Originally posted on August 8, 2011

(more than skin deep)

I flew through surgery a year and a half ago to remove a large ovarian tumor that fortunately was benign.  Unfortunately, I have a monster incision that runs from just above my belly button down to the top of my pubic bone. My recovery was fabulous, thanks to my good friends and therapists at ALTA.

I began treatment 6 weeks after surgery to release adhesions. Scar tissue adhesions occur in 67-100% of patients following abdominal surgery and 55-100% of patients following gynecological surgery. Lori and Jane used a combination of Integrative Manual Therapy, Visceral Manipulation and BodyTalk to address poor blood circulation and the adhesions that occurred after surgery.

Six weeks ago I went in for a second surgery to repair a hernia that developed at the incision. The surgeon found absolutely no adhesions to release during the surgery. He was astounded. How’s that for beating the odds?

15-20% of all vertical incisions in the abdomen fail for no known reason. The remaining 80-85% are caused by too much tension during suturing or increased stress on the scar from a patient’s activity level.

We’ll never know for sure what caused my sutures to fail, but I take partial responsibility.  Normal tissue healing time is 6-8 weeks, no matter what the injury.  I felt so good that I thought the rules did not apply to me.  Consequently, I sat through a 5-day seminar 2 weeks after surgery and returned to work one week after that instead of waiting the suggested 4-6 weeks.

Learn from my misfortune. Understanding the 3 stages of tissue healing will help you heal with fewer complications.

Three Stages of Tissue Healing

Acute inflammatory Phase:  up to 72 hours after the injury/surgery

1. Inflammation causes pain, swelling, redness and warmth around the injured area and is the body’s way of protecting itself.
2. Intermittent easy movement, such as  walking  around the house, is important in this early phase.

Repair Phase: 72 hours to 6 weeks after the injury/surgery

1. Inflammation decreases and your body begins to repair the injured area.
2. Collagen is laid down to repair the damaged tissue.  The collagen is unorganized and susceptible to excessive stress during this time.
3. Good nutrition and circulation are critical during this time to decrease pain and facilitate good tissue formation.
4. Activity level should increase gradually.

Remodeling Phase: 3 weeks to 2 years.

1. The collagen is like sticky glue at first and needs to remodel to improve the quality, orientation and tensile strength of the fibers to mirror the functional capabilities of the tissue it is replacing.    Appropriate stress placed on the tissues allows it to properly realign.  Without the stress, the result will be a weaker, less elastic scar tissue.
2. The remodeling phase is the ideal time to begin therapy to address adhesions, improve joint and soft tissue motion, address any postural imbalances that have occurred, and begin a strengthening program.

What are adhesions and why are they so common after abdominal and gynecological surgeries?

Adhesions are bands of scar tissue that can distort anatomy and glue together organs and tissues that are normally separate.

It is normal for the body to form some scar tissue following any trauma or surgery as a result of the inflammatory response.  But if the scar and surrounding tissue are not able to regain normal movement ,  or if there has been an alteration in posture as a result of the trauma, then scar tissue becomes an integral part of the new structure, causing restricted movement and various tensions on and between tendons, ligaments, and even the organs themselves.

The longer the scar tissue has been present and the more scar tissue that exists, the more treatments are necessary for change to take place.  Don’t wait for a problem with movement or pain to slow you down months or years after a surgery.   Schedule an evaluation by a skilled manual therapist with interest in visceral manipulation and adhesions (such as Lori, Jane or me) 6 -8 weeks after your surgery so that you too can beat the adhesion odds.

In health,

Mary