Abdominal Scars and Pelvic Pain Abdominal scars can contribute to pelvic floor symptoms If you observe the abdominal wall as the supine patient is asked to ‘raise your shoulders’ (rectus abdominis), or ‘suck in your tummy’ (transversus abdominis) and to cough The tissues of the anterior abdominal wall should move in concert, however troublesome scars may cause surrounding tissues to move paradoxically. Scars should move freely with other subcutaneous tissues without causing pain or urinary urgency Its suggested that all scars should be palpated and treated as necessary Regions where two abdominal wall scars cross are commonly ‘active’ sites Trigger points are commonly located in and around scars.(Lewit et al 2004) “Assessment for, and treatment of, active scars, should be part of the routine management of painful conditions of the locomotor system”. “This seems logical if there is frequent recurrence of symptoms not otherwise explained, if clinical findings do not sufficiently explain a patient’s symptoms, or if a patient’s complaints begin or significantly deteriorate when a scar is formed.” “In our experience, scar trigger points (in skin or mucous membranes) refer burning, prickling, or lightning like jabs of pain. In this case, a 20-year-old appendectomy scar seemed to be related to a patient’s low back pain and groin pain.” (Kobesova et al 2007) Valouchova & Lewit (2009) report that active scars in the abdomen and pelvis commonly restrict back flexion, which the patient feels as low back pain. Treatment methods are simple, involving ‘mini-myofascial release’ methods – where skin alongside scars is treated initially, with subsequent attention to deeper layers. Treatment involves “engaging the pathologic barrier and waiting; after a short delay, a release gradually occurs until the normal barrier is restored” - See more at: REFERENCE Kobesova A Morris C Lewit K 2007 Twenty-year-old pathogenic ‘‘active’’ post-surgical scar: a case study of a patient with persistent right lower quadrant pain J Manipulative Physiol Ther. 30:234-238 Lewit K, Olšanská Š 2004 CLINICAL IMPORTANCE OF ACTIVE SCARS: ABNORMAL SCARS AS A CAUSE OF MYOFASCIAL PAIN Jnl. Manipulative & Physiological Therapeutics 27(6):399-402 Valouchova Lewit K 2009 Surface electromyography of abdominal and back muscles in patients with active scars. Journal of Bodywork and Movement Therapies 13:262–267 SEE ALSO leonchaitow/2010/04/29/manual-approaches-to-pelvic-pain-related-fascial-and-myofascial-structures/#sthash.rpI3tnIe.dpuf AND: A major chapter in the new Fascial Dysfunction book by Willem Fourie PT - on scar management: UK: astore.amazon.co.uk/leonchaitow-21/detail/1909141100 USA: amazon/Fascial-Dysfunction-Manual-Therapy-Approaches/dp/1909141100/ref=sr_1_1?ie=UTF8&qid=1412230045&sr=8-1&keywords=fascial+dysfunction+AND+chaitow
Posted on: Thu, 02 Oct 2014 06:09:47 +0000