Pelvic Pain: The Role of Scar Tissue

In Pelvic Floor Physical Therapy by Melinda Fontaine478 Comments

Scar tissue is a common contributing factor to pelvic pain. The good news is: it’s an issue that’s highly treatable with PT.

In this blog, I plan to give you the rundown of how scar tissue can impair the pelvic floor as well as how PT and self-treatment can successfully treat these impairments.

Before we get into what scar tissue does, let’s take a look at what it is. Scar tissue is fibrous tissue that replaces normal tissue after an injury. It’s made of the same stuff as the tissue it replaces—collagen. However, the quality of the collagen is inferior to the tissue it replaces. Plus, the tissue is usually not as elastic as the original tissue. This is especially the case with a keloid scar, one type of scar that is extremely restricted and raised.

It’s important to bear in mind that the scar that you can see is actually only the tip of the iceberg as most scars extend deeper into the body than the bit of scar that is outwardly visible.

Scarring that affects the pelvic floor can happen as a result of any trauma to the area, including a C-section, perineum tear or episiotomy during childbirth as well as a prostatectomy, a hysterectomy, a vasectomy, bowel surgery, endometriosis surgery, bartholin’s abscess removal, or physical injury.

And there are three major ways that scarring within or adjacent to the pelvic floor can cause problems:

First, scar tissue is indiscriminate in what it attaches to. So it can adhere to skin, muscle, or connective tissue. Wherever it decides to hang out, it pulls on the surrounding tissue making the area taut and restricting blood flow, a situation that often results in pain.

For instance, we have a patient who had a bartholin’s abscess removed. The abscess was buried within her pelvic floor. The scar tissue that resulted from the surgery now causes pain to the internal pelvic floor muscles that surround it.

The patient presents with pain in the area surrounding her scar because the tissue isn’t getting the blood flow and oxygen that it needs.

Another way that scar tissue can wreak havoc within the pelvic floor is as a result of referred pain. Remember, there is a network of nerves that innervate the pelvic floor. If a scar is on top of or impinging on a nerve that also innervates another part of the pelvic floor, then that area can also be affected.

For example, the round ligament that attaches from the sides of the uterus to the labia can be caught in scar tissue after a C-section because the incision is also right over the area where the round ligament crosses the pelvic brim. If this happens, a woman can experience labial pain, especially with transitional movements like going from a seated position to a standing position.

That’s why it’s important to remember that the pain and dysfunction caused by a scar is not always going to be in the area where the scar is located.

Another way scar tissue can cause problems within the pelvic floor is by impairing function in the area where it’s located. The pelvic floor is a major hub of the body. Muscles, nerves, connective tissue, and organs are all located there, and they all have important jobs to do, such as keeping us continent.

For instance, if a muscle is torn and then a scar forms—as in an anal sphincter tear during a difficult childbirth——that muscle may lose some of its ability to contract, which could lead to a loss of control over urination, bowel movements, or sexual function.

So how scar tissue treated in PT?

In all cases, a scar can be made more flexible by manipulating the scar tissue. The more scar tissue is moved and massaged, the softer and more similar to the tissue around it it becomes. This reduces tightness and breaks up adhesions (an “adhesion” occurs when scar tissue attaches to a nearby structure).

So if a scar is pulled in all directions, the body will lay down the fibers of the scar tissue with more organization, and in a similar alignment to the tissues around it. This results in the scar blending in better and behaving more like normal tissue.

What this means during your PT treatment is that the therapist will massage and manipulate your scar tissue and the area around it. Scars (internal and external) can be pushed, pulled, pinched, rolled, and rubbed.

Warning: manipulating a scar can be painful. That’s because tissue that has restricted blood flow is super-sensitive to touch, so treatment can be painful, and sometimes breaking up an adhesion can cause temporary discomfort.

But, this is a pain that comes with gain. Ultimately, scar mobilization promotes collagen remodeling, which increases pliability of the tissues and reduces uncomfortable sensations, such as itching or sensitivity.

It’s best to start scar mobilization early in the healing process, usually six to eight weeks after the trauma that caused the scar. The reason that early intervention is ideal is because the tissue will respond quickest during this period.

However, the body remodels scar tissue constantly, so your tissues are being replaced with new tissue all the time, just at a much slower rate when scar tissue is older. So scar mobilization can help with scar tissue and adhesions that are years old. Scar mobilization can be performed on scars anywhere on the body including the abdomen, pelvis, and vagina and can also be used to desensitize the area surrounding the scar, which often becomes extremely sensitive to touch.

Physical therapists can perform scar mobilization and also instruct patients on how to perform the mobilization at home if appropriate.

Scar tissue mobilization has a definite payoff. For instance, one of my patients had bowel surgery that included an incision on his left lower abdomen eight months ago. As a result, his pain levels were an 8/10 in his left testicle, and he had pain with urination and ejaculation. Upon examination, he had a restricted scar and tight abdominal and pelvic floor muscles. I taught him how to massage his scar and relax his pelvic floor, and after eight visits, his pain is down to a 2/10, and I foresee additional improvement for him.

I hope I have done a good job explaining how scar tissue can impact the pelvic floor and how it can be treated with PT and self-treatment.

But if you have any questions on this topic, please do not hesitate to leave them in the comments section below!

