What Spiderman can teach us about C-section scars.

What Spiderman can teach us about C-section scars.

Last week I posted a facebook update about C-section scars and asked how many of you had been advised to undertake scar massage following your surgery and healing. I was utterly surprised that not one of you had been given this information. Just as none of the amazing ladies I had spoken with at a presentation recently had either.

So I’ve decided to write a post on the subject. Because I get the feeling this is an issue which is affecting many, many women unknowingly. If you’ve ever had a C-section (or any other type of abdominal/pelvic surgery), if you had a severe perineal tear during birth or if you’ve had gynaecological surgical procedures, such as for endometriosis – then read on!

First post on the subject: What’s an “adhesion”?

This series is all about scar tissue and adhesions, and the impact they can have on your insides! But I’m going to start by talking about hands. Bear with me, it’ll all make sense soon….

I first came across the issue of scar tissue and “adhesions” when I was working in hand therapy. At this time a fair percentage of my clients were angry young men who had punched walls or windows instead of people in acts of displace rage, and had sustained significant traumatic injuries to their hands – a far cry from my current role as a Women’s Health OT! My job back then, as an OT/Hand Therapist was to custom build a thermoplastic hand splint for my client and to develop a rehabilitation program to promote healing, repair, motion, flexibility and strengthening of their hand structures. Part of this was to advise them how to prevent adhesions. In hand therapy adhesions are a big bad. We want to avoid them at all costs, because they can seriously interfere with the functioning of your wrist, hand and fingers. As anyone with opposable thumbs will tell you – that’s pretty important.

Whenever we cut or tear a body tissue, as in a surgical cut or an accidental gash or puncture wound, the body will immediately start to repair itself through the inflammation process and the formation of scar tissue. Now, trust me when I say that scar tissue is a pretty awesome invention – I’m not bad-mouthing it at all. It’s a totally necessary function of our amazing bodies which allows us to repair and put back together parts of our body which have been cut open. Quite important really.

So the primary goal of scar tissue is to close over wounds in the fastest way possible – but left unchecked it will just shoot this scar tissue out everywhere forming messy webs, instead of the nice neat bonds which adhere only to the structures we want them to adhere to.

Do you remember the scene in Spiderman when Tobey MacGuire first realised he could shoot spiderwebs out of his wrists? (Which, btw, is totally gross!) Anyway, he goes a bit cray-cray, shooting webs here, there and everywhere in the privacy of his bedroom – which ends up with spiderwebs soaring all across the room haphazardly, sticking everything together in one big interconnected webby mess.

Yeah. Good one Spidey.

Now, I couldn’t find a screenshot of the scene I’m talking about, so here’s a gratuitous pic of Tobey Maguire without his shirt on instead. You’re welcome.

This is kind of like what scar tissue does inside your body when it’s left to its own devices.

Basically, it goes all Spiderman-in-training on you and shoots little scar tissue tendrils out everywhere. So the scar tissue that is forming within your skin layer might start shooting tendrils down to your underlying muscles – which bonds the skin to the muscles, or it might go further and send tendrils down which attach the muscles to your internal organs – such as your bowel or bladder. This is what we call an “adhesion” when two structures which aren’t supposed to be joined, end up stuck together. This is bad news, because it means that one or more of those structures might not work the way it’s supposed to work from that point on.

Here’s a little activity for you to try. Make a fist a few times with your right hand. See how far tightly you can close that right fist. Now, with your left hand, pinch the skin on the back of the right hand and try to close the right hand into a fist. Notice how you can’t close it as far. Now let go of the skin and see how you can close that fist even further.

This is kind of like what an adhesion does. It attaches the skin to the muscle, which means that we can’t move that muscle through its full range of motion anymore. See why we’re pretty hot on it in hand therapy?

Yeah, yeah Sarah – but what has this got to do with C-section scars??

Clearly, the impact of adhesions is quite obviously demonstrated on our hands, which are designed to move through a wide range of intricate movements. But it’s not so easily demonstrated on our bellies. Which don’t require the same dexterity as our hands. Which is why this so often goes untreated for so many women.

But the fact is, that this very same scar tissue process is happening in our bodies after we have a C-section. And the thing with a C-section is that there are several layers of skin, muscle, organs and fascia involved. All of which are cut and which need to be sewn up separately following the delivery – which is why the stitching up phase is much longer than the incision phase.

So knowing that we have several layers of body tissue all healing and all producing scar tissue at the same time, there’s a very real possibility of abdominal adhesions here. So there you go. Hand therapy to C-sections in quick flick of a surgeon’s scalpel.

Stay tuned for the next instalment, where we’ll talk about the impact scar tissue and adhesions can have on our internal abdominal and pelvic structures, how we can go about prevention adhesion formation and what we can do to reverse any which may have already formed.

Until next time,

Be well.

Sarah xx

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Half way – Woot!!

Half way – Woot!!

