What amount of scar massage is effective for abdominal scars?
Following a client’s abdominal surgery, a physical therapist may administer scar massage, or teach a client to perform scar massage. Currently, there are no protocols backed by literature for the correct amount of scar massage to apply specifically to an abdominal scar. However, there are parameters from a handful of studies that may serve as guidelines for determining the dosage of scar massage. The amount of scar massage that was found effective in these studies ranged from 10 to 15 minutes, and it was administered daily to three times per day. Three of the five articles involved the use of silicone gel, something I do not use in my clinical practice.
A critical component of dosing scar massage is to remember that every person with an abdominal scar has a different physiology and structure to her or his scar depending on the type of surgery performed. (Cesarean section, panniculectomy, exploratory, etc.). Clients should be reminded not to induce significant pain or burning during scar massage. Scar massage should not begin until the doctors post-surgical protocols allows. Generally, this is six weeks after the surgery.
During scar massage it is important to keep scar anatomy in mind. Some scars will only be in the most superficial layer of the skin. However, abdominal scars usually reach into deeper layers of our body. In fact, some scars may adhere to the organs and bowels. These deep layers can be reached by working the more superficial layers of the scar first, and progressing deeper with massage pressure only if there is not significant pain or irritation. Scar massage does not need to be too aggressive or last greater than 10-15 minutes.
For more information sign up for my newsletter and email list to download a FREE scar mobilization handout designed as a marketing and patient education tool for my practice. You will also receive the summary of articles referenced in the handout.
References (summaries provided in Download of Scar Massage Research)
- Arung W, Meurisse M, Detry O. Pathophysiology and prevention of postoperative peritoneal adhesions. World J Gastroenterol. 2011; 17(41): 4545-4553.
- Lewit K, Olsanske S. Clinical Importance of active scars: abnormal scars as and the cause of myofacial pain. J Manipulative Physiol Ther. 2004, 27: 399-402.
- Wallace, K. Reviving Your Sex Life After Childbirth, Your Guide to Pain-Free and Pleasurable Sex after the Baby. 2014. Visit KatheWallace.com for publication notification.
Thank you to Katie McGee, DPT for assistance in preparing this summary and the educational handout.
Photo by atomicpuppy68