Be well,



  1. I toldly agree with your scar tissue theory but can not find a PT pelvic floor person who agrees with you or beleives in your methods. i know you teach all over the US but your method are not getting to the Pelvic fl specialist around Atlanta. ihave been to four Pt pelvic specialist and none have done the kind of therapy you are mentioned.

    if I come there I am afraied i would not beabe to stay long enought for you to really help. medication is keeoping me going mad but it wears off in about a month. then we change medication and go on for another month. I have been a bike rider for a list 30 years and have had a hysterectomy. a 10 lb baby at 41 and am 65 now. my burning is in the vaginal are and the spasm are in the rectal area so i think i have
    adhesions some where in the pudendal nerve area around the rectum. Ao far i have no bladder systems. Do you suggest i see you for a visit and go from there, I can tell you now i do not care what kind of credentials the Pt pelvic people are not very good here and have not help me at all

    1. Dear Ann,

      I am so sorry that you’re having such a hard time finding a PT in your area.

      Below are three PTs that we recommend in the Atlanta area:

      1. Lone Howell at Physiotherapy Associates, Auburn, GA, 770-995-5242/[email protected]

      2. Jenny Hunt at Sovereign Rehabilitation Women’s Health, Alphretta, GA, 678-528-7519/[email protected]

      3. Blair Green at One on One Physical Therapy, Atlanta, GA, 770-500-3848/[email protected]

      If you have already tried these PTs, please let us know, and we’ll then talk about what other options you might have.

      All the best to you,

      1. Please give me PT in the Charlotte or NC area. I have been suffering for a long time. The VA does not offer such help; but they have diagnosed my pain as scarring from a c-section. Please contact me by email.

          1. Just wanted to say , I have suffered for over a year & could not walk 1/4 mile without pain . I had epidurals & muscle injections after having adhesion removel surgery at Duke my insides were a mess . I spent all year in PT & having all sorts of muscle injections due to hip pain , sacrum & pirformis , low back . Finally my water PT had the instinct to send me to Emily Wegmann !!!!! Life Changer from the initial exam she hit the area within that had been the culprit (obturator internas ) she has made me understand biofeedback & within a month I was finding my way off meds & back to being able to care for my family ! I am now walking for daily life & added on my exercise & I’m up to mile & 1/2 .. I still have things to work through with my pelvic floor but I thank god they sent me to Emily Wegmann .. I was just doing some research on my intestinal issues & the connect to my pelvic floor , when I saw this post & her name & just had to write . Hope with whom ever you’ve found your doing better & pain free .

          2. Greensboro and Raleigh are quite far from Charlotte. Is there nobody closer you recommend? These would be hard to see on a regular basis.

          3. Dear Jac,

            I’m sorry, but these are the only PTs we are familiar with in your area. Please check out this blog post we wrote about finding a qualified local PT; the tips included in the post may be of help to you.

            All the best,

        1. you were dianosed with scarring pain from c-section do you also have spotting or beeding problems like double periods?

          1. Dear LJ,

            I have never heard of those two being related.


      2. Dear Liz,
        Thank you so much for taking the time to post that for Ann….as I have lived in the Atlanta area for over a year now and am struggling immensely re: the same issues shes having. I am 35/F have had over 8 pelvic floor surgeries,,,,and have been suffering immensely w- regaining any sort of sustaining quality of life back after seeing specialists now, full-time, for 5 years. I really feel like the majority of the lasting & often debilitating abdominal pain that has taken over, following my last surgery (hysterectomy) is likely due to a significant amount of scar tissue that has built up quite quickly in last yr in a half…..
        …….but I have yet to find a pt that seems to be incredibly knowledgeable within this area…vs just knowing the “basics of what to do” and spending a great deal of money only to discover after a few months, that they just don’t seem to know what their doing.

        Have you tried any of the above atlanta, ga references ^^^??
        If so, who did you believe was the best suited for this, as it seems like we may be struggling w- some common similarities? I could really use your advice… as I feel like Im losing hope for something I just cant locate the correct help on.

        Thanks so much

        1. Dear Melissa,
          I’m so sorry to hear about everything you’ve gone through. I know how hard it is to function with all the pain. I had a fourth degree tear during labor and have had 9 reconstructive surgeries vaginal and anal. I hurt all the time. No one told me about physical therapy after these surgeries, and the scar tissue keeps growing and changing. I am now about to have my 10th surgery and am scared to death. I also need a hysterectomy but have put it off because of the pain I know I’ll have to endure. I wish all the best for you, and hope we can find someone to REALLY help us. You are in my prayers.

          1. Hello Jennifer,

            Have you been evaluated by a pelvic floor physical therapist? I may be able to recommend a local therapist.

            All my best,


      3. Could you please provide your recommendations for a PT in Omaha, Nebraska?

        1. Hi Nicole,

          We recommend Alicia Birky at Methodist Physical Therapy Women’s Center, her number is 402-354-1702 or Lauren Potach at Wellspring Physical Therapy, her number is 402-934-9711.


      4. I am having trouble finding a pt near grand rapids mi. I have had a laparoscopy for endometriosis, a c-cection and a hysterectomy. My current doctor doesn’t seem to understand my pain, he put me on Norco, which help some, but he is now saying he wants me to try to get off them. I’m trying to work and am in a lot of pain, I feel like I’m at my wits end. I have 5 children, 3 grandchildren & one on the way, I can’t keep up anymore. Please send some information as soon as possible. Thank you Anne

      5. Do you have any PT in Arizona? Just had a surgery consult and before I seriously consider a surgery to clean up a surgery I would love to try PT/massage.

      6. Please give me a list of POSSIBLE in my area. Lake Charles, Las or Alexandria, La

      7. I have been suffering of this for over a year, more surgery did not help. Please recommend someone in Southern Oregon who can help me. Thank you!

    2. Thank u so much for your help i have been in distrss for so long i have had three c sections and a bowel resection and many oter surgerys on my stomach.thank u.

