression. ©2012 MendMeshop


If you had muscles in your shoulders that felt that tight, you would get a massage, right? Well, scar tissue needs massage as well.  A skilled massage therapist has an important job in helping to release that scar tissue. The sooner you can get an appointment to start working on that scar, the better. The scar must be fully healed though. So 4-6 weeks post partum is a good time to start scar massage.


Don’t fret if you’ve never had a c-section scar massage. Even if you’re 3+ years post partum, you can still do self-massage on your scar.


The scar tissue often creates a relationship with the brain. Your brain recognizes the scar as overactive. When one area is overactive, it often means another muscle or muscles are underactive. Unfortunately, this means the core typically gets weak. The scar overrides the function of your abs, hip flexors, glutes, adductors, and possibly more.


How to Check for Functioning Abs

Let me give you an example from my own experience. While I was getting trained in NeuroKinetic Therapy, I told the instructor that I had a c-section. She tested my transverse abdominus (TVA) for function. It failed.


She instructed me to put a couple fingers on my cesarian scar. When I did, she retested my transverse and it tested strong. The simple touch created a relationship between the scar and my brain.


My homework is to release my scar with gentle self massage and do very low intensity TVA strengthening exercise such as the Dead Bug. The key word here is low intensity. It doesn’t matter that I can do harder versions of the Dead Bug. Those harder versions are too intense for my brain to understand at this point. The consequence of progressing too quickly is…other muscles will kick in and help me through those hard ab exercises because my TVA is not strong enough to do it on its own yet.  Then I’m just strengthening the already strong muscles and continuing to neglect the weak one.


I urge you to get your core function assessed if you’ve had a c-section. I can test which muscles are functioning and which are not, then provide corrective exercise homework. Homework includes release of your overactive muscles and activation of your weak muscles. Sounds simple right? It is when you’re doing it right!  This homework is not time-consuming.


This is the part of ab rehab that isn’t talked about enough. Crunches and planks are not the answer to getting your abs back after having children. Thoughtful exercise that addresses dysfunction is a well-rounded approach to building a strong foundation. When we’re too quick to return to exercise in post partum, we neglect the underlying issues and leave our bodies prone to injury and pain later.