Frequently Asked Questions about Abdominal Adhesions
If you don’t see the answers you are looking for here, please see my Articles and the Blog. They are really comprehensive.
Does manual therapy really work for abdominal adhesions?
Without a doubt, it does. Adhesions regularly occur throughout the entire body and while releasing them is greatly influenced by your state of mind, your level of hydration, and several other factors, manual therapy is made for this work. Treating adhesions in the abdomen is sometimes more complicated than treating them in the rest of the body because of the presence of the internal organs, but it is still very effective work. You can expect good results from regular sessions.
Different practitioners have different methods and timelines for treatment. For me, over the last eight years, I have found that 1-hour weekly sessions with me is the most effective timeline during the first 3-6 months, lengthening out to every-other-week, every-three-weeks, monthly and longer as time goes on. In this “model,” I give my clients homework for in between sessions to ensure they maintain their progress from week to week and month to month. The entirety of treatment time, from first session to the point where clients are only seeing me once every few months for tune-ups, is usually two years.
The vast majority of my clients who stick through the whole two years end up with little to none of their original symptoms (assuming they continue with their self-care and any additional lifestyle changes, as needed).
The reason I don’t encourage (and rarely allow) multiple sessions per week is because of the time it takes for the central nervous system to adjust to the changes being made in the body as adhesions are released and tissues are finding new and freer ways of working in the body. If too much is done in the body too quickly, it can actually slow down progress. I know this seems a bit counter-intuitive, yet I have experienced this slow-down in progress with clients receiving too-frequent treatment many times over the years.
There are other practitioners who do not operate with this understanding and who treat with far more intensity (for example, Clear Passage therapists) and practitioners who are much less rigid in their recommendations and only ask clients to have sessions once per month or “as needed.” Different people get relief from both of these types of treatment models – it just depends on your individual body and your desire for how you work with your body in recovery.
My particular way of working with people is based on what has reliably helped my clients experience full and consistent relief from their symptoms over and over again through the years.
How can I find a practitioner near me? Or, Isabel, do you know a practitioner near me?
One of the best ways to get good recommendations is through the growing Abdominal Practitioner Directory. If you don’t see someone in your area, google search terms like “abdominal massage” and “visceral massage” – this might turn up someone near you. (If you find someone, please encourage them to join the directory!)
Additionally, I have posted interviews with practitioners from around the country whose work I admire on my blog. If you don’t see a practitioner there, please check the listings of practitioners at arvigotherapy.com, barralinstitute.com, or chineitsang.com as these folks have solid training in the belly. While their work is not always the same as what I do, interviewing practitioners will give you a good sense of whether or not they can help you.
Will the effects of the treatment last?
Yes. However, how long the effects of treatment last depend somewhat on how long the adhesions have been giving you problems. Once abdominal adhesions begin to release, it generally takes very few sessions to maintain the change. However, if the adhesions have been around for a while (more than a year) your body has likely developed other patterns of pain or dysfunction around the adhesions themselves, or the original area of adhesions may have expanded and more organs or tissues may now be affected.
These extended issues can be as (or more) difficult to address as the original adhesions themselves. However, in my experience, these patterns are almost always possible to “fix.” After the initial release, there may be a long period of time in which your body tries to go back to what it knows (the patterns of pain and dysfunction) and it is always possible that the adhesions will reform, especially if they were particularly bad or if your body is prone to easily create adhesion. In these cases, it is usual for people to continue with maintenance treatment once per month for about two years until the body starts to calm down. Also, of course, if the area is re-injured, if you are a true-blue couch potato, or if you have to undergo another surgical procedure, there is a much greater likelihood that the adhesions will reform.
To create the most positive environment for lasting change, it is best to stay hydrated, avoid excessive stress, and receive regular maintenance sessions and/or perform regular self-care.
How will I know if it’s working?
Decreased pain and increased mobility are the strongest indicators that treatment is working. However, it can take some time for you to feel the results. Often, if you are not feeling better right away, that doesn’t mean you aren’t getting better. Symptoms can become a bit of a habit for our bodies – the longer you continue consistent treatment (either through self-care or with a practitioner, or both) the better results you will get, generally.
It is very important to keep a written log for yourself – it doesn’t have to take a lot of time, just a basic spreadsheet that you can tick boxes for your level of pain, discomfort or other symptoms you are having each day. This way, you don’t have to rely on memory to see your progress.
If you are working with a therapist, s/he will be able to tell you whether the tissue is beginning to change or not. In this case, if you are not experiencing at least moderate change by your fifth or sixth session, that specific therapy or that specific therapist is probably not for you. As I mentioned on the treatment page, there are a number of therapists in different modalities working in this field, so don’t give up.
How long will it take to start working?
Usually treatment for abdominal adhesions starts to have a significant effect around the fifth or sixth session at the very latest. Some people feel a huge difference after one or two treatments, for some it takes more. Treatment time is always influenced by how long you have been suffering from the adhesions, how much medication you are taking, your level of hydration and activity, frequency of treatment, and your overall level of stress. If you have been living with adhesions for more than a year, or have surgeries that happened years ago, you should expect to work with them for six months to two years before you have “full” resolution. Often, you will need to do some work with the adhesions (in many cases no more than 2-3 times per year in the long-run) for the rest of your life.
What if I have already had one or more surgeries? Will massage or manual therapy still work for me?
Surgery almost always complicates treatment, but that doesn’t disqualify you in any way! Whether you have had no surgery or seven surgeries, it is worth receiving this type of care and you can definitely benefit from it.
Does the treatment hurt?
While treatment is not usually painful, it is sometimes uncomfortable for short periods of time during the session. Resolving adhesions is a lot like removing a bandaid. The two surfaces are stuck together and have to be worked apart – that can be uncomfortable. However, most people feel that the relief which follows the session far outweighs the temporary discomfort of the work. It is important to note that treatment should not be excruciatingly painful. If it is, either this type of work or the person you are working with is not the right fit. It is also worth noting that you may sometimes feel a little sore after your first treatment, or after your first treatment that produces a lot of release. Some soreness is normal in these situations but, on the whole, sessions should not cause huge pain flares or leave you sore for more than 2.5 days. Also, the two days of soreness should be followed by some kind of relief. If you are feeling sore after your sessions without any material change in your comfort, then you should probably reconsider the type of treatment you are receiving.
What do I do if the treatment doesn’t work?
Don’t give up! Whether you are working with self-care, or a practitioner, or both . . . If five or six sessions doesn’t provide any kind of relief, you should consult another professional or get some private instruction on the self-care. Because all bodies are different, abdominal massage is not an exact science and sometimes a little change in technique can make a big difference in the result. Also, a good practitioner should be able to refer you to other excellent resources in your community, including acupuncturists, chiropractors, and other manual or massage therapists.