    3. this article is excellent. I have been suffering with excruciating pelvic pain for over a year. Finally dr decided to do a laperoscopy on me just yesterday. She found tons of scar tissue sticking to things everywhere, bladder, colon and in between. She removed some and today i am home and 80% better. I have to go in for more surgery because she couldnt remove enough at the time. I also go to PT which has allowed me some good days, and i will continue until I am completely healed. I am so so happy that this has finally been figured out. Worst pain I ever had. Wish my dr would have ordered the test months ago.

      1. Hi Anneg, I have alot of scar tissue that causes me great pain. I am going through pt but after 8 months I am at my pain limit. Can you tell me if you you still feel the surgery helped relieve the pain? My physical therapist warned that the scare tissue could just grow back. Can you share how you are doing today?

    4. I am a neurosurgeon that had an alpine injury some years ago, it tok 3,5 years to find and surge an inflammed hip labral tear, next year a partial adductor Magnus tear was scarred, calsiied and inflammed when surged. My pain is localized to internal obturator which have shown to be in spasm and a bit scarred. I have a temendous pain when exploring the area, also on a regular basis. Xyl takes the pain Down for hours, but it is very resistent. How can I get this muscle desensitized. Pudendal nerve has been thought of but no respons to Blocks towards the nerve, Aix or Nantes criterion excluded, perhaps a myotendinitis With a neurogen Component. Have you advice?

      1. Dear Henrich,

        I would recommend that you make an appointment with a qualified pelvic floor physical therapist.

        If you would like to read more about how a PT treats pelvic floor dysfunction you can check out the following links:


      2. I too am a physician- I have PN and my left obturator interns is always painful -I have pelvic floor pt once to twice a week which helps.
        Can you tell me what is Xyl?

    5. Please recommend someone in Knoxville, Tennessee. I just found your website tonight and I am so excited that there might be help for me! Thank you!

    6. Please advise PT’s in Tallahassee area. I had a tram flap 2011 and had complication that causes horrible scaring and then had a revision that was performed beautifully. Nine the less my pain is from lower left up to left breast and now moving to the right of my abdomen. If I could have this pain alleviated then I would only have my joint pain to deal with. Thanks so
      Much !

    7. I have been searching for answers to my pelvic pain for over 18 months. I’ve been to my gynecologist, urologist, and then sent to a urogynecologist for a second opinion. The pain is on the left side in my pelvis and seems to be from the area that my bladder sling is attached on that side. My urologist is recommending having this removed (mesh) and replaced with a sling made from my own tissue. I’m extremely nervous about going through this surgery. Is there any other options? Would PT help? It is painful just sitting. It worsens with standing and walking. I use to walk 2-3 miles daily and barely stand to work my 8 hr shift and then go home and do the basic necessities. I don’t want to use pain medications, because this is just masking the real issue. If there is a possibility this could help, is there a PT specialist near Evansville, Indiana? Thanks!

    8. Dear Ann, Do you know any doctors in Atlanta who knows anything about Dyspareunia Pain?

    9. Hi Ann. I’ve had a c-section in 1985. In 2012 I had hemmroid banding done for my 3 hemmroids at separate times. It was a “non surgical procedure” according to the CRH Regan System. On November year (2016) , I started to notice coccyx pain when I sit down and siting down for long periods of time. I’m now having to sit on a donut pillow. I do not recall falling, traumatizing or doing anyithing to my tailbone. I am going through chiropractic treatments and PT. What I read is when the hemmroids fall off, an adhesion develops where the hemmroid was. Can scar tissue be the cause of my pain? Is it possible? I so much regret doing the hemmroid banding. Any hope?

    10. His. I forgot to mention something else in my first reply. I also have feces leakage from my second childbirth. My Spchinter muscle is weak and I’m doing the quick & endurance contractions 3x day 10 times for that. My biggest concern though is my coccyx/tailbone pain if I’m gonna have to endure this pain and if I have any hope and what can I do about this?

    11. Is there a pt in Ontario CA my doctor told me that I will have to live with the pelvic ?pain the rest of my life he said I had too many sugerysand that my body grows scar tissue too fast

      1. Hi Maureen,

        We recommend Laura Disenhaus (416) 591-1123.


    12. I was in a horrific car accident a couple of years ago. Is it possible that scar tissue is just now starting to give me pain in the pelvic area even though it’s been two years?

      1. Author Melinda Fontaine says:

        Hi Lindsay,

        I’m sorry to hear about your accident and your pain. Yes, it is possible and common for scar tissue from a trauma to build up over time and cause symptoms years later. Treatment would be a good thing for you to look into.


      2. Sorry to hear that! I was also in a horrific car accident, but it was back in 1991. I started getting pelvic pain in 2004 and nobody has figured it out until I just started seeing a pelvic floor PT and she said my abdomen is full of scar tissue. I am having visceral organ massage done and am hoping it starts to help.

    13. I had my second csection 19 months ago and ever since the day after my 2nd csection I knew something was wrong my left side did not feel right which got way worse as the time went on I have been to doctor to doctor and no one wants to help me! I have pain in groin hip and down my whole left side. My left side feels swollen but doesn’t look it my legs feel tighter in my jeans on that side. I have gone to PT but it was so demanding that I ended up stopping but know I have to start back. I have been going to accupuncture as well. I will try anything please me! I can’t exercise bc it makes me feel worse but not doing anything is also making me feel worse. I have always been an athletic and fit person and I just feel so out of shape and in pain! My dr said he cleaned out a whole bunch of scar tissue in my last csection on the side

      1. Author Melinda Fontaine says:

        Hi Jillian,

        The fact that you started noticing symptoms the day after your C-Section confirms that it started at the same some as the procedure. The sensation of swelling and tightness without visible swelling makes me think the nerves could be a cause for the pain and altered sensation. There are multiple nerves that pass from where the c-section scar is and continue into the leg, such as the genitofemoral nerve and ilioinguinal nerve. I would suggest finding a good pain doctor or anesthesiologist who would be willing to try some nerve-directed treatments with you. Also, make sure your PT is aware of this possibility.

