Why Does My Physical Therapist Want To Know If Anything Has Ever Happened to My Abdomen?

Many of the patients I treat are coming to physical therapy for care of pelvic pain, low back pain or both. And one of the most useful things they can tell me during their evaluation or session is if, when and where they had an abdominal surgery, injury, or pregnancy history. Even if it was deemed minor and many years ago.


These events may seem unrelated to your low back or pelvic pain, but let’s dive in as to why this information can impact your treatment.


In addition to structures like bones, muscles, organs, fat, and nerves, our movement patterns are deeply impacted by what is known as myofascial chains throughout the body. “Myo” refers to muscle. Meanwhile “fascia” can be thought of as a sling that envelops and connects our muscles and other tissues. One can break down an understanding of myofascial chains as systems of muscles and other structures that are connected by fascia to accomplish movement.


Surgeries and injuries can result in scar tissue or fascial restrictions. Scar tissue can be thought of as a messy reorganization of the same type of collagen fibers that made up the original tissue. Scar tissue is also immobile and restricts the mobility of its associated fascial chains. The effects of this immobility in one area can lead to altered movement patterns in other areas. The body will overuse the more mobile parts of the body, which can result in injury. Additionally, because our lungs and diaphragm need space in the torso to coordinate breathing, immobility around the abdomen can also affect how much or how little we can breathe. 


Scar tissue can affect muscle recruitment. Examples of surgeries or conditions that may affect core stability include:


  • Hysterectomy
  • C-section delivery
  • Hernia 
  • FLAP breast cancer reconstruction
  • Spinal fusion surgeries
  • Bariatric surgery

 

In these conditions and others, one may have less access to core stability due to altered sensation in the lower abdomen, which can make utilizing abdominal muscles really difficult, if not impossible. So again, our bodies are smart, they do whatever it takes to complete our activities of daily living. The body seeks stability wherever it can find it, which may be by gripping the pelvic floor, low back muscles, or even our jaws and necks, which results in pelvic pain.        


Thus, during a pelvic floor treatment, your pelvic floor PT can assist in helping to release these fascial adhesions and increase tissue mobility through manual therapy, facilitate breathing coordination and assist you in achieving your functional goals.


Disclaimer:  The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.

Dr. Molly Weingart

Physical Therapist | Doctor of Physical Therapy
Molly Weingart is a Doctor of Physical Therapy (DPT) who specializes in pelvic health, women's health, and general orthopedics. She works at Activcore in Princeton, New Jersey, located just 2 miles from Princeton University. With a passion for pelvic health, Molly believes in tailoring each patient’s treatment to fit that individual’s goals and lifestyle. She aims to normalize all health conditions and create a treatment environment that is open, accessible, and inclusive.
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