Scars, Adhesions, Endometriosis and Infertility
Successful Pregnancy after Pre-IVF Physical Therapy
A 32 year old female patient of mine conceived twin daughters in January 2020 and was so excited she wrote to me and said:
What a gift after two prior failed IVF’s. I really feel like the work you did made it possible for me to have my miracle babies!! Thank you!!!”
Here is the Story of Her Journey:
This patient, who is a physical therapist by profession, was diagnosed with stage 3-4 endometriosis and subsequently had laparoscopic surgery October 2018 to remove the endometrial lesions and scar tissue. She had hoped the surgery would improve her fertility chances, reduce menstrual cycle and intercourse pain, as well as resolve the nagging discomfort in her lower abdomen.
But to her dismay, none of this happened. In fact, both Fallopian tubes were surgically removed as they were not salvageable. Her doctor recommended assisted reproductive techniques post surgery, IVF or in-vitro fertilization which became her only means to conceive.
What Studies Say About Reproductive Age and Endometriosis
According to The American College of Obstetrics and Gynecology (October 2012) One in 10 women of reproductive age in the United States has endometriosis—making it one of the most common gynecologic disorders.
The European Society of Human Reproduction and Embryology reports that 50% of infertile women have endometriosis. This disease presents when endometrial-;like tissue grows around the ovaries, on or in the Fallopian tubes, on the outside of the uterus, or on other pelvic or abdominal organs. Laparoscopic surgery is used to remove endometriosis. This is done by either cutting it out or by freezing, heating, or lasering to destroy the tissue. This technique removes the invasive endometrial cells but the down side is the post-surgical scarring and adhesions.
What you can you do when two rounds of IVF fail?
Through word of mouth, this woman heard about Cox PT for pre-IVF infertility assistance. Her goals for therapy were to reduce, soften and/or remove post surgical adhesions from the uterus to prepare the tissue for her final two female embryos.
Assessment:
By using an “insightful touch” I am able to identify lines of tension, adhesions, scar restrictions, tissue dryness and roughness, pain and simply looking for areas where there is loss of motion.
Findings:
We identified a lack of uterine mobility. The uterus was scarred down toward the left back wall on the sacrum and tail bone, compressing against the rectal colon and thus compromising stool elimination. Due to the left uterine scarring, pelvic organs had shifted. This created a great deal of cross tensional stretch on the right side of the pubic bone, right bladder and associated kidney pathway.
Other Concerns:
She reported having daily bowel elimination difficulties. Elimination was moderately painful, and the stools were pencil thin. Not only did it hurt to have bowel movements, the left pelvic floor muscles were in spasm which made sitting very uncomfortable, tolerable for about 30 minutes. She also had chronic daily lower abdominal pain with mild to severe bloating; this discomfort was described as sharp, pressure, cramping and a dull ache.
Reproductive Treatment Goals:
My treatments targeted removal of elements that could hinder or obstruct reproductive function and fertility. I worked the primary restriction by releasing the uterus away from the left sacrum and tailbone. Then I freed up the tension and adhesions binding the small bowels, sigmoid colon, rectal colon, uterus and bladder together. I worked locally on the uterus to soften all areas of thickness and fibrosis until soft, slippery and with a “marshmallow like” consistency with compression and decompression. I then finished globally with all associated fascial tissues, organs, muscle, ligaments, and tendons, especially the diagonal restrictions found on the right bladder, ureter and kidney.
As an expert in manual therapy, I want my work to any or all of the following:
- Improve tissue elasticity and muscle function.
- Increase range of motion, blood flow, and nerve function.
- Increase organ, soft tissue and joint mobility.
- Reduce tissue swelling.
- Resolve pain, inflammation, post surgical scarring and adhesions.
Cox Physical Therapy can prepare the way for your future children with pre-IVF infertility assistance.
This is true, especially if it is related to mechanical restrictions from adhesions and scarring. Adhesions and scars can form after falls on the back side, a fractured hip or pelvis, pelvic infections, pelvic inflammatory disease, appendicitis, endometriosis and from surgeries to the back, abdomen or pelvic organs. Adhesions are a frequent cause of unexplained infertility and are difficult to diagnosis because ultrasounds, x-rays, CT or MRI scans do not show adhesions. You literally have to do surgery, usually laparoscopic, to look inside at the tissues and organs as they are lifted, moved, separated and spaces are parted open to see and identify if there are adhesions.
I am seeing more and more young people with serious compression issues that can affect not only muscle-skeletal health but concentration and decision making. When the upper back rounds forward, the chest, sternum, and ribs put pressure on the heart, lungs, and diaphragm; thus reducing blood and oxygen flow. The upper spine connects with 150 joints and performs three million movements per day just for breathing. Constant compression can lead to adhesions and scarring that restrict our bony skeleton and associated organs.
I put my hands around the back of his head as if it were a tethered balloon. F or a child his age, I should feel a soft spring-like suppleness, and elongation of the tissues when stretched. As he stood still in the effects of gravity, I could feel moderate muscle and tissue tension on his head and neck coming from the left lower body.
After her first few rides, however, she noticed that her central abdominal muscles did not seem to be as sore as the rest of her muscles. She knew something wasn’t working correctly and scheduled a visit for my help. I felt the lines of tension to her pelvis and hip joints especially the left. Sure enough, old pelvic scarring was preventing normal hip and pelvic range of motion. So instead of the bones moving separately, as they should, they were moving as one piece. Her central abdominal muscles from lower ribs to pubic bone could not engage properly because of adhesions restricting the pelvis from tipping upward. It is a good thing that Mare noticed her abdominals were not working as expected. Her inner thigh muscles and associated pelvic muscle groups, which help maintain her in the saddle, were not engaging properly. This compromised Mare’s security and balance.
