Post-C-Section Fibrosis

10 April, 2025

What Is Post-C-Section Fibrosis?

Post-surgical fibrosis is a natural response of the body following surgery, such as a C-section. It involves the formation of excess scar tissue, which can lead to adhesions between different layers of tissue that would normally glide smoothly over one another: skin, muscles, fascia, peritoneum, or internal organs. While this process is part of normal healing, if not managed correctly, it can cause functional problems, pain, and movement limitations.

Why Does Fibrosis Form After a C-Section?

After a C-section, the body initiates an inflammatory process to repair the damaged tissues. During this process, fibroblast cells produce collagen to close the wound. If this production is excessive or disorganized, dense scar tissue forms, which loses elasticity and causes restricted mobility. These adhesions can develop between the skin scar and deeper abdominal layers and may even affect internal organs such as the bladder or intestines.

Common Symptoms of Post-C-Section Fibrosis

Adhesions following a C-section may not cause symptoms immediately, but over time, they can lead to:

  • Persistent abdominal or pelvic pain
  • Tightness around the scar when coughing or moving
  • Lower back pain or pain radiating to the hip
  • Digestive difficulties (bloating, gas, constipation)
  • Pain during intercourse (dyspareunia)
  • A sensation of “blockage” or stiffness when moving or stretching the abdomen
  • Pelvic floor dysfunctionsConsequences of Not Treating C-Section Adhesions

If left untreated, adhesions can become stiffer and more problematic over time, affecting overall quality of life. Long-term consequences include:

  • Chronic pain or persistent inflammation
  • Altered posture and movement limitations in daily life
  • Difficulties in future pregnancies or deliveries
  • Increased risk of complications during future surgeries
  • Urogynecological or functional digestive issues

How Can Physiotherapy Help with Post-C-Section Fibrosis?

Physiotherapy specialized in post-C-section recovery is essential for treating fibrosis and preventing complications. Some of the most effective techniques include:

  • Percutaneous electrolysis (EPI) to break down fibrotic tissue and restore functional mobility
  • Percutaneous neuromodulation to modulate pain, enhance neuromuscular function, and accelerate tissue regeneration—especially effective in early stages
  • Radiofrequency therapy and cupping techniques to improve tissue quality
  • Manual therapy and myofascial release to soften and mobilize tissue
  • Tailored abdominal and pelvic therapeutic exercise programs for each patient

Physiotherapy also focuses on educating patients about scar care, breathing techniques, and deep muscle activation, all of which contribute to safely restoring abdominal and pelvic floor function.

When Should You Start Physiotherapy After a C-Section?

Ideally, patients should consult a women’s health physiotherapist between 6 and 8 weeks after a C-section. However, percutaneous neuromodulation can be started as early as the first week post-surgery to help prevent the formation of fibrotic tissue. That said, it’s never too late to begin, even if months or years have passed since the surgery.

Conclusion

Post-C-section fibrosis is a common but treatable consequence. Identifying its symptoms and addressing them with the right physiotherapy approach can make a significant difference between living with pain and regaining comfort and function. If you’ve had a C-section and are experiencing discomfort, tightness, or changes in your abdomen, don’t ignore it. Consult with a specialized physiotherapist and start taking care of the root cause.

Scientific References

  1. Järvinen TA et al. “Muscle injuries: biology and treatment.” Am J Sports Med. 2005.
  2. Diamond MP, Freeman ML. “Clinical implications of postsurgical adhesions.” Hum Reprod Update. 2001.
  3. Tabibian N et al. “Abdominal adhesions: a practical review of an often overlooked diagnosis.” World J Gastroenterol. 2019.
  4. López-de-Celis C et al. “Effectiveness of physiotherapy interventions for abdominal scars: a systematic review.” Physiotherapy Theory and Practice. 2022.
  5. Vercellini P et al. “Adhesions and pain in gynecology.” Curr Opin Obstet Gynecol. 2009.
  6. Hidalgo-Tallón J et al. “Treatment of adhesions using percutaneous intratissue electrolysis (EPI®): a clinical proposal.” Rev Int de Ciencias del Deporte. 2018.