Abdominal Adhesions

In this article, we explore abdominal adhesions —what they are, what causes them, their symptoms, and how Visceral Manipulation and abdominal massage therapy can help. 

Abdominal Adhesions are fibrous bands that can form between abdominal tissues and internal organs due to abdominal or pelvic infections, inflammation, surgery, or serious injury. Surgery is the most significant cause.

Internal organs have slippery surfaces that enable them to slide and glide against other organs and tissues. When adhesions are present, the tissues no longer glide, and the internal organ’s motility is inhibited; organ function is affected, pain may result, and larger movements of the body may be inhibited. Other symptoms of adhesions may include fertility challenges, chronic pain, bloating, and constipation.

Unfortunately, most adhesions can’t be seen with imaging tests and are usually found during surgery, although imaging is improving. This study is relevant to adhesions around the uterus and bladder after c-sections and may not apply to adhesions elsewhere. “With the improving resolution of ultrasound, ever smaller pathologic structures may be visualized, particularly if they are considered in the differential diagnosis.” (source)

It’s also not possible to diagnose abdominal or pelvic adhesions through palpation, but a trained manual therapist can feel restrictions. A restriction occurs when the organ loses its ability to move, partially or entirely, which may or may not be due to adhesions.

Some perhaps, but I wouldn’t recommend vigorously “breaking up” adhesions. When adhesions are torn, it creates wounding, and more adhesions can form.

I take an indirect approach when working with restrictions to avoid further wounding. As a manual therapist trained in Visceral Manipulation™, I tune into the tissues to feel for restrictions, work as precisely as possible to gently increase the natural motility and mobility of the organs, and then let the body do its thing. Your body knows what to do. I give it a little nudge, then you self-correct for a couple of weeks, reevaluate, and nudge again if needed. What I mean by self-correct is that your body has built-in mechanisms to keep the organs moving. For instance, every time you breathe (if you aren’t just upper chest breathing), you massage the internal organs. That’s a gentle internal massage that happens about 30,000 times each day! 

Another example of the body’s intelligence is the natural innate motility, which keeps tissues sliding, improves blood and oxygen delivery, and supports lymph flow. Motility and mobility are required for optimal physiological function. Life requires movement, both internally (on the cellular level and in intrinsic visceral movement) and in your whole body in relationship to your environment. Varied full-body movement is another way to decrease restrictions. Natural movement and proper breathing mechanics are built-in fascia release mechanisms.

I cover alignment, breathing mechanics, nutrition, and gentle abdominal massage in my Free The Belly course. This course is appropriate whether you have an abdominal scar or not.

There are different degrees of adhesions, and if you’ve ever seen someone break a thick adhesion with a scalpel or other means during a dissection, you will quickly realize there is no way adhesions of that severity could be broken up manually during an abdominal massage, or would it be advisable to try? Even if the adhesions can’t be resolved (and there is no way to know for sure unless you did exploratory surgery before and after treatment), manual therapy should help reduce pain and improve organ function. 

Severe adhesions can be serious and may lead to small bowel obstruction. This would warrant a medical emergency and may require surgery or other medical intervention. 

If you are experiencing severe symptoms like obstructed bowel, intense abdominal pain, or a hard, distended belly, please see your doctor to rule out other serious conditions and get permission to receive Visceral Manipulation™ if it is indicated.  Some Osteopaths also practice manual therapy.

If you do require surgery for (c-section, appendectomy, etc.), it may be appropriate and beneficial to receive Visceral Manipulation™ 6-8 weeks post-surgery or when your physician has cleared you.

You may find a practitioner who practices Visceral Manipulation™ in your area by visiting the Barral Institute website.

If you live in the West Michigan area and are interested in working one-to-one with me, please visit my website at www.nurturance.net.

If you can’t find a practitioner near you, I offer an online course called Free The Belly that works with abdominal scars and restrictions.

Author: Barbara Horsley has more than 26 years of experience as a licensed massage therapist. She specializes in abdominal massage and Visceral Manipulation™ and is an NCBTMB-approved educator. In addition to being certified in abdominal massage, she also studied biomechanics and restorative exercise. She is also a Certified Women’s Herbal Educator and a graduate of the IWHI Perimenopause & Menopause Certificate Program.