Episiotomy Scars

Perineal / Vaginal Massage Therapy

(Reference: Isa Herrera, Ending Female Pain (2009) )

  • This type of massage is helpful for all women who have had an episiotomy/tear, undergone biopsies, vestibulodectomy, and/or reconstructive surgeries
  • For the perineal massage, it is helpful to use a mirror to examine the scar before stretching and mobilizing it
  • These methods can be used to help mobilize the pelvic floor muscles, and to make them more supple, flexible and painfree
  • These can also be great techniques for women who don’t have a scar but have perineal pain

Perineal Scar Rolling

  • Place the scar between the finger tips. You might have to place one finger inside the vagina and one finger outside the vagina, gently gripping the scar between the fingertips in order to roll it
  • Roll the scar between your fingers for 2-3 minutes or as tolerated until the scar feels loose, less painful and more pliable.
  • Perineal scar rolling is a great method to get the scar more flexible ad mobile

Perineal Body Massage

  • Using a trigger point release technique, press with your finger on the perineal body, and find a tender point
  • Once you locate a painful area or trigger point, push on that spot for 90-120 seconds; Be gentle; do not create more than a 5/10 in pain as you press on it. As you hold the spot for up to two minutes, the intensity of the pain should decrease significantly
  • Do this once a day until the perineal body is no longer tender
  • For best results, try pressing into the perineal body at different angles and locations in the perineum. Hold each different direction for 90-120 seconds.

Traditional Perineal Thumb Massage

  • This massage works great for perineal scars, for pelvic pain sufferers, women with vaginismus, and in preparation for labour and delivery
  • Pregnant women can start this massage on the 34th week for 3-5 minutes daily
  • Teaching your partner to do this massage helps in preparation for delivery

What to do:

  • Lubricate your thumbs, insert them into the vagina up to the first knuckle, and press straight downward towards the rectum for 3-5 minutes
  • After 3-5 minutes, press down to the right for 30-60 seconds and then to the left for 30-60 seconds
  • Another technique is to do ½ moon strokes with your thumbs. Place your right thumb up to the first knuckle in the inside of your left pelvic floor muscles. Start from 2 o’clock position and take about one minute to stretch down to the six o’clock position; then change sides and perform the ½ moon strokes on the other side.