February 14th. It’s a momentous day. I think we all know what I’m talking about…

No, no. Not V-Day. I’m not really fussed about Valentines. I know my husband definitely isn’t! More importantly, today marks the halfway mark of my “no chocolate or alcohol for the entire month of February“. Oh yeah!

I’ve been doing pretty good. I haven’t wanted alcohol at all, so that’s awesome. Occasionally I’ve thought about chocolate, but I’ve been able to quickly dismiss the idea. I actually had a near-miss on Tuesday when I got super-hungry at work and grabbed one of those protein ball thingos from the reception desk. I automatically picked up the cacao-mint one – but don’t worry, I quickly swapped it for the macadamia variety! (Note to self – must eat decent protein at lunch – vegie soup just doesn’t cut it for me.)

So yeah, I’ve been doing well – until today that is. And, no, it’s not just because its Valentines Day and there is chocolate literally everywhere. It’s because the girls were driving me B.O.N.K.E.R.S(!!) today. Gah! My one (in one week) year old is teething – again. She had about three days of relief after the last lot came in, poor poppet. And my three year old has just gone completely cabin fever on me – being stuck inside on an unseasonably wet day is not her scene. So yeah, if there was any chocolate in the house today I would have SMASHED it. But there wasn’t, so I didn’t.

Luckily for me, hubby came home early today – without any Valentines flowers (or chocolate – phew!). So I left him in charge of the girls and took myself out on a V-day date for a solo coffee.

Oh coffee... How I love thee...

Oh coffee… How I love thee…

Yes, I’m not crazy enough to give up chocolate, alcohol AND coffee all in one month. A girl has her limits!

Until next time – Be Well!  Sx

The oxygen mask theory

The oxygen mask theory

Show of hands – who actually pays attention to the flight attendant when she (or he!) gives the safety demonstration when you board a plane? I think I’m one of the three percent of people who are nerdy enough to do so. Most others seem too busy with their nose buried in the latest 50 Shades instalment, or devouring the mini-sized packets of Pringles. Or if you’re travelling with your children – trying to keep them entertained as they’re already SO BORED!!!, before the plane has even started moving.

One thing I’ve noticed in these demonstrations is they always tell us to “fit your own oxygen mask first, before helping others to fit theirs”. And this totally makes sense right? You’re not going to be much help to someone if you pass out unconscious from lack of oxygen. Thankfully, I’ve never been in a situation where those little masks have dropped from the cabin ceiling – and frankly – I hope I never am.

But it often makes me wonder about how we implement this logic in real-life – particularly as Mums.

We Mums are well-known for putting ourselves last. It happens all the time, it happens in tv shows and movies and it’s universally accepted as a truth. And to be perfectly honest, some of us wear it like a badge of honour. Because it’s when we’re completely selfless and spend all our time doing everything for everyone else, that we’re the best Mum we can be, right?

Wrong.

Completely wrong.

Mum’s need to LOOK AFTER THEMSELVES. And yes, that means that we simply MUST put ourselves first sometimes.

I know running a family is hard work – there’s lots to be done, and a million competing demands on any given day. And I know that taking an hour out of the day for a pilates class or a much overdue waxing session might seem selfish. But it’s actually not.

Let’s think about what happens when we don’t do the things we know we should do for ourselves.

  • If we don’t fuel our bodies with the right kinds of nutritious foods – we get fat and sick – or underweight and sick
  • If we don’t make time for exercise – we get fat and unfit
  • If we don’t get enough sleep – we get tired and grumpy
  • If we don’t prioritise spending time with our own friends and loved ones – we get lonely
  • If we don’t make time for rest – we get fatigued and potentially adrenally exhausted
  • If we don’t take the time to recover properly from an illness or injury – we get sicker or our injury worsens
  • If we let our hormones become disregulated – we get grumpy and emotional
  • If we don’t make time for meditation and reflection – we lose direction and lack inspiration
  • If we do everything for everyone else all of the time – we lose sight of who we are and we get resentful

Now who wants a Mum who is fat, sick, unfit, exhausted, grumpy, lost, uninspired and resentful? More importantly, who wants to BE a Mum who is all of those things? Certainly not me.

The Mum who is fat, sick, unfit, exhausted, grumpy, lost, uninspired and resentful runs the risk of becoming quite unwell and therefore being able to do less for her family in the long run.

But more importantly, this Mum is not putting forward the best version of herself to her children. Ultimately, this is the most significant point. We all want our children to grow up happy, healthy, strong, clever, confident and vibrant. We can help this along by modelling this behaviour. Our children learn so much through observation and role modelling – from the very earliest ages – they are tiny little sponges and they take in EVERYTHING – whether you want them to or not.

So when you take the time to look after yourself – for the sake of your own physical and mental health, you’re setting the best example for your children and encouraging them to look after themselves too. Because eventually, they will have to venture into the big, wide world on their own – without you at their side 24 hours a day. At this point you’ll want to be confident that they can keep themselves well – that they are perfectly capable of fitting their own oxygen masks.