    14. Hello i would like to also know where I can find a PT in Tampa fl that can do the services you mention here. Thank you.

  2. I have never had surgery, just 2 vaginal births 25 years ago. A recent MRI shows scar tissue in various pelvic areas. I’ve been told this could due to a mechanical issue.
    Could you comment on this type of scar tissue and if it differs. It is causing me pain and neuralgia. I never thought a person would have tissue changes if there was no surgery involved.
    Luckily for me after a two year medical journey, I have found a therapist that is familiar with some of your techniques… once again I’m trying to heal.

    I love this newsletter! Thanks

    1. Dear DSW,

      Thanks for sharing your story. That is a great point you brought up. Mechanical stresses to the body can create micro injuries to the tissues, which the body will heal by making new tissue. Sometimes your body will make too much of this tissue, and then it will cause similar symptoms to scar tissue caused by surgeries, such as limiting blood flow or entrapping nerves. I am so glad to hear that you have found a therapist to help you through the healing process.

      Please let me know if you have any further questions!

      All my best,

  3. Your recent blog re: scar tissue is timely as I believe I am suffering from pelvic floor pain resulting from multiple pelvic surgeries for endometriosis. My gyno had excised endo from the vaginal/rectal wall on two separate occasions. Now I have pain during BMs and chronic constipation. My stools are either small and hard or soft and pencil-thin. Endoscopies are normal. Could scarring from endometriosis surgery result in a constricted bowel? Could pelvic PT help in softening the scarring around the bowel and thus making the passage of stools easier and less painful? Your advice would be much appreciated, as well as any past experience in dealing with similar situations as mine. Thank you kindly.

    1. Dear Isabel,

      Great questions. Scarring from endometriosis surgeries on the vaginal and rectal wall could absolutely cause restrictions in the rectum and less ability to stretch, which would create small or thin stool and pain with bowel movements. Pelvic PT can help improve scar tissue, so I absolutely think it is worth having an evaluation by a physical therapist. Restrictions in the rectum or anus are common causes of chronic constipation and painful bowel movements.

      All my best,

      1. I totally agree, I have lots of scar tissue from a big episiotomy 2 years ago from a traumatic first birth! i also have a rectocele and pelvic floor dysfunction, this effects my daily life, i have become depressed over it! my PF muscles are so tight and spasmic, i cannot empty my bladder or bowels properly, on top of that i have severe bloating and constipations with hemorrhoids and fissures! let me tell you thats the last and first time i ever go through childbirth!

        1. Hi Heidi, I had 3 childbirths the last one 24 years ago. 3 months ago I started having very bad incontinence issues. Doctors are great at not really understanding the issue. I was at a lost so I started accupuncture, which has always worked for me, it worked some but did not take care of it. I then found a PT in Kansas City just a week ago, and she explained to me that I had really bad scar tissue from the last 2 births I had. I have experienced similiar bladder problems as you and some bowels issues. Had no clue about the scarring. I had my first pt Friday and my therapist says I am fixable. I would recomend you find a pt now as your scar tissue is so young compare to mine. I will pray for you and hope that you can find the help. If you are close to the kansas city area let me know and will send you the clinic I am going to. Please believe there is help and hope you can get your being depressed in control as that will help, I suffer with anxiety and relaxing will help. I hope by now that you have found help, as I know just 3 months has drove me about crazy, but I do believe that I will be seeing an improvement within the next month. Take care and may God bless you. Please don’t give up on childbirth children are the most precious thing that will happen to you. I had 3 and now am enjoying 5 beautiful grandchildren. (I will be able to enjoy them more when I get this problem under control)

          1. Rhonda. I live in kansas city and would love to know if you’d share the name of the therapist you see and have had good luck with…in desperate need of a quality therapist…maybe better luck then finding a good doctor who will listen….thank you rhonda

    2. Isabel,
      From what you have posted I am going through very similar side effects to the surgeries that I have had from endometriosis. I am curious if you have been to a pelvic PT and how this has affected you. Would love to hear back from you – it is always nice to talk to someone who understands what you are going through and what they have found that helps. Take care.

  4. Your site gave insight into my issue, I have been to the dr. And they can’t. Started three years ago, and am having a lot of uti’s and have low sex drive, as well as clitoral discomfort and orgasms are hardly there and if I do its not the same as before? My dr. Prescribed nerve medication, but I am hesitant to take it. It seams like she is guessing. Any advice on what to specifically have done or if this is indeed result of surgery?

    1. Dear Stacey,

      I’m sorry, but I can not give you any advice based on the limited amount of info in your question. The only way you are going to find out if your pelvic floor is related to the symptoms you are having is to be evaluated by a good pelvic floor PT. Where do you live? Perhaps we could refer you to a pelvic floor PT in your area.

      All my best,

    1. Dear Daniela,

      No I am sorry, we do not know of any PTs in Mexico. Is there anyway you could travel to the U.S.?

