Soooo, women's health research is LIT these days.
And y'all know (omg did I just say y'all?) I'm a card-carrying member of the nerd alert club. As often as I can I'm reading studies, papers, and meta-analyses in order to learn about (and disseminate with you guysss) the latest information I can find related to fitness, nutrition, pregnancy, and everything/anything it means to be a healthy active mama with healthy active kiddos.
A lot of the time I'm surprised (in both good and bad ways) by the data I find. But sometimes, something magical happens: I find evidence that reinforces EXACTLY the kind of stuff I utilize not only for myself but for my community, too.
So, for those of you who've used my C-section recovery plan, you can imagine how loudly I squealed when I stumbled across a recent randomized controlled trial published in the September/December 2018 issue of the Journal of Women's Health Physical Therapy.
FYI, randomized controlled trials (RCTs) are legit AF when it comes to research study design. And while all studies should be read with a critical eye, I'm thrilled to say that this one offers some insightful and bona fide evidence as to why I STRONGLY recommend tissue work in my C-section recovery program. And as far as I know, this is the first RCT investigating this topic.
So go ahead and start reading about the study—I'll catch up with you after I'm done jumping for damn joy over here.
(quoted by Nancy Anderson from her c-section recovery plan)
Dealing With C-Section Related Pain? Evidence Supports Soft Tissue Mobilization for Relief
The authors of this study begin by pointing out a pretty amazing statistic:
Of the 1.27 million+ cesarean sections (C-sections) performed every year in the United States, up to 18 percent of them will result in chronic pain. That's potentially almost a quarter of a million new mamas dealing with chronic pain and dysfunction annually. WTF.
The team of researchers (all of them physical therapists, most of them with doctorates) wanted to see whether soft tissue mobilization reduced pain and improved function and scar mobility for women who've undergone C-sections. To determine this, they recruited 28 women with C-section pain and randomly divided them into two treatment groups:
- Group 1 got superficial abdominal and lumbothoracic massage in addition to superficial skin rolling of the painful scar
- Group 2 recieved this plus abdominal myofascial release and direct deep scar tissue mobilization
After four treatment sessions, both groups saw statistically significant improvements in pain, scar mobility, and scores on the Oswestry Disability Index, aka ODI (this is considered the gold standard for evidence-based outcome measures of back pain treatment). These positive benefits were the same regardless of BMI and number of prior C-sections.
The authors conclude succinctly: "This study demonstrates that 4 sessions of [soft tissue mobilization] techniques are effective in reducing stable chronic pain following C-section." Can I get a, 'yasssss!'
UGH: It just FIRES me UP to see therapists, researchers, and scientists carrying the banner and doing more research on important topics like this! This is what we need to have the tools and backing to PUSH for better standard of care for c-section Moms. This is a big WIN for us.
Any drawbacks of the study? Relatively small sample size, for one. There also was some missing follow-up data for a few of the subjects, and notably missing was a true control group that got only "sham" treatment (which, the authors point out, is tough to do in physical therapy practice, anyway).
But the researchers used reliable and valid outcome measures—including the ODI, the numeric pain rating scale ("rate your pain on a scale of 0-10," which is surprisingly accurate and consistent), average scar tissue pain pressure threshold (as measured with a digital pressure algometer), and the modified adheremeter (a nifty little tool used to measure scar tissue stretchability).
Plus, the trained therapists providing the treatments were blinded to the results of the outcome measures, and the subjects and people who measured the pre- and post-treatment results were blinded, too—greatly reducing the chance for bias.
AND I'd be remiss to point out something that I'm sure a lot of you guys have noticed—these women only underwent FOUR sessions of tissue work. Just FOUR! Imagine how much more improvement could be seen after ten, twelve, or more sessions?
It's exciting to think about.
Learn About Soft Tissue Mobilization (And So Much More) In my C-Section Recovery Plan
There's something really interesting about this study I haven't mentioned yet:
There were no significant differences in the outcomes between the two groups—the superficial treatment offered to the women in Group 1 was just as effective as the combined deep plus superficial treatment offered to the women in Group 2.
I'm actually a little surprised but at the same time kinda happy to hear this, because it suggests that even simplest at-home work we do on ourselves can reduce C-section pain and improve scar mobility.
I mean if that ain't butt-kicking self-care, I don't know WHAT is.
That said, I believe that if we don't address the deeper core and organ layers affected by our C-sections (which I tell you how to do yourself in my program), then we're simply not going to heal and thrive as optimally as possible—and we're potentially setting ourselves up for longer-lasting complications. Additionally, the authors logically point out that if their sample size had been larger, the data may have been more accurately able to shake out any differences in superficial only vs. deep plus superficial treatment (I agree with this).
We go into ALLLLL sorts of detail about this in my C-section recovery program. I tell you:
- When and how to self-mobilize both superficial AND deep layers
- Explain the many (surprising) ways your external AND internal scarring is likely affecting your health (and your sex life, and your gut, and your lymphatic system, and your body image, etc.)
- When to consult with a physical therapist or other women's health professional for extra help
But true to my shotgun approach for optimal healing, I also talk about topical treatments, nutrition, and a lot more—all the other tools in our disposal we can use to optimize our healing and recover from the trauma of a cesarean delivery.
Interested in learning more? Get in touch with me with your questions and be sure to check out my one-of-a-kind C-section recovery program. It has already helped hundreds of women, and I'd be honored if it found its way into your recovery corner.
XOXO, Nancy