Managing Symptoms of Adhesions With Pelvic Floor Therapy

Adhesions refer to internal fibrous scar tissue that forms between two organs or structures. In the pelvis, these can affect organs such as the bladder, bowels, uterus, fallopian tubes, ovaries, and other areas.

Typically, these structures will glide smoothly past each other as needed, but adhesions can make organs or other inner structures stick together. This restricts movement, creates tension, and can cause pulling of the affected tissues.

Scar tissue can form as a result of inflammation, injury, or surgery. It is a normal part of the healing process, especially after surgery, so adhesions are actually pretty common.

Even normal healing from surgeries that have no complications may create adhesions. Therefore, the effects that adhesions may have can differ from person to person and may cause a range of symptoms that vary in severity—for some, this could mean no symptoms at all.

Those who do experience symptoms may have pelvic pain, abdominal pain, back pain, painful menstruation, painful sex, constipation, nerve compression, and more. In some cases, adhesions can affect the function of reproductive organs. When adhesions significantly affect the reproductive organs, it can cause symptoms of infertility.

While adhesions are more common for those born with a uterus (as it is often related to gynecological surgeries), people born with a penis may also get adhesions. This can lead to symptoms most often affecting the bladder or bowels.

The tension and pulling created by adhesions can also cause pelvic floor dysfunction. The pelvic floor is a group of muscles that every person has, regardless of the genitals they are born with. These muscles are very interconnected with your pelvic organs and other structures. When adhesions cause tension and straining, it affects the pelvic floor, too.

This is a problem, as the pelvic floor performs many jobs and supports proper function for many of your pelvic organs.

When the pelvic floor experiences dysfunction, an individual can have symptoms of pelvic pain, urinary incontinence, urinary urgency, constipation, and much more. Pelvic floor dysfunction can make the symptoms from adhesions worsen, and may create a cycle of tension and pain.

As mentioned earlier, adhesions do not always cause symptoms. However, those who do experience symptoms may need to find long-term management solutions such as pelvic floor physical therapy.

Some individuals may choose to undergo minimally invasive surgeries to have their adhesions separated, but this does risk the creation of adhesions from the removal surgery.

Adhesions form as a response to inflammation, injury, or surgery. This can include pelvic surgeries, pre-existing pelvic conditions, physical trauma or injury, or treatments such as radiation therapy. 

Surgeries are a very common cause of adhesions. Some common pelvic surgeries that can cause adhesions include hysterectomies, cesarean sections, endometriosis procedures, appendectomies, genital reconstruction, or any surgery located in the pelvis or lower abdomen. 

Pre-existing conditions such as pelvic inflammatory disease and endometriosis can cause significant inflammation in the pelvis that may create adhesions. Similarly, physical impact or injury to the pelvis may create inflammation that results in this restrictive scar tissue.

Adhesions cannot necessarily be healed, and can be difficult to diagnose in some cases. Some individuals with severe symptoms may opt to try for surgical separation of their adhesions, but as mentioned earlier, adhesions may form as a result of that surgery, too. 

Therefore, treatment for pelvic adhesions mostly looks to explore long-term management solutions. This can mean lessening the symptoms caused by the scar tissue, encouraging tissue mobility, and maintaining function of the organs and structures in the pelvic area.

Pelvic floor physical therapy is a great way to encourage better tissue mobility and manage your symptoms of pelvic adhesions in the long run. If you didn’t know already, pelvic floor physical therapists such as myself are especially trained and educated about this unique area of the body. 

I have many years of experience under my belt, too, so I am very familiar with addressing things like pelvic tension, pelvic pain, and other symptoms. When working with me, you can expect a very comprehensive treatment plan that is curated to your individual needs.

Your first session will allow me to get a better idea of your symptoms, medical history, and pelvic floor health through evaluation and examination (only performed with your consent). Once these are completed, I’ll be able to create your care plan!

Pelvic floor physical therapy is not one-size-fits-all. Every treatment plan I create is made with my patient’s individual needs in mind. After all, each person’s pelvic floor health and the cause of their adhesions will vary.

Additionally, I craft every care plan with a holistic approach. This means in addition to physical treatment, you can expect to discuss pelvic floor related education, at-home strategies for long term symptom management, and more. I want to set you up for success!

I know you may be wondering what treatment could look like, so below I’ve described some different treatment methods often utilized in pelvic floor therapy…

Manual Therapy

Manual therapy is a treatment that involves the physical manipulation of tissues. It helps relax tissues and release tension with targeted massage and trigger point release. This treatment can be done for the pelvis, pelvic floor, hips, abdominals, lower back, and other areas to help manage pain and other symptoms associated with adhesions!

Manual therapy can also involve scar tissue mobilization. While adhesions refer to internal scar tissue, external scar tissue from surgeries or injuries can be restrictive, too. This will only add to your pelvic tension and symptoms, so in these cases I may use gentle tissue mobilization techniques to improve flexibility, reduce sensitivity, and decrease pain caused by your scars.

Behavioral Modifications & Education

As mentioned before, I try my best to create plans of care that address many different aspects of your daily life and habits. By including things like education and behavioral modifications into your treatment, you’ll be better equipped to manage your symptoms and prevent their worsening in the long run.

Behavioral modifications can include things like standing and sitting posture, restroom habits, form while lifting or during recreational activities, and much more. I’ll teach you how doing these daily activities in poor form can cause tension, and how you can make adjustments to prevent the worsening of your symptoms.

In terms of education, I will teach you not just about your pelvic floor, but actual at-home practices you can do to manage tension, stress, and pain. For example, breathing techniques are a very effective way to release tension in the pelvic floor and practice active relaxation of these muscles.

Understanding how to relax your pelvic floor is an important part of managing tension from adhesions and pelvic floor dysfunction. Breathing techniques may seem simple, but they are a great way to actively relax your muscles and can even help reduce stress!

Improving Pelvic Floor Health

As described above, being able to relax your pelvic floor is an important part of managing tension—but when pelvic floor dysfunction is present, this can be rather difficult. Therefore, I’ll utilize treatments that help you regain control over your pelvic floor!

This can include treatments such as neuromuscular re-education and biofeedback. These may sound complicated, but they actually just allow you to practice contracting and relaxing your pelvic floor muscles on command. As you make these movements, you’ll receive real-time auditory or visual feedback that will help you understand each movement.

These treatments help you better understand your pelvic floor’s voluntary movements, and allow you to actively relax those muscles to release tension. This will be important knowledge for managing tension associated with adhesions, and preventing symptoms like pain.

Being able to actively control your pelvic floor will also help you strengthen these muscles through targeted exercises. Exercise and movement is a very important part of health even for the pelvic floor, so you can expect to receive a unique exercise and stretching plan! 

This plan will target your pelvic floor as well as other related areas of your body, such as your lower back, abdominals, hips, and more. These areas can create tension in the pelvis too, so it’s important to balance the muscle tone for all of these parts of the body.

As you can see, there are many different treatments you may experience while working with me—and this isn’t even all of them! However, there’s no way to know what your needs are until you get started with your first session. If you’d like to get started with an evaluation to see what your care plan may look like, make an appointment!

Or, if you have other questions about appointments or treatment, explore the discovery call option.