  5. I am a runner who has had 2 children. I have been battling hip and glute/piriformis pain for about 1.5 years (my youngest will be 2 next week). And just recently started having horrible IT band issues along with pelvic pain similar to that of when I was pregnant.
    I started back to running about 4 weeks after my son was born and ran a half marathon 6 months after. I also had a rather traumatic delivery as I lost a large amount of blood and ended up having an epidural for about 16 hours to manage the pain. I am curious as to your opinion regarding the cause of my pain. I have been doing PT for the piriformis and IT band with little relief. We finally figured out that my pevlic floor muscles may be the culprit for all this pain that has kept me from running comfortably for quite some time. At this point, I am drained emotionally, physically, and financially from trying to figure this out. Are there ways to perform myofascial release in this area on your own so that I can at least avoid further financial strain?
    Any advice would be greatly appreciated.

    1. Dear Emily,

      I’m sorry, I can not give you advice on a home treatment program unless I have examined you to find out exactly what is going on with your pelvic floor muscles. My best advice to you would be for you to find a good pelvic floor PT in your area and get an evaluation. That is the only way you will be able to learn whether your pelvic floor muscles are indeed culprits in the pain/discomfort you are facing.

      Where do you live; perhaps we can refer you to a pelvic floor PT in your area.

      All my best,

    2. Hi Emily,

      Did you ever find relief from this pain? I have the exact same pain and have seen every doctor known to man. I finally found a physical therapist that has been performing pelvic floor mayo facial realease and have already started seeing a difference. My question for Theresa is, would scar tissue buildup in the internal wall of vaginal area, would it cause butt and hip pain on right side and knee pain?

  6. hi dsw

    I am based here in the UK in Leicester.. so not heard of any pt therapists before?
    i have been suffering my pain in my lower abdomen and pain in bladder and lower back since i had my last c section, constant period like pain and severe back ache, especially when i have been laying down or sitting for a long time, had 2 internal scans and advised my uterus is attached to one of my ovaries and also scar tissue around my bowl and i do suffer a lot before i go to the toilet .
    ive been to doctors numerous times and they just say its scar tissue and nothing can be done.. but i do suffer most days and don’t want to live on painkillers

    1. Hello there is a list of pelvic pain physiotherapist in the uk at pelvic pain .com under manual therapy x

  7. Hi Louise fr UK? I just had laparoscopy done a week ago. My obgyn thought it will be endometriosis or will take off my left ovary on his preop final talk to me, after the surgery he told me it is the worst 10 out of 10 being the worst adhesions he operated on. My kidney is pulled 10inches from it’s “regular” place, my colon twisted and wrapped with my left ovary.
    MRIs, X-rays didn’t pick up all these mess. So, I am surprised that your doctors know about your scar tissue but say nothing can be done. It might be worst than what they can actually see since it is hard to see scar tissues on MRIs , X-rays. I had 2 csections 2007&2009. My obgyn told me I don’t have to worry about scar tissues coming back but I will now consider pelvic PT. Thank you.

    1. Just wanting to know if the laparoscopy helped u. I hurt on my right ovaries and they say its scar tissue I was looking into having the surgery.

  8. Hi. I am here at Pittsburgh, PA 15237. Please recommend good PTs for me to check out if covered with my insurance network. Thank you

    1. Hi Theresa,

      Below are two PT referrals in your area-All my best, Liz

      1. Bryant Janice Pittsburgh PA (412) 422-4775 [email protected] UPMC Centers for Rehab Service
      2. Woods Christine Pittsburgh PA (412) 967-9229 [email protected] Fox Chapel Physical Therapy

  9. Hello! Thank you for such an informative site! I have been struggling with severe sacroiliac joint, back issues since the birth of my son almost 4 years ago. I have significant scars both internally and externally from my vaginal birth and feel this may be at the heart of things. Could you recommend a pelvic floor pt in Chicago?
    Thank you so much,

  10. Hi! Thank you for your site! I have had endless problems since the birth of my son 4 years ago, could you recommend a pelvic floor pt in Chicago?
    Thank you,

    1. Hi Claudia,

      Rhonda or Elizabeth Kotarinos or Brandi Kirk are my recommendations.

      Please let me know if you have any further questions!


  11. Hi. I don’t know if I am in the right place for my question. I had a Laparoscopically Assisted Vaginal Hysterectomy many years ago. Since I had this done I have painful intercourse. I kept my ovaries, so it is not Menopause. They think it could be from scar tissue. I was told that the only way to find out is to have surgery again, and if they see the scar tissue they can remove it but it will probably only return. I have stopped having sex because of the pain in the upper part (in the far back) of my vagina. Is there anything that can help with this pain without having surgery? Thank you, Kathy

    1. Hi Kathy,

      You have most definitely come to the right place!

      There are many possible causes for pain with intercourse. A thorough physical therapy exam could help determine what structure is causing the pain. Tight pelvic floor muscles and trigger points may also cause that symptom (see the blog on trigger points: and can be treated with manual therapy. If the problem is indeed scar tissue that can be reached vaginally, then manual therapy could be helpful. (Take a look at this blog post that describes what a good pelvic pain PT session is like: As with any surgery, surgical removal of scar tissue does carry the risk of creating its own scar tissue. So that is definitely something you have to consider before opting for surgery.

      Please let me know if there is anything else I can help you with!

      All my best,

  12. Thank you for your article. I have had lower back pain that radiates into my right buttock for the past 30 years. I have it every day as I said for the past 30 years. some days it is very severe to the point of not being able to sleep, sit or lay down. I had a serious car accident 30 years ago and my pelvis was fractured in 3 places and my lower back tendons or muscles were torn. I also just recently had a colon resection, then an emergency cholestomy a week later then 5 months after that I had a reversal.(2 years ago) However, I no longer have a transverse colon. so not only do i have lower back pain all my life , I don’t have any feeling in my abdomen due to scar tissue and I was told I have scar tissue in my pelvic area. Do you think PT can help both of these problems?

