T Nation

Scar Tissue in Butt Crack...

If the title of this thread didn’t grab your attention, idk what will.

Basically I have been dealing with a pilonidal sinus for the past 2 years. 3 surgeries, and the thing is still not healed. The past 2 have left open wounds, and left to heal from inside out. My question is this. Obviously some significant scar tissue will have built up from this experience. Will i be able to squat again without risking tearing it open?

Obviously this area gets a lot of force with squats and deadlifts, but I would like to think that the scar tissue will be strong and pliable enough for me to continue squatting. I was thinking about still staying away from both movements for maybe a month after its completely healed, and then slowly increasing ROM before I even start loading. Anybody who has been through this, your input is gold. Obviously healing is the first step and I’m thinking ahead here, but I love lifting and I can’t stop thinking about this. Thanks

Your plan sounds reasonable. I would check in with your surgeon/PT regularly to monitor things. The problem with scars is that they aren’t pliable and the surrounding tissue is left with the burden.

I had a pilonidal sinus removed in 2012, but fortunately had no complications whatsoever. As soon as the wound healed (about 6 weeks, open wound), I got back into training, and slowly increased range of motion and load. Squats and deadlifts soon felt normal again, however, seated/lying excersies such as leg press, leg curls/extentions and bench press (to name a few) took a little longer to feel comfortable. In my opinion, it would be a good idea to work on range of motion as soon as the wound has healed (unless your consultant says otherwise of course). This will maximise whatever flexibility the scar tissue will allow and improve your chances of comfortably squatting and deadlifting.

In order to minimise healing time, ensure you eat a high protein diet. Do not skimp on healthy fats and also consume plenty of fibrous (comfortable bowel movements are essential as straining could easily tear the wound), micronutrient dense foods too. Keep your home exceptionally clean (or have someone else do it if it’s too uncomfortable to do so yourself, which I expect it is), and if possible have someone (preferably a nurse) periodically shave any hair around the wound while it heals, being careful not to allow loose hair to fall in. If you are particularly hairy, laser hair removal might be a good option. The nurses I spoke with during my visits to the hospital said that this was very successful for folks whose pilonidal sinus kept returning (I presume this is your issue, or is it that your wound itself will not heal?)

Fortunately, I was in a position to be able to do absolutely nothing while my wound healed. I pretty much lay on my side and front for the entire duration, playing video games and watching TV. I also slept frequently and ate lots (somehow I didn’t get fat). I showered before I had the dressings changed (daily at the hospital in the morning, and again at home if necessary). Warm water only, and if you can bear it, direct the shower head at the wound (low water pressure of course).

This is what worked for me, and the nurses could not believe how quickly it healed, considering that initially, you could fit a mobile phone inside the wound (we did not actually try this btw!).

I hope this helps, and best of luck.

[quote]James Brown wrote:
I had a pilonidal sinus removed in 2012, but fortunately had no complications whatsoever. As soon as the wound healed (about 6 weeks, open wound), I got back into training, and slowly increased range of motion and load. Squats and deadlifts soon felt normal again, however, seated/lying excersies such as leg press, leg curls/extentions and bench press (to name a few) took a little longer to feel comfortable. In my opinion, it would be a good idea to work on range of motion as soon as the wound has healed (unless your consultant says otherwise of course). This will maximise whatever flexibility the scar tissue will allow and improve your chances of comfortably squatting and deadlifting.

In order to minimise healing time, ensure you eat a high protein diet. Do not skimp on healthy fats and also consume plenty of fibrous (comfortable bowel movements are essential as straining could easily tear the wound), micronutrient dense foods too. Keep your home exceptionally clean (or have someone else do it if it’s too uncomfortable to do so yourself, which I expect it is), and if possible have someone (preferably a nurse) periodically shave any hair around the wound while it heals, being careful not to allow loose hair to fall in. If you are particularly hairy, laser hair removal might be a good option. The nurses I spoke with during my visits to the hospital said that this was very successful for folks whose pilonidal sinus kept returning (I presume this is your issue, or is it that your wound itself will not heal?)

Fortunately, I was in a position to be able to do absolutely nothing while my wound healed. I pretty much lay on my side and front for the entire duration, playing video games and watching TV. I also slept frequently and ate lots (somehow I didn’t get fat). I showered before I had the dressings changed (daily at the hospital in the morning, and again at home if necessary). Warm water only, and if you can bear it, direct the shower head at the wound (low water pressure of course).

This is what worked for me, and the nurses could not believe how quickly it healed, considering that initially, you could fit a mobile phone inside the wound (we did not actually try this btw!).

I hope this helps, and best of luck. [/quote]

Thanks so much for your help. My issue wasn’t that it kept coming back as much as it wouldn’t heal. Anyways its almost gone and hair removal has played a huge role in that this time. Shaving multiple times a week. I think Im gonna go for laser hair removal once its completely healed. I’m a little worried how that will go with the scar tissue there. Any thoughts on that?

And its good to hear you could train again, especially since the size of your wound was similar to mine. I have also been keeping wound very clean and eating tons of protein like you said. Its so small now that it doesn’t require any packing. I’m also a college student taking minimal classes (mostly online) so I have time to rest. Thanks again for your help, if I have any further questions I will direct them towards you.

[quote]CroatianRage wrote:
Your plan sounds reasonable. I would check in with your surgeon/PT regularly to monitor things. The problem with scars is that they aren’t pliable and the surrounding tissue is left with the burden. [/quote]

Thanks for the input. I’m not going to be working with a PT but I will ask my surgeon again before I leave the wound clinic I am going to. I was just worried that the less pliable tissue would be prone to reopen. I can’t go through what I did the past 2 years again, but I also want to continue lifting.

I have no idea how the scar tissue will respond to laser hair removal. I haven’t personally had it done, in spite of the fact that I am fairly hairy in that region.

[quote]James Brown wrote:
I have no idea how the scar tissue will respond to laser hair removal. I haven’t personally had it done, in spite of the fact that I am fairly hairy in that region. [/quote]

At the risk of sounding like a weirdo do you do anything to prevent hair growth in that area? Only reason I ask is that the nurses at the wound clinic told me that hair could cause it to come back.

So to dig this old thread up again… My wound healed up completely a little over 2 weeks ago. However, 2 weeks after healing the scar split when I was checking to see how it looked… My surgeon had said to give it 3 weeks to start squats/deads but now I have no idea. Any advice on returning to activity? I work on a farm and have to start soon so thats pretty physical. I think the split is almost gone, but now Idk how to tell when I’m ready to start slowly stretching the thing. I apologize if this post is all over the place, just trying to make sense of a tricky situation.

I had my surgery about 6 months ago. It was my 5th surgery with this damn problem. And its still painful if I sit for long periods of time and the scar tissue rips open if im to active. So I would say to stay away from that type of training for a year or so