Physical Therapy after Abdominal Surgery

May 29, 2023

After an abdominal surgery, the result is often weakened abdominal muscles and the pelvic floor. While you may want to return to your favorite activities and sports right away, a slow recovery involves rebuilding your abdominal muscles. Read more about the importance of physical therapy after an abdominal surgery.

My Doctor Cleared Me After My Abdominal Surgery. Why Do I Need Physical Therapy?

Surgical incisions cut through our skin, fat, muscle and other connective tissue to get through to the target structures. All connective tissue has receptors that communicate by signals to our brain. Our connective tissues do not know the difference between an intentional incision and an injury. Any time there is an incision, there will be scar tissue.

You can sometimes think of scar tissue like an iceberg. While the incision may look small on the skin, adhesions can form deep and wide below. This is why even with a great surgical outcome, you can be left with numbness and tingling at the site and tension of the surrounding connective tissue.

Even organs are surrounded by connective tissue. These layers need to be able to slide and glide against each other to maintain lubrication, blood flow and mobility for whatever the job of those tissues are. Think about organs like the bladder. It should be able to expand against the abdominal wall in front and the uterus above and behind it, as it collects fluid and waste. When we empty, the bladder needs to be able to squeeze downward and together, without pulling and sticking to tissues around it.

While we don’t necessarily feel pain from organs the same way that we feel musculoskeletal pain, pelvic organs and muscles have a communication highway of reflexes between each other and the spinal cord. Therefore, pain from a muscle could be occurring as your body’s attempt to protect a nearby organ.

How Pelvic Health Physical Therapy Can Help

Your Pelvic Health PT can assess tissue mobility externally, and sometimes internally, in order to determine causes of your pain. Scar tissue tends to pull other tissues toward it, which may result in joint pain, nerve compression or sensitivity of the area. It also can inhibit the affected muscles, requiring other muscles to overwork and contribute to discomfort.

Lack of tissue mobility in this region can contribute to urinary or bowel symptoms, fertility difficulty and menstrual pain. As part of any good Rehab evaluation, tissue mobility will be assessed and treated if needed. With manual therapy, mobilization and muscle retraining, function and mobility can be better restored after abdominal surgery.

Addressing Scar Tissue Mobility

When should you address scar tissue mobility? The truth is many people have tissue restrictions that have unfortunately existed for decades. Even deep scar tissue from an appendectomy that you had during childhood can result in challenges as your body undergoes change. There are women with Cesarean incisions from children delivered years ago, still reporting numbness, tingling and tension in the area.

While it is ideal to begin while tissue is still healing, it is never too late to address this. Following delivery, you can start working with your Pelvic Rehab Specialist 4-6 weeks postpartum. They know how to treat you based on your timeline.

Cesarean delivery is a major surgery. It cuts through seven layers of tissue. Episiotomy, by definition, is a grade 2 perineal laceration, meaning muscles of the pelvic floor have been cut through. Prostatectomy is a surgery that often involves incision through the urethra of the penis, in close proximity to parts of the pelvic floor sphincters. These are vulnerable and important areas for our quality of life. We should be talking more about them instead of accepting pain, urinary symptoms, sexual dysfunction, etc.

Any surgery that cuts through the muscles of your shoulder would require rehab. Why should we not have the same care for the muscles surrounding our abdomen, pelvis and their organs?