    1. Dear Susan,

      It sounds like you have been through a lot. In addition to scar tissue, you have the possibility of having muscle imbalances and other musculoskeletal changes due to your injuries. A PT evaluation would be very helpful to identify these issues and address your scar tissue to decrease the severity of your pain. Thank you for your question.

      All my best,

  13. I’ve been suffering with PN-type pain, also symptoms in one leg, for 3 years. Three years before that I had a procedure that involved cutting out at least an inch of my cervix in order to examine my uterus (utterly unnecessary, as it turned out). Is it possible that scar tissue from that could cause PN a few years down the road?


    1. Dear Marion,

      There are many musculoskeletal issues that could be causing your pain. And, yes scar tissue from your procedure is one possibility. That said, you never want to rush to slap a diagnosis on yourself, i.e. PN. PN simply means that there is pain somewhere along the trajectory of the pudendal nerve (please see our upcoming post this week which will cover this very topic!) Muscle tightness and trigger points can cause symptoms that are the same as “PN-type symptoms.) My advice to you is to see a qualified pelvic floor physical therapist and get an evaluation. There are many treatment options for your pain!

      All my best,

      1. Just a clarification: Does the pain caused by scar tissue show up within months of the episode that instigates the scar tissue forming–or is it possible that pain only shows up years later?

        1. Dear Marion,

          Typically, if scar tissue is going to cause pain, it will occur close to the time the incident occurred.

          All my best,

        2. Hi thank you for this site. I had 4 c-sec, after the last 9 yrs ago, been having digestive problems, was miss diagnosed with diviticuli, but a very good surgeon looked over test results, (CAT, MRI)and said my problems are caused by the scar tissue, the pocket in the intestine is too small to cause this. when discussing with a PT friend, she didn’t know I had c-sec, she massaged the area, was able to break up lots of it, I didn’t realize how bad my posture had gotten, I now stand straight&have had way less bouts of food not digesting properly. However my PT friend has now had second brain surgery to remove tumor(not cancer), She is recovering amazingly well, but is busy with her revover.Do you know of any specialist in North Jersey?

          1. Hello Michelle,

            We recommend the following therapists in New Jersey:
            Niva Herzig, MS,PT Englewood NJ (201) 568-5060 Core Dynamics PT
            Jamie Besante, PT Beachwood NJ (609) 978-3110 Southern Ocean Medical Center
            Michelle Dela Rosa, DPT Columbus NJ (609) 379-0900
            Nancy Ely-Maskal, PTA Englewood NJ (201) 567-2277 Physical Medicine and Rehabilitation Center



  14. I have had a complete hysterectomy as well as colon surgery for severe endometriosis. I have been told that I have a lot of scar tissue and much like Isabel it is impacting my colon (same symptoms) and causing a lot of discomfort. I just underwent another test -ultrasound of the colon and was told that endometriosis could not be found near the colon so this article really has me wondering if the pain I am experiencing is related to the scar tissue. Is there a Pelvic PT in Northeastern NC or Southeastern VA area?
    Thank you

    1. Hi Debbie,

      These two PTs are the only two that we refer to near the areas you mentioned:

      Wilda Young in Greensboro, NC: contact number: 336 275 6380
      Jennifer Briggs in Raleigh, NC: contact number: 9195719912

      Another great resource for finding a PT who can treat the pelvic floor is the Yahoo message group, Happy Pelvis:

      It is a support group for folks undergoing PT for pelvic pain/dysfunction.

      All my best,

  15. Hi. I have been suffering with Pelvic pain / Pelvic floor dysfunction for about 1 and a half years. It came on gradually. I had a removal of my sigmoid colon for severe diverticulitis in 2004 and also suffered a wound infection in the hospital. A year later I developed a ventral hernia and had to have an open laprotomy repair and they also removed my navel. I would have pain only in my abdominal scar for the next 6 years on and off. Then in December of 2010 I developed what I thought was prostatitis. Long story short and three urologists later and massive antibiotics , I still had frequency and urgency of urination but no pain in pelvic floor yet. Then in Spring of 2011 my abdominal pain became severe and I could not work for 6 months. Found my way to a PT who treated me for my abdominal scar pain and reduced it from an 8 to a 2-3. Then, in the summer of 2012 I developed pelvic pain. It got more and more severe and started to need a percoset daily to reduce the pain. Heat always helps a lot to reduce the pain. I started to see a PT pelvic floor specialist last October and have been seeing her ever since. The pain presentation has changed since I began with her. It no longer stays in the same place but moves around from the right perineum area to the coccyx. I think this is a good sign that the pain is moving. She is also using an Ondamed Machince to reduce scar tissue. She does about 10 minutes of manual rectal internal work on me. I am willing to go the distance with her. She says that I am exhibiting signs of improvement on what she observes with my internal muscles. I am hopeful that I will start to have more good days than bad. Some days I am almost normal, then the next day it comes back. She says that this is because of the tension shifts that occur as the scar is softening. What do you think of my treatment and the things I have told you? Would appreciate any response.


    1. Dear Ed,

      Based upon the info you’ve shared, I believe that a pelvic floor physical therapist is definitely the right choice for you. It sounds as though your PT is working on your pelvic floor, which is great, however, I don’t know exactly what she’s working on.

      Is she evaluating and treating the levator ani muscles as well as the urogenital diaphragm muscles? What else is she doing? Has she evaluated your muscle and conective tissue from your abdomen to your knees? If not, she needs to.

