Kirk Center for Healthy Living
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C-section: Scar Massage and Adhesion Release
1. What are some of the common symptoms?
2. What are some of the common causes?
3. What can I expect my first day of therapy?
4. What can I expect my ongoing therapy to be like?
5. How long can I expect my therapy to last before I begin to see improvement?
6. How long can I expect my therapy to last before I am healed/cured/fixed?
7. What are the credentials of my uro-gynecological physical therapist?


1. What are some of the common symptoms?

Caesarian sections are sometimes necessary for various reasons, but just like any other surgery there are issues that physical therapy can help resolve. During a C-section, surgeons have to cut through 8 layers of tissue, including your uterus. As the body heals it tends to create scar tissue along the surgical site. This scar tissue, if left untreated, may cause increased menstruation pain, pelvic pain, various bladder issues, various rectal issues, constipation and bloating/distention. One of the common complaints after a C-section is the sensitivity of the scar itself. It hurts to lean over the babyís crib to pick him/her up, or to lean against a counter. Other symptoms include pain with holding your child, pain with lifting or pain with positional changes. This pain can be in the pelvis, back or hips. Urinary leakage or the inability to stand erect or reach over your head is another common symptom.


2. What are some of the common causes?

Your C-section scar is like looking at an iceberg. You are only seeing the tip. Remember that this scar is 8 layers deep. It may have irritated nerves in that area to cause pain. The scar tissue may wrap around certain organs like your uterus, bladder, small intestines or large intestines and either cause pain or dysfunction of the organ itself. After a C-section there may be increased back pain caused by the scar tissue pulling you forward and the decreased support of the back from the abdominal muscles.


3. What can I expect my first day of therapy?

It helps to write down all of the questions that you have about your condition and therapy. If we do not answer your questions during our evaluation process, you will be prompted by your list to ask your questions at the end of your first session.
Once in the treatment room, your therapists will ask you numerous questions pertaining to your condition. Then they will analyze your posture, balance, back and hip motion, pelvic alignment and scar integrity. They will explain the anatomy of the pelvis using an anatomical model. Then your therapist will give your privacy and ask you to get undressed from the waist down. A sheet will be provided for you to cover yourself, as you lie back on the treatment table. Your therapist will exam the perineum (the area covered by your underwear), and possibly perform a vaginal and/or rectal exam. This is only done with your consent, but can provide very important information used by your therapist to create your Plan of Care. Your therapist will use non-latex gloves and lubrication during this part of the exam, which will make the exam more comfortable. Once this part of the exam is finished, your therapist will give you privacy to dress. Your therapist will then explain their findings and what your Plan of Care should be, as well as answer any questions that you still have.
Please arrive 30 minutes early for your first day of therapy. There will be paperwork for you to fill out and we do not want to eat into your hour of evaluation time with your therapist. Also please bring a list of medications, a list of your past surgeries and list of your conditions. If you downloaded the forms and filled them out in advance of your appointment, you can arrive 15 minutes early, as there are still a few forms to handle in the office. Please bring a photo ID and your insurance card.


4. What can I expect my ongoing therapy to be like?

Every patient is different but the following techniques may be included during your treatment sessions. Scar mobilization (manual therapy technique where scar tissue is broken up) will be the main focus. Other manual therapy techniques such as visceral manipulation, myofascial release, connective tissue manipulation and sacroiliac corrections (see manual techniques page for details) will be included. Once the scar tissue is pliable and your organs are moving normally then the focus will be on strengthening along your surgical site. Strengthening will consist of deep abdominal muscles, deep back muscles, deep hip muscles and deep pelvic muscles. If there is a split (diastasis recti) in your abdominal muscles we will need to correct that first with manual techniques and specific strengthening techniques to help decrease the width of the separation. Ergonomic education will be provided to aid in preventing further issues.


5. How long can I expect my therapy to last before I begin to see improvement?

Since every patient is unique, itís hard to answer this question. We have seen some patients acknowledge improvement in just two visits, while others, although rare, may need months of therapy before seeing improvements. Usually some improvement is seen within 4-6 visits. Your participation in your own healthcare can also have a big impact. This means that you have to take some responsibility for your own health and do what your therapist asks you to do outside your treatment sessions. You are your therapist are a team. Improvement rates also depend on the severity of your condition and how long you have been suffering from it. The longer youíve had your problem, and the more severe it is, will increase the time needed for treatment before you see improvements.


6. How long can I expect my therapy to last before I am healed/cured/fixed?

Again, each patient is unique, so this time frame can vary greatly. Research shows that it takes at least three months of treatment to create a permanent change in the body. We most often request a frequency of once a week for 12 total visits. That is why our office staff will ask you to schedule all 12 of your sessions before starting therapy. If you need more than 12 sessions, your therapist will discuss this with you after you have completed 12 visits and you will decide together whether continuing with therapy would benefit you or not. If so, your therapist will reevaluate you and send a progress note to your physician requesting an extension.


7. What are the credentials of my uro-gynecological physical therapist?

At Kirk Center for Healthy Living we are very selective in our hiring process. We take great care in selecting the most skilled therapists we can find. We also require that they attend multiple post-graduate continuing education courses every year, predominantly with the Herman & Wallace Pelvic Rehabilitation Institute and the Barral Institute, in addition to receiving one hour of one-on-one training with the owner of Kirk Center, Brandi Kirk, PT, BCB-PMB.
All licensed physical therapists have had to apply and be selected to attend Physical Therapy school. It is a very competitive process and only those will the highest grades and best potential are selected. Physical therapists have invested a minimum of 5 years into their undergraduate and graduate training at universities. Once they graduate, they have to sit for a State Board Exam and pass to receive their license to practice. In order to keep their license active, they must dedicate a certain number of hours to continuing education each year.
Uro-gynecological physical therapists have done everything listed above, but have also become a specialist in the field of pelvic health. As a specialist, all continuing education is focused on the conditions that we treat at Kirk Center. Some physical therapists have multiple letters after their names, indicating a license and/or certification in an area of study. Uro-gynecological physical therapists have been trained in internal vaginal and rectal evaluation and treatment techniques and by our state license we are legally allowed and qualified to perform these procedures.
   
16618 W 159th Street, Suite 402, Lockport, IL 60441  |  5851 W 95th Street, Suite 300, Oak Lawn, IL 60453
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