Posted on August 12th, 2024

Have you ever noticed discomfort in your abdomen, perhaps long after your surgery or during certain phases of your simple, daily activities?

This could be attributable to banding scar tissues, known as abdominal adhesions, that form internally, subtly affecting your well-being over time.

Often a consequence of our body's natural healing mechanisms, these adhesions can quietly bind together tissues and organs, altering the otherwise smooth internal functions.

A wide range of conditions or past interventions can trigger this formation, each contributing to a complex web within your abdomen.

In this blog post, we will provide a well-informed perspective, to help you achieve meaningful improvements in both your immediate comfort and long-term health.

What Are Abdominal Adhesions?

Abdominal adhesions are bands of scar tissue that form between the tissues and organs in the abdomen. These fibrous bands bind structures that are normally separate, often linking loops of the intestines or attaching to the abdominal wall. When the body's healing process kicks in after surgery, infection, or inflammation, it sometimes overcompensates, leading to the formation of these adhesions. They may develop after a surgical procedure like a C-section or hysterectomy, or as a result of the body's reaction to peritonitis or other inflammatory diseases. Over time, the adhesions can cause the organs to stick together, which can impede their normal functioning and lead to various complications.

These adhesions can have a significant impact on the body's internal workings:

• For starters, they may restrict the movement of the intestines, causing blockages that can lead to severe pain and digestive issues.
• Sometimes, they might envelop other organs such as the bladder or fallopian tubes, leading to pelvic floor issues like chronic pelvic pain.

If you suspect you have abdominal adhesions, a thorough evaluation by a healthcare provider is crucial. In the next section, we'll see how abdominal adhesions are diagnosed.

Diagnosing Abdominal Adhesions

Diagnosing abdominal adhesions can be particularly challenging due to the non-specificity of the symptoms you might experience. Pain, nausea, and changes in bowel habits are common to many other gastrointestinal issues, making it difficult to pinpoint adhesions as the culprit.

Detailed Medical History

Creating a detailed medical history is the first step of the diagnosis process. Your healthcare provider will inquire about any past surgeries, instances of peritonitis, infections, or any condition that might have caused internal inflammation. Your medical history provides vital contextual background, giving your provider clues about potential risk factors for adhesions.

Physical Examination

Following the medical history, a physical examination can reveal more about your abdominal health. While the physical exam alone often isn't sufficient to diagnose abdominal adhesions, it can help rule out other potential causes of your symptoms. During the exam, your healthcare provider will palpate your abdomen to check for tenderness, distension, or abnormal masses. These findings, together with your reported symptoms, might indicate the need for further diagnostic tests. Asking you to describe and locate your pain might also provide essential insights, especially if there's a connection to specific movements or activities.

Imaging Studies

Imaging studies, although not always conclusive for diagnosing adhesions, can offer additional pieces to the puzzle: 

• Modalities such as ultrasound, CT scans, or MRI can help visualize the internal structures of the abdomen. However, they often fall short in directly showing adhesions.
• More definitively, diagnostic laparoscopy serves as a key tool in identifying and assessing abdominal adhesions. A minimally invasive surgical procedure, laparoscopy allows the healthcare provider to view your internal organs directly. This method can confirm the presence and extent of adhesions and, in some cases, even allow for their treatment during the same procedure.

Managing and Treating Abdominal Adhesions

For some individuals, adhesions can be asymptomatic and may not necessitate treatment. However, if you are experiencing significant discomfort, pain, or complications such as intestinal obstruction, a more proactive approach is warranted.

Pain Relievers and Medication

Medical management typically focuses on pain relief and alleviating symptoms. Over-the-counter pain relievers or prescription medications may be recommended to help manage pain and inflammation. In cases where pain is persistent or debilitating, stronger opioids or nerve blocks might be employed under strict medical supervision. Additionally, anti-nausea medications can be prescribed to control symptoms of gastrointestinal distress.

Laparoscopic Surgery

On the surgical front, laparoscopic adhesiolysis is considered when conservative methods fail to provide relief or when obstructions are severe.

This minimally invasive procedure involves using a laparoscope to visually inspect and subsequently cut through the adhesions, freeing the organs and allowing them to move more freely.

Although this approach can provide immediate relief, it is not without risks. The potential for new adhesions to form after surgery is a significant consideration, which underscores the necessity of weighing the benefits and risks carefully. Occasionally, open surgery may be required, especially in complex cases where laparoscopic methods are insufficient or if there are widespread adhesions.

Physical Therapy

Physical therapy for abdominal adhesions plays a key role in managing this challenging condition. Pelvic floor physical therapy focuses on the muscles, ligaments, and connective tissue supporting the pelvic organs. Our approach involves a thorough evaluation to understand how the adhesions may be affecting your pelvic floor muscles and overall function. A tailored pelvic floor treatment plan is developed, often starting with manual therapy techniques designed to break down excessive scar tissue.

These techniques might include: 

• Myofascial release and specific forms of soft tissue mobilization are useful for improving the flexibility and mobility of the affected areas. When adhesions impair the normal movement of organs, these targeted interventions can Core stabilization exercises can help strengthen the muscles of the abdomen and pelvis, providing better support to the internal organs and potentially reducing the strain caused by adhesions.
• Breathing techniques are also emphasized, as they can help enhance diaphragmatic movement and improve overall abdominal relaxation. Proper breathing helps decrease intra-abdominal pressure, which can alleviate discomfort and promote a more natural alignment of the abdominal organs. When combined with gentle stretching exercises, this approach can significantly improve your range of motion and reduce the sensation of tightness in your abdomen.
• Biofeedback training and electrical stimulation offer additional avenues for managing the symptoms associated with abdominal adhesions. Biofeedback helps you become more aware of your pelvic floor muscles, teaching you how to better control and coordinate them. Electrical stimulation can further assist in reducing pain and improving muscle function by enhancing neuromuscular activation.

Related: What is a Pelvic Physical Therapist?

Wrapping Up

Physical therapy is not just about treating the physical manifestations of adhesions; it’s about fostering a holistic improvement in your quality of life. For instance, balance and coordination exercises help harmonize your body functions, while biofeedback training empowers you with greater control over your pelvic floor muscles. You might find foam roller exercises particularly effective in enhancing tissue flexibility and alleviating muscle tension. Moreover, craniosacral techniques can offer another layer of relief by promoting relaxation and pain reduction.

At Lotus Physical Therapy for Women, we understand that dealing with abdominal adhesions and their symptoms can be daunting. That's why our tailored physical therapy interventions are designed to address not only the adhesions but also their impact on your overall well-being. Our physical therapy services, including manual therapy, myofascial release, and soft tissue mobilization, aim to reduce scar tissue and enhance the flexibility of abdominal structures. We're here to support you with core stabilization exercises, gentle stretching, and focused breathing techniques, all of which can significantly improve your mobility and relieve tension.

The path to managing abdominal adhesions may appear challenging, but with a customized and well-rounded approach, significant improvements are possible. Get in Touch Now!

Should you have any questions about whether these services are right for you, please do not hesitate to contact us at (845) 517-5100 or email us at [email protected].