An episiotomy is a surgical incision on the perineum (the tissue between the vagina and anus) in order to make more room for the delivery of a baby. Whenever the soft tissue in our body is damaged it goes through a healing process that results in the laying down of a specific type of tissue called fibroblasts to help the area heal. These cells are primarily made up of a substance called collagen. You can think of collagen like thin strands of ropes. Unless a scar is manually mobilized these cells will be laid down in a very haphazard manner, which can cause thickening or tightening of the scar tissue itself as well as binding to the surrounding tissue. If this occurs, the scar can not only affect the range of motion of the surrounding tissue, but it can also surround and entrap nerves and other tissues causing pain. Manual therapy and scar release helps to soften and increase the elasticity of the scar tissue increasing range of motion, decreasing adhesions and decreasing pain. Episiotomy scars can affect a women’s ability to have a bowel movement, cause pain and weakness of their pelvic floor muscles. This can lead to or perpetuate, urinary incontinence, painful intercourse, or pelvic organ prolapse.