Abdominal (and other) adhesions which are not caused by surgery are very common. While the diagnosis “abdominal adhesions” means scar tissue, that’s a little misleading in regards to what the full range of possibility is when talking about adhesion. Depending on how they have formed and how long they have been hanging around, adhesions can be much less complex and much easier to resolve than actual scar tissue.
Just like most things in our bodies, there are early stages, middle stages, and “what the f- is happening” stages in the development of abdominal adhesions. In my work with my clients I have never seen the “early” stages of adhesions coming anywhere close to being actual scar tissue.
Remember that scar tissue is (as you may have guessed from its name) its own kind of tissue in the body. Almost always, the body grows scar tissue on purpose – to fix something that has been torn, cut, etc. Adhesions are not usually like that (at least they’re not until, or if, they step into their more advanced stages).
In the beginning of adhesions, there is usually no distinct “extra” tissue. There is a slow-down of the blood flow to the area, there is very often fascial restriction, there are usually trigger points of various kinds, there is usually local inflammation, and yes, there is usually one soft tissue sticking (adhering) to another. Myofascial (muscle-fascia) adhesion is one common name for this process.
But What Causes Them!?
Yes, yes, you’re right. It took me a long time to get to the point. Sorry about that.
Through my seven years of working with abdominal adhesions, I have seen four primary causes of non-surgical adhesions. There are probably more, but these are the ones I can speak to directly. They are:
♦ Blunt force trauma – In my work, current or former martial artists show up a lot, though any kind of blunt force blow or fall that impacts the abdomen can be the cause. Parents beware, I’ve had more than one parent come in with abdominal injuries inflicted on them by their unwitting children.
♦ Dehydration – This can be so tricky. Most people already don’t drink enough water, so figuring out where things went wrong can be difficult. However, if adhesions form from dehydration it is often due to a combination of chronic dehydration or periodic more-than-usual dehydration coupled with inactivity – such as sitting through a multi-day seminar, a period of illness that keeps you rather immobile, etc. This is my blog post about the best hydration advice I’ve heard.
♦ Overwork of the abdomen – This can mean so many different things. Years ago I tore some belly muscles doing too many weight-bearing situps at the gym. That’s one way to create a batch of belly adhesions. So is repeatedly picking up and carrying children, especially the heavier varieties. There is also this process called “body armor” that happens when we become absolutely terrified of bodily harm. I talk about it more in the self-care videos but, briefly, it’s when our belly muscles lock down and harden faster and stronger than we could ever consciously make them do so. They do it to protect our internal organs. And they do a good job of it, too. So good, in fact, that it can be hard for this process to release fully without help.
♦ Sudden, extreme (often unexpected) weight bearing – I have seen this most often in Occupational Therapists and Nurses. Even if you’re healthy as a horse and using excellent lifting techniques, having to suddenly bear a lot of weight can take a huge toll on the abdomen. Interestingly, the people I have seen for abdominal adhesion in these cases exhibited no problems with their spine, i.e. they didn’t have back pain, just belly pain. . . which is not to say the two can’t go together. Also, see again the parent clauses above.
♦ Chronic Inflammation – Whether you have a disorder or disease that creates chronic inflammation in your abdomen or you had an isolated period of intense or drawn-out abdominal inflammation, this can be the starting point for a lot of adhesions. Chron’s, IBS, ulcers, or local infections can lay the way for later and sometimes debilitating adhesions.
Ok, So What Do I Do About It?
This partly depends on what “stage” you are in with the adhesions. If you’re within a year of what you think is the primary cause, then very probably the right kind of manual therapy or massage will be able take care of the adhesions. How long you can expect to treat them and what kinds of self-maintenance you will need to do depends largely on how often you tend aggravate the adhesions. Do you hit karate class or a heavy weights workout three times a week? Do you have kids who you need to pick up and carry around? Is the abdominal aggravation in the nature of your job? Are you constantly stressed out?
Do you stay hydrated???? (Hint, hint . . . hint, hint, hint)
If you are in the two-years-or more category, then you have a little (or possibly a lot) more work ahead of you. In these “later” stages, you may want to consider things like taking a cold, hard look at your diet and your exercise (extreme amounts of exercise can be just as bad as no exercise when it comes to adhesion), as well as at your stress levels.
From my experience as a practitioner, once you are beyond the first year of having adhesions, it’s going to take a minimum of six months before the work really starts to hold. By “hold” I mean your body finally readjusts to not having the adhesions in place and stops creating the associated pain patterns, or recreating the adhesions themselves.
If the adhesions have been around a long time, they can certainly have created a situation where actual scar tissue is present. In this case, successful treatment can take as much as two years – and this is, of course, not usually of weekly treatments the whole time. After about 3 months, most of my clients move to an every-other-week schedule until the process is complete. At that time, they generally choose to move into once-a-month treatments.
If your non-surgical adhesions are producing (or are the product of) something like bowel obstructions or an underlying inflammatory condition, then of course your process may be more complicated. But that is certainly no reason to give up on it. Just like everything else in our health, adhesions are highly individual and they are as intricately connected with our emotional, mental, and energetic well-being as anything else.
While I know it can be hard for many different reasons, I encourage you to engage with your belly and all of the complexity that is happening there. At the very least you may learn something new and surprising and ultimately wonderful about yourself.