What’s going on with your Post C-Section/Hysterectomy Tummy?

In my job I see a lot of ladies post-surgery and I love giving their tummy some love.

I help them to understand what might be going on at a physical, mental and emotional level….don’t forget a lot of these surgeries can be very emotional for some ladies so they need this support as well.  I gently guide and support them on their individual journeys back to health and wellbeing, get them functioning again and I love watching how they grow in strength and confidence during this time.  It’s like watching a butterfly hatch

When I see you for your first assessment there are 10 areas I look at with regards to the scar and tummy:

  • Skin stretched beyond recoil.  Lots of changes happen to the abdominal wall during pregnancy.  The skin stretches and can leave permanent marks, fat can collect around the lower trunk, and no matter how much diet or exercise, it can seem that the tummy always “pooches”.  The abdominal wall is composed of many layers: skin, fat, fascia, muscle, etc.  Skin normally has elasticity – up to a certain point.  This means that you can pull on the skin and when you let go, the skin will recoil back to its normal shape.  The layer of the tummy that provides the most strength and shape is the fascia and muscles.  The stretching of these tissues during pregnancy cause the “pooching” that occurs afterwards.  A separation of the vertically paired abdominal muscles (rectus abdominus) can occur in the midline creating a weak spot (diastasis).  Even performing sit-ups, planks or other core exercises to strengthen the muscle are often not effective to eliminate the “pooch”.  In fact they may be adding to it due to the additional intra-abdominal pressure created when performing them.  This is when we need to go deeper with specific core and pelvic floor exercises, soft-tissue work and nutrition.


  • Excess fat.   This may sound harsh but there is no judgement here at all but maybe this lady is carrying excess adipose tissue and we need to start working on nutritional and lifestyle protocols to help this lady to lose some of the excess which in turn will help her to heal and recover.  I’ve got to say however this isn’t my main focus it’s just part of the picture.  I care more about functionality rather than physical appearance.  Once I help this lady to understand the importance of a nutrient dense diet then I usually find the excess starts to drop off all by itself especially when we’ve done some soft-tissue work on and around the scar to help free it up.


  • Lack of movement/fascial restriction.  This is a massive one with regards to your abdominal muscles being able to function properly.  Fascia surround individual muscles, muscle bundles within individual muscles, groups of muscles, blood vessels, and nerves.  It binds these structures together in much the same manner that cling film may be used to hold the contents of your sandwich together. It extends from the top of the head to the tip of the toes and this is why I take a holistic approach to healing.  Abdominal surgery has the potential to impact the whole front line of the body.  When fascia is stretched beyond its normal load-bearing capacity, it begins to tear.  These micro-tears can be caused by sports injuries, repetitive trauma, postural distortions, falls, child bearing etc.  Collagen microfibers are then laid down in-between the fascia to help them heal.  Unfortunately these do not automatically go away after the area has healed so they tend to accumulate over time.  This means that over time, the elastic, collagen-based tissues (particularly muscles and fascia) get increasingly stiffer and less stretchy.  I see this a lot in abdominal scars and this is where we then get a lack of movement, mobility, fascial restrictions and a loss of function.


  • Nerve Damage. Abdominal surgery can sometimes lead to chronic nerve or pelvic pain.  For people whose abdominals or pelvic nerves have been cut, stretched or otherwise damaged during abdominal surgery the conditions can be very disabling.  In this case I would be referring the lady to a specialist who could diagnose further.


  • Numbness.  I get asked a lot by ladies “will the numbness go away?” and the answer to this is how long is a piece of string?  Everyone is different. An injury that cuts a nerve can lead to numbness in the area where that nerve works.  The area immediately around the incision is often numb after surgery and may continue to be numb for several months after surgery.  I’ve worked with some ladies who’s scars are still numb 10-20 years post-surgery!! With some soft-tissue work I’ve witnessed ladies start to feel areas of their bodies they haven’t felt in years.  This can be a very emotional time for them as you can imagine.


  • Poor ‘early days’ recovery.  Ideally I would love to work with ladies pre-op to really help them plan this part of their recovery.  Get everything in place before the surgery so they can just rest, recover and allow their bodies to heal.  Most ladies I know are back driving/back at work 3-4 week post-op!!  Back to lifting and carrying items that really should be avoided.  These early days are crucial for your long time health and recovery.  If you know you are having abdominal surgery soon then please get in touch so I can help you plan your recovery.


  • Poor ‘early days’ nutrition.  This is linked to number 6 really but honestly nutrition is HUGE with regards to healing and the more you can plan and prepare pre-surgery the better.  Feeding yourself healthy, nutritious food is going to help your tissue to heal and improve the quality of your connective tissue in order to heal and to build itself back up.  Inflammatory foods/drinks such as sugar, alcohol, dairy, caffeine (yes I know all the good stuff!) take you one step further from healing. I’m not asking you to give them up forever…I would just love you to think about doing it for those first 6-8 weeks post-surgery to really give yourself the best chance.



  • Lack of attention (trauma/acceptance).  Again this one is huge and one that is hugely forgotten about.  I can’t tell you how many ladies have opened up to me whilst on my treatment bed.  The lack of support after the surgery and the actual surgery/procedure itself can stick with ladies forever and there is a massive missing link in this picture.  Ladies need support at this time. A debrief so they can talk to people about what happened, why it happened and a chance to ask questions so they can accept it and start to move on with their lives.


  • Constipation.  One of my favourite topics with my ladies is Bowel health.  Constipation can play a huge role in how your tummy is looking and feeling.  Constipation/trapped wind that can lead to bloating that be very uncomfortable and make people look 6 months pregnant.  Having regular bowel movement with no straining is crucial for core and pelvic health and abdominal massage can help to get things moving in the right direction. We should be a type 3 or 4 🙂


  • Giving Up! I’ve got one thing to say…..NEVER GIVE UP ON SOFT-TISSUE!!  I’ve worked on scar tissue that is 10-20+ years old and got great results.  Never accept that you have to live in discomfort.


I hope this blog has helped you to understand what might be going on with your post C-Section/Hysterectomy tummy.  If you would like help then you may be interested in the following services I provide:

C-Section Recovery Programme

C-Section, Hysterectomy and Scar Adhesions Massage

C-Section Scar Massage and Mobilisation Workshops


Looking forward to help you heal and recovery in the safest and quickest way.



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