15 FAQs The Role Of Manual Therapy In Pelvic Surgery Rehabilitation

1. What is manual therapy?

Manual therapy is a hands-on approach used by physical therapists to assess and treat soft tissues, muscles, joints, and fascia. In pelvic surgery rehab, it helps restore mobility, reduce pain, and improve function.

2. How is manual therapy used after pelvic surgery?

It’s used to gently address scar tissue, release muscle tension, improve blood flow, and rebalance the nervous system—supporting a smoother, more complete recovery.

3. What types of pelvic surgeries benefit from manual therapy?

Manual therapy is helpful after:

• Hysterectomy

• C-section

• Pelvic organ prolapse repair

• Endometriosis surgery

• Laparoscopy

• Gender-affirming surgery

4. What techniques are used in manual therapy for pelvic rehab?

Common techniques include:

• Scar tissue mobilization

• Myofascial release

• Visceral manipulation

• Trigger point therapy

• Internal pelvic floor release (with consent)

5. Is manual therapy safe after surgery?

Yes—when performed by a trained pelvic health therapist and started at an appropriate time after surgery (usually 4–6 weeks, or once cleared by your doctor).

6. Does manual therapy hurt?

Manual therapy should not be painful. Some techniques may feel intense or tender, but your therapist will work within your comfort zone and adjust based on your response.

7. What are the benefits of scar tissue mobilization?

It helps reduce adhesions, pain, itching, and pulling sensations. Mobilizing scar tissue improves tissue glide, organ function, and overall mobility.

8. Can manual therapy help with pelvic pain or discomfort during sex?

Yes. Manual therapy can relieve muscle tension, trigger points, and nerve sensitivity—often key contributors to pain during intimacy.

9. How does manual therapy affect bladder or bowel symptoms?

By addressing muscle imbalance and fascia restrictions, manual therapy can improve symptoms like:

• Urgency or frequency

• Leaking

• Constipation

• Incomplete emptying

10. Can manual therapy help even if I had surgery years ago?

Yes! Many people benefit from manual therapy months or even years post-op, especially if they still have symptoms like pain, tightness, or mobility issues.

11. What’s the difference between internal and external manual therapy?

• External therapy involves work on the abdomen, hips, thighs, back, or sacrum.

• Internal therapy (vaginal or rectal) targets deep pelvic floor muscles, and is always done with full consent and privacy.

12. What is myofascial release, and why is it used?

Myofascial release targets the fascia (connective tissue) to reduce tightness and restore fluid movement—important for releasing tension caused by surgery or guarding.

13. Is manual therapy part of a full pelvic rehab program?

Yes. It’s typically combined with movement retraining, breathing techniques, education, and exercises for a whole-body approach to recovery.

14. How many sessions will I need?

It depends on your goals, symptoms, and how your body responds. Some people feel relief in just a few sessions; others benefit from ongoing care over several weeks or months.

15. How do I find a qualified provider for manual therapy?

Look for a pelvic floor physical therapist or physiotherapist with advanced training in manual therapy and post-surgical care. Directories like APTA Pelvic Health (US), POGP (UK), or local pelvic health clinics are a good place to start.