      It is a good sign that you feel an improvement in your symptoms right after PT, that relief should hopefully get longer and longer with continued comprehensive physical therapy. Unfortunately, since I can’t evaluate you I can’t say if there is something missing in your treatment since I don’t know what your musculoskeletal impairments are, but I can say, if she hasn’t evaluated your external muscles and connective tissue from your abdomen to your knees, she is likely missing something.

      All my best to you,

  16. Your article is very informative. I have had pelvic floor pain for almost seven years now due to prolapsed uterus, followed by hysterectomy, then mesh removal. I have been seeing a great pelvic floor pt for almost a year now, but the going is slow. Will this ever resolve?

    1. Hi Laura,

      Pelvic floor Rehab/PT can be a slow slow slow process, especially the longer it takes to find the right treatment. Usually, that’s half the battle! It’s hard not to get discouraged, but don’t give up! The keys to a successful outcome are the right PT within a multidisciplinary framework, so definitely make sure you’re including other treatment methods in the mix!

      Please keep reading our blog and if you ever want to talk to Stephanie or Liz for advice, schedule a free 15-minute consult. They would be happy to chat with you!

      All my best,

  17. It’s nice to read that I am not alone in this struggle. Not that I wish this on anyone else.
    I have been fortunate enough to find a great PT in St Pete FL who uses sonogram type lasers to break up the scar tissue as well as manual manipulation. I am moving to High Point NC. I am
    Anxious to find a PT that understands this type of therapy. As its been helpful, it is not a cure and I am now experiencing much pain in my left hip area as well as abdominal, so I am writing to ask you if there are PTs in the Greensboro, High Point, Winston Salem area that can treat me???
    Thanks so much in advance

    1. Hi Joyce,

      We recommend Wilda Young in Greensboro. She’s at: 336 275 6380.

      All my best,

    2. Hi Joyce,
      I was wondering where the PT in St Pete was? I am really interested in trying this therapy as I have suffered from endometriosis induced pain for quite a long time..

  18. Hi Melinda

    2 questions;

    1- can pelvic floor scar tissue keloid?

    2- can you please recommend a pt who does your
    Type of work in melbourne, Australia


    1. Dear Shay,

      Yes, pelvic floor scar tissue can keloid. Any scar tissue can.

      All my best,

  19. I have had 3 pelvic support related surgeries, 1998, 2001, and 2005. Length and dimension was maintained but scar tissue makes intimacy very painful. Is I likely to be able to relax the scar tissue at this point in time and how do I go about finding someone locally. Also, I was told that taking Chlorophyl supplements might be somewhat helpful.
    I would appreciate any information you can share.

  20. Hi,
    In my research about severe pelvic pain I happened upon your article regarding scar tissue and I found it very interesting. As I am writing this my 33 year old wife is lying in bed, basically in tears, from pain associated with something going on in the pelvic region. This has been going on for about 6 or so years and is steadily getting worse. We are grasping at straws to keep from having a hysterectomy but she’s about to give in. Basically it started with ovarian cysts that would come and go. During that time she got pregnant with our second child and things were great during the pregnancy. Once the pregnancy was over it started again. Within the last 3 years her OB has refereed her to a GI dr and had a lower GI scope and found everything ok. After that, between her OB and a urologist, they determined she had interstitial cystitis so she had her bladder distended? to supposedly help that. Things were still not significantly better and the pain continued mostly on the right side. The OB did an exploratory laproscopy to hunt for endometriosis. A small amount was found as well as an adhesion to one of her ovaries. Pain was better for a short while but then it came back. OB then recommended removing the ovary that was constantly having cysts come and go.(second laproscopy). So here we are about a year and a half later. Still pain where there is no ovary. The pain is getting more severe and now on both sides of abdomen. Now there is bleeding during 75% of the times we have intercourse and always followed up by a couple days of bad pain. The fact that they have cut on her twice opens up the door for scar tissue (not to mention two kids via natural birth). The OB says it’s time for everything to go. We’ve been holding off because what we’ve read seems to indicate that that just opens up the door to more problems, pain and (after reading your article and subsequent responses from readers) more scar tissue that could cause other issues. I’m frustrated because I can’t seem to help my wife, I can’t take the pain away, and the doctors only want to cut, cut, cut. Yes that may be the answer but with all the dr “guessing” I’ve lost faith in the medical community here and my wife has all but given up herself and ready for the hysterectomy. With all of our research, I’m just so afraid that would create bigger problems and pains for her after it’s done. Having read our story, do you think there would be any merit in seeking out a qualified PT in our area to discuss the issues and see if it’s all related to existing scar tissue? We’re located in Mississippi but not far from New Orleans, LA and Birmingham, AL.
    Thanks for your time,

    1. Dear Chris,

      First of all I’d like to say I’m so sorry you and your wife are going through this ordeal. There are a lot of unknowns in your wife’s case. For example, what is the source of her pain? Scar tissue? Endometriosis that wasn’t discovered during the laproscopy? Could it be adenomyosis? Could it be due to something myofascial in nature? Something else? What we do know are: yes, surgical procedures do result in scar tissue, typically myofascial impairments result after any surgical procedure, endometriosis could still be present and be causing pain, and it is possible that the pain could be coming from the rest of her reproductive organs. My recommendation to you would be to start with the most conservative treatment first, which is physical therapy. Just to be clear, PT is not going to resolve any scar tissue from her surgeries. However, PT could identify and treat any possible pain generators coming from her muscles in her pelvic floor and the muscles and tissue in her pelvic girdle. If after 8-12 sessions of PT her pain has not changed at all, not even a temporary decrease in pain, then I would at least consider a hysterectomy.

