Scar Tissue, Fascia, and the Ripple Effect on the Pelvic Floor: How Breath and Posture Can Help
Scar tissue is a natural part of the body’s healing process after a hysterectomy, pelvic floor surgery, or any abdominal intervention. However, while it serves as the body's internal "patchwork," it doesn’t always integrate seamlessly into the surrounding tissues. Instead, scar tissue can form adhesions—dense, fibrous bands that create restrictions and pull through the biotensegrity of the entire body.
This post will explore how these adhesions impact movement, hydration, and nerve glide within the fascia and muscle chains—and how postural awareness and Hypopressives can be powerful tools in restoring balance and function.
Scar Tissue and Adhesions: A Tug-of-War on the Body’s Structure
Unlike healthy, elastic fascia, scar tissue lacks the same level of hydration and flexibility. Instead of sliding and adapting to movement, adhesions act like a web of tension, binding layers of tissue together that should ideally remain mobile. These adhesions are not just localised to the site of surgery; because of the interconnected nature of fascia, they create a pull throughout the entire system, affecting posture, muscle recruitment, and even organ function.
In a biotensegral system (where forces are balanced through tension and compression), a restriction in one area creates compensations elsewhere. This explains why someone with an abdominal or pelvic floor scar may experience discomfort in seemingly unrelated areas—low back tension, hip restrictions, even breathing inefficiencies.
The Role of Fascia Hydration: Why Dryness Creates More Adhesions
Fascia, when healthy, is well-hydrated and gel-like, allowing for smooth movement and adaptability. However, when adhesions form, they reduce fluid exchange within the tissue. This leads to a cycle of dryness and stiffness, further encouraging additional adhesions to develop. The result? More restriction, more compensation, and increased difficulty in movement and nerve glide.
What does this mean for the pelvic floor and beyond?
The lack of hydration in fascia can contribute to increased sensation of tightness and discomfort.
Nerves need a hydrated, mobile environment to "glide" smoothly between fascial layers. When restricted, nerve irritation and altered sensation (numbness, tingling, or even pain) can occur.
The muscle chains that rely on free movement (including the deep core and diaphragm) may not activate optimally, leading to further dysfunction.
How Adhesions Affect Nerve Glide and Muscle Function
For nerves to function properly, they must be able to slide freely through the fascia and surrounding muscle layers. Adhesions, however, create a stiff, sticky environment that can trap and compress nerves, leading to altered sensation, discomfort, and compensatory movement patterns.
The most affected nerve pathways in pelvic and abdominal surgeries:
Iliohypogastric and Ilioinguinal nerves – May lead to lower abdominal tightness, pelvic discomfort, and sensory changes.
Pudendal nerve – Compression or restriction may contribute to pelvic pain or dysfunction.
Sciatic nerve – A restriction in the fascial connections from the pelvic floor and hips can impact sciatic nerve mobility, leading to referred pain down the leg.
When nerves cannot glide smoothly, movement and breath are often altered subconsciously as a protective mechanism, further reinforcing dysfunctional patterns.
Restoring Mobility Through Posture and Breath: The Role of Hypopressives
Addressing post-surgical adhesions requires a multi-faceted approach, but breath and postural awareness are two key components that can begin shifting the body toward more balance and fluidity.
Breath as a Fascia Mobiliser
Slow steady, intentional breathing—especially lateral and diaphragmatic expansion (without excessive belly breathing)—helps mobilise fascial layers and create internal movement that can help soften restrictions.
Hypopressive breathing, which involves subtle pressure shifts and decompression, can encourage better fluid exchange in the fascial system and help nerves regain their natural glide.
Postural Alignment and Decompression
Scar tissue creates imbalances in muscle activation, meaning certain areas compensate while others become underutilised.
Hypopressives, which encourage a neutral pelvic position and decompression of the core, can gently release tension from adhesions and help realign muscle activation patterns.
Facilitating Glide & Hydration
Gentle fascial release techniques, movement, and breathwork can restore hydration to the fascia, breaking the cycle of dryness that leads to more adhesions.
Movement that focuses on elongation and global expansion (rather than isolated contraction) encourages biotensegrity restoration.
Conclusion: Reclaiming Mobility and Function
Scar tissue post-hysterectomy or pelvic floor surgery doesn’t have to mean permanent restrictions. Understanding how adhesions affect the body's biotensegrity, fascia hydration, and nerve glide allows for a more targeted approach in restoring function.
Breath, posture, and mindful movement (such as Hypopressives) offer a gentle yet effective way to:
Reduce the impact of adhesions
Improve hydration and glide within the fascial system
Encourage nerve mobility and reduce restriction-related symptoms
Restore balance and function throughout the whole body
By addressing the interconnected nature of scar tissue, fascia, and movement, we can shift from a state of restriction to one of greater ease and adaptability.
Would love to hear your thoughts—have you noticed the effects of scar tissue post-surgery? Have breathwork or movement practices made a difference for you? Let’s start the conversation!
