How C-Section Scars Can Cause Sacroiliac Joint Pain

You may have experienced low back pain in your life and not realized that it was actually your pelvis. Your spine articulates with your pelvic bones via the sacrum. When the sacrum connects to the pelvic bones, it creates a joint called the sacroiliac joint (SIJ).

Pain at this joint is a very common complaint during and after pregnancy. There are many reasons this pain can exist and one major driver that often gets missed is scar tissue in the abdomen. When postpartum folks have c-section scar tissue that has not been addressed, it can be a major reason for SIJ pain.

Scar tissue lays down differently compared to normal tissue. It usually has less mobility overall and therefore less blood flow. Mobility and movement in our fascia is key to having pain free experiences in our body. 

When scar tissue mobility is not addressed, some of the important areas that dictate the health of the SIJ are affected. The first and most important area is the abdominal muscles. With a c-section, all of the abdominal muscles are cut through, including the very important deep abdominal muscle called the transverse abdominus (TA). When the TA is cut through, it will have a harder time coordinating for the abdominal engagement that is needed for the SIJ to function optimally. Scar tissue mobility work and proper coordination training can help this muscle get back online.

Another important aspect of our core system is the pelvic floor muscles. The TA and the pelvic floor work together for optimal core coordination and so when the TA is affected, we usually see the pelvic floor function non-optimally as well. This can explain why folks with c-section scars still demonstrate signs of pelvic floor dysfunction including urinary incontinence and pain with penetration.

The respiratory diaphragm is another important muscle that contributes to core coordination. When there is scar tissue in the abdominal wall, the diaphragm can experience movement restrictions as well. Restricted movement of the diaphragm has been linked to low back pain and SIJ pain, so addressing these deficits can be vital in compressive treatment plans.

Lastly, scar tissue in the abdomen also affects the internal organs and their fascial structure. Many internal organs, including the uterus, lay in front of the SIJ. When these organs lose their full range of motion due to scar tissue, they can pull on the sacrum and sensitize the joint further. At Bodyful, we are trained in visceral fascial techniques that can target this type of scar tissue directly.

Treating scar tissue does not mean we are “breaking up adhesions” or “making the scar tissue go away”. Rather, it means we are working with the fascia around the scar tissue and how the nervous system has developed holding patterns around it. At Bodyful, we are working with your body to introduce new possibilities of movement and blood flow through slow and targeted hands on work in addition to individualized movement that reinforces these new possibilities.

If you have low back pain, pelvic pain, or sacroiliac pain and you also have scar tissue that has not been addressed, you would benefit from working with one of our pelvic floor physical therapists. At Bodyful, we know how to treat scar tissue and educate you on how to sustain techniques at home in an safe and evidence based way.

Bodyful Physical Therapy and Wellness is a pelvic floor physical therapy private practice in the Bay Area made up of Dr. Karah Charette and Dr. Maryssa Steffen who are both pelvic pain specialists. 

Reach out here to book a free discovery call and learn more about what it would be like to work with one of us.