Let's talk overhang. Also known as a C-section belly, shelf, mum 'pouch'......I'm shaking my head as I type as it just feels downright wrong to label it as anything other than a warrior mark! A completely normal and natural part of recovery from birth.
An area of additional swelling and/or soft-tissue that can protrude or overhang a C-section incision site (C-section scar).
Some people are lucky enough for it to be barely noticeable once the initial swelling and normal postpartum fluid retention have reduced, and core stability has improved. Most people find it sticks around for a few years postpartum and may reduce with either reduction in body fat percentage or more likely, an increase in abdominal tone and core strength. For a few, it can be significant, persistent and affect them greatly.
A scar of any kind, is caused by an injury to deeper layers of tissue. You can read more about the healing process and formation of scars on my blog post about C-section scar massage.
Factors such as where the injury occurs, how well healing and recovery happens, whether there are any complications during healing such as infection, skin tone and genetics can all affect the overall appearance and texture of the resulting scar. Some things, such as a predisposition to keloid scar tissue, cannot be easily prevented, however there are lots of things you can do to improve the functionality of skin tissue and deeper layers.
Most people carry a bit of subcutaneous fat on their tummies and certainly, during pregnancy, the body creates fat stores to help support a developing human. A more noticeable overhang occurs when there is an interruption in the smooth transition between your mid-stomach, and your lower abdomen. Those who carry more subcutaneous fat (regardless of whether they have had a C-section) tend to have a more pronounced 'bump', but it can become exaggerated when you have a line of taut, immovable (or less moveable) tissue tucking in underneath.
So how can the appearance of your overhang be reduced?
Confidence
How you feel about your birth journey and your postpartum body is individual and completely valid. Familiarity with your scar and your new body can significantly increase your confidence. Having a c-section scar assessment and someone explaining the normal healing process, can reassure you that all is going well and give you the confidence to care for your new postpartum body at home. This may be in the form of moisturising or performing self-massage on your scar. Having the knowledge of what to do when looking after your scar, can take away a lot of the fear surrounding it, which in turn helps with the acceptance of the appearance of your postpartum body. Many of us have hang-ups over certain areas of our body, and sometimes you need the reassurance that your overhang is not as bad as you think, or what to expect during the healing process. Dispelling a lot of fear and anxiety about your healing postpartum body can really help improve how you feel about it and can encourage you to feel more confident about your C-section scar and any resulting overhang.
C-Section Massage
Massage is beneficial at promoting healing and reducing tension in scar tissue and fascia. It does this by:
Increasing blood flow to the area. This brings in white blood cells, oxygenates tissues and removes waste products.
Breaks down any areas of tension by reducing any cross-fibres that may have formed within layers or between layers of tissue.
Moisturises the skin reducing dryness, itching and redness and/or scar discoloration.
Assists in nerve regeneration by stimulating nerve ends with touch and pressure (both light and deep).
Deep soft tissue work can help reduce scar tissue that may have formed in the pelvic cavity, which can significantly reduce symptoms such as tugging and pulling or deep aching within the pelvis. Mobilising organs during abdominal massage can also help conditions such as painful periods and gastrointestinal conditions.
Lymphatic drainage
During pregnancy the amount of fluid your body carries increases. This is due to hormone changes and the extra blood volume needed to support baby. Fluid retention from pregnancy is very common, especially in the last trimester, or during hotter weather when our blood vessels are dilated to cool us down. Fluid retention can be compounded during and after surgery, especially if we are bed bound or not moving as much during recovery. After birth, we lose a lot of this extra fluid through urinating and sweating, but the normal flow of lymph around the body can sometimes be interrupted and fluid can collect in areas such as the lower limb or abdomin (tummy). Lymphatic Drainage therapy helps move fluid around the body so that it can be drained and cleared through the main collecting ducts in your tummy and chest area. Lymphatic massage when combined with c-section massage, can greatly reduce swelling that contributes to the overhang above your c-section scar, leading to a less noticeable bulge.
Myofascial Release
The whole body is made up of a network of fascia (a connective tissue) which links one area of the body to another. During a C-section, the fascia that runs through the pelvis and abdomin is interrupted and scar tissue can affect the way your core coordinates with the pelvis and lower body, the diaphragm and beyond. This can present clinically as tugging or pulling or pain deep within tissues, an inability to breathe deeply and freely (especially abdominal breathing), uncoordinated pelvic floor activity (including symptoms of incontinence), and difficulty returning to activities such as running and lifting. It can almost feel like your body has been put back together slightly wonky and combined with the lasting affects of the hormone relaxin, feel like everything has settled in not quite the right place. Myofascial release is a specific and specialised soft tissue technique which manually moves fascia to reduce restrictions and deeper adhesions, especially within scar tissue. This maximizes movement, rebalances the body, improves functionality across the body and restores coordination of biomechanics.
Core Stability
Improved posture and greater core stability can significantly reduce the appearance of a C-section overhang. During pregnancy, our core stabilising muscles have had to go through huge adaptations and changes, stretching to accommodate a growing baby. During a c-section, all layers of abdominal muscles are damaged and repaired, making it more challenging to get them working properly again. The initial challenge (applicable to all postnatal bodies regardless of how you gave birth) is to re-engage the connection between your brain and your deep abdominal muscles. This can be done by relearning how to breathe fully (now that baby is no longer taking up most of the space) into your abdomin, back and sides, practising finding pelvic neutral (after months of your centre of gravity being in-front of the body), and slowly building resilience and movement in the entire core including deep abdominals, low back, pelvis and hip stabilising muscles, diaphragm and pelvic floor. The whole lot works in symphony and takes a little bit of time to readjust after the significant changes that occur during pregnancy and beyond. For further reading on Diastasis Recti and how to Restore your core.
With a combination of direct massage techniques, cross friction, deep tissue work on the deeper layers of the pelvis and abdomin, myofascial release and lymphatic drainage techniques you will see a great reduction of your overhang and improvement in your c-section scar. By learning and performing self-massage on your scar and surrounding areas, and by working on regaining control and coordination of your core, it will not only improve the appearance of your overhang but increase your confidence and functionality of your postnatal body.
For more information on how you can seek further support at Melyn, get in touch.