Can episiotomy scars be treated months and years later?

Delivering your baby by a vaginal birth is a wonderful experience but......


For some women, vaginal delivery may result in tissue tearing or a surgical incision that has to be sewn back together.


Despite using cold compresses in the days after, the normal healing phase results in scar tissue forming. The amount of scar tissue varies between people, but the important features of scars are:

  1. Scars never go away

  2. Scar tissue is less elastic than the tissue it replaces

  3. Tight scars can affect the stretch of other nearby tissues and structures like skin, nerves and blood vessels and muscles.




My first episiotomy is now 30+ years old and I still remember the pain and discomfort and that it persisted for way longer than I thought it should - about 2 years! I found it painful to stand for long periods of time for AGES!


But the latest research on scar tissue shows that this timeframe of 2 years is "normal" for active scars and that scars can remain active beyond 2 yrs for some people. The definition of active scars is- "there is a noticeable restriction in the elasticity of the scar tissue and it is painful to touch and may remain a little red instead of a lighter colour".



This loss in elasticity at the vaginal opening and extending towards the anal sphincter

(perineum) maybe noticed in several ways:

  • The vaginal opening may become misshapen as compared to the "pre-delivery of baby" shape.

  • There may be a tightness in the skin and muscles between the perineum and the sitting bones (ischial tuberosity).

  • There may be tightness in the local nerves and blood vessels that travel in this area.

  • There may be persistent tightness at one or both pelvic bones, which someone may experience as persistent pain- like SI joint pain or hip pain.

  • Your hip flexors and adductors may be overworking and tight even at rest.

  • sexual intercourse may become a little less pleasant


So you can see that there is the original scar tissue and then overtime, secondary changes to other nearby structures can occur because of changes in elasticity, resulting in pain or stiffness. This is not a hard concept to understand; when something gets a bit tight, then other structures have to work differently- either they overstretch or get tight as well. The body is good at compensating for changes!



Two new areas of investigation by bodyworkers offer new approaches to managing tightness associated with scarring in this region:

  1. BioTensegrity and pelvic tightness associated with vaginal prolapse (full free read of this research is available here)

  2. Local arterial and nerve release- Neurovascular Release TM


I've been online training with Kieran Schumaker, a USA structural integrator, in her neurovascular TM release methods and I'm loving this approach for its gentle and localized stretch method. Kieran has produced a short video to demonstrate how this approach can be used in the area nearby to the perineum.


Check this Facebook video out here as you'll be able to compare the internal sensation of tension around this lower region. If tension is present, the tissues will feel tender or even numb.




Q: Can problematic episiotomy scars be treated months and years after?

A: Yes, there are new approaches that can help reduce secondary tightness in the area.


Since training with Kieran, I've been trying different ways to approach this area, when scarring and tightness are present. If you are interested in investigating your episiotomy scar changes and secondary tightness, then connect to make a booking. In one session you will be able to try several release methods and test for their effectiness in your hip positioning and standing posture, aswell as elasticity in the local skin.


Our session together will be gentle, clothes will remain on, and expect to get homework, as changes to elasticity in tight tissues are incremental. And remember scar tissue will never have the same elasticity as the tissue that was there, but the surrounding tight tissues can be released of extra tension.


Make an appointment in rooms( Brisbane) or online: Deniseot@bigpond.net.au



Photo of mother and baby by Sergiu Vălenaș on Unsplash











28 views0 comments