15 FAQs Dealing With Scar Tissue After Pelvic Surgery: How Physical Therapy Can Help

1. What is scar tissue, and why does it form after surgery?

Scar tissue is your body’s natural way of healing after an injury or surgery. It forms to repair incisions or internal trauma, but it can become stiff or sticky, binding to surrounding tissues and affecting function.

2. Can scar tissue cause pain or discomfort?

Yes. Scar tissue can restrict movement, irritate nerves, and create pulling sensations or pain—especially in areas like the pelvis, abdomen, hips, or lower back.

3. How do I know if scar tissue is affecting my recovery?

Signs include:

• Tightness or pulling around your incision

• Pain with movement, sex, or sitting

• Limited flexibility or core strength

• Numbness, tingling, or sensitivity near the scar

• Ongoing pressure, discomfort, or stiffness

4. What types of pelvic surgery often result in scar tissue problems?

• C-section

• Hysterectomy

• Laparoscopy

• Endometriosis or fibroid removal

• Prolapse repair

• Abdominal or pelvic trauma surgeries

5. Can scar tissue impact pelvic floor function?

Yes. Scar tissue can restrict how pelvic floor muscles move and contract, leading to issues like urinary urgency, pelvic pain, constipation, or sexual discomfort.

6. How does physical therapy help with scar tissue?

Pelvic PTs use hands-on manual therapy, scar mobilization, stretching, and movement retraining to reduce restrictions, ease pain, and restore function in and around the scar.

7. What is scar mobilization?

Scar mobilization involves gentle, targeted massage or stretching of the tissue around and underneath a scar to improve flexibility, blood flow, and reduce adhesions.

8. Will working on scar tissue hurt?

No. Scar tissue work should be gentle and respectful of your comfort. Some areas may feel sensitive or tight, but your therapist will go at a pace that feels safe and effective for you.

9. Can physical therapy improve the appearance of scars?

While the main goal is function, scar therapy often improves the texture, color, and mobility of scars, making them feel and look smoother and more integrated.

10. How long after surgery can I start scar tissue therapy?

Typically, you can begin light scar mobilization once the incision is fully closed and your surgeon has cleared you—usually around 6 weeks post-op. Earlier interventions (like breathing and mobility) may begin sooner.

11. What if I’ve had surgery years ago—can PT still help?

Yes! Scar tissue can cause problems long after surgery. Many people see improvements in mobility, pain, and pelvic function even if they’re years into their recovery.

12. What other techniques are used besides scar massage?

Pelvic PTs may also use:

• Myofascial release

• Nerve desensitization

• Breath and core retraining

• Stretching and mobility work

• Postural correction and movement strategies

13. Can internal scars (like from laparoscopy or endometriosis) be treated?

Yes. While you can’t see internal scars, PTs can use external and internal techniques to reduce restriction and support surrounding muscles and fascia.

14. Will I need internal pelvic therapy to treat scar tissue?

Not necessarily. Many scar-related issues can be addressed externally, but internal therapy may be recommended if deeper pelvic floor muscles are affected. You’ll always be asked for consent first.

15. How do I find a pelvic PT who works with scar tissue?

Look for a licensed pelvic floor physical therapist with training in post-surgical rehab and manual therapy. You can ask your doctor for a referral or search directories like APTA Pelvic Health, Pelvic Guru, or local women’s health clinics.