      Here are some recommendations for PTs in your area:

      Butler Rachel Birmingham AL (205) 298-9101 [email protected] Birmingham PT
      Bravo Jacqueline PT Lafayette LA 3374060712 [email protected] Bravo Therapy Services

      I hope this helps.

      All my best,

  21. Hello my name is Crystal and I have been experiencing pain in my right side for 2 1/2 years it started right after I gave birth to my son. I have had 3 c-sections. I have been to pain clinics, I have seen my pcp, ob/gyn, neurologist, urologist, pelvic floor specialist and PTs. I have had numerous MRI’s and to no avail nobody can tell me what’s wrong. At one point I was told I had intersistial cysticitis. But now they are saying its not that. The pain is located on my right side just below my rib cage it is a sharp stabbing pain that is there all the time. It never goes away there are times it feels like my insides will fall out, I have problems sitting standing and walking. It hurts worse if I have sex and normally after sex the pain is a 12 for 3 days and even if I don’t have sex my pain is a 10. I am very frustrated and am tired of pain what could possibly be the problem I feel helpless and my life is suffering terribly. I am 29 and I have urinated on myself in public and I don’t have a sex life at all. What can I do after almost 3 years the pain is not getting better its getting worse. Can you help me PLEASE PLEASE PLEASE. I JUST WANT TO BE NORMAL AGAIN.

    1. Dear Crystal,

      I’m sorry that you’re suffering. Without doing a physical exam it is impossible for me to tell you much about your situation. I would have to get your full medical history and then complete a comprehensive physical exam at the very least to be able to tell you if your symptoms are caused by musculoskeletal impairments. I’m sorry I can’t be of more help.

      All my best,

  22. Hi and thank-you for your work. I’m a 61 yr. old male who had bilateral laparoscopic inguinal hernia surgery, 4 1/2 yrs. ago, during which meshes were installed. In the last 3 months, I’ve had recurring pain on the right side, medial to the front hip bone, about where the surgical incision was made. Before that I had increased my movement, stretches, and exercising this past year.. If it’s a scar tissue(adhesion) problem, would the physical therapy help? Can you recommend some in San Diego, CA ? Thank-you. Jim

    1. Hi Jim,

      Yes, PT likely could help you. We do not have a PT referral for San Diego, however, there is an excellent PT in Los Angeles who actually specializes in male pelvic floor PT. He is also an orthopedic PT, so it sounds like he would be the perfect fit for you. His name is Daniel Kirages, and he teaches/practices at USC. His contact info is: phone: (323) 442-2900, email: [email protected]. All my best, Melinda

      1. I am a female with both abdominal and pelvic adhesions, most likely moderate to severe. Would you recommend USC for women also? Are there any other PTs in the L.A./Pasadena area you’d recommend? Thank you.

        1. Hello RJ,

          We have a Pelvic Health and Rehabilitation Center in Los Angeles please call us at 424-293-2305 and we would be happy to schedule you an evaluation.


  23. Hi – have you hard of this happening to children? My 12 year old son has had two fistulotomies and has pelvic floor pain now, years after. Do you recommend anyone in Toronto? Thanks! Susan

    1. Dear Susan,

      Yes, we have treated children with pelvic floor pain/dysfunction. I’m sorry but we do not refer to anyone in Toronto, but we do have four referrals in Canada. Three in Ontario and one in Quebec. The Ontarios PTs are: Nelly Faghani: 4167257525, Carolyn Vandyken: 5196248798, Eliabeth Givenrod: [email protected]. The PT in Quebec is: Marie Josee Lord: 5144261000.

      All my best,

      1. I have numerous issues C-section 1989, cholecystectomy 2001, Total Hyst 2000, bladder repair w sling, cystocele, rectocele, urethrocele repair in 1982 fissurectomy, hemorrhoidectomy, and sphincteroplasty due to a fall. My stomach is numb except for constant feeling like I am ovulating and chronic pain in lower right side and slight swelling. Colonoscopy and CT scan normal. Interstitial cystitis, severe fibromyalgia and myofascial pain, arthritis, chronic pain. Sex is miserable and cannot have orgasm anymore. Is there something that u think might be related to adhesions on me? I live in Oklahoma are there any PT here you could recommend?? I feel my life is really over. Thank you so much.

        1. Hello Teresa,

          It sounds like scar tissue may only be one of the culprits causing your pain. I would reccomend that you see Lisa Herring in Oklahoma City.

          All my best,


          Lisa Herring, PT
          Oklahoma City OK
          (405) 751-9955
          Specialized Physical Therapy

  24. Hello, I am a 62 year old female and in May of 2012 I had a vaginal suspension and fixation surgery with mesh. As soon as I woke in the recovery room I knew something was wrong. My left butt cheek was numb. I mentioned this to those in the room and they didn’t seem concerned and told me it would return to “normal” The doctor also was not concerned. The next day I left the hospital not able to walk on my own. Was still told it may take a few days until it would feel “normal”. Long story short..I spent most of June, July and half of August in the house and unable to be on my feet more than 2 minutes at a time. Mornings were a little better so I’d try to take a quick walk outside. contacted the doctor at least every two weeks telling him of the pain I was having and was told to just try to keep moving and that it would return to “normal”. In August he finally referred me to a doctor in milwaukee. Saw him and he thought the suspension was too tight on the left side and a nerve was trapped. Scheduled surgery with him to have a partial mesh excision to loosen it. It did help some, but far from “normal”. He gave me a couple options..See a Doctor in Arizona, medication such as lyrica, vaginal suppositories, pelvic floor rehab and time. I chose the pelvic floor rehab..have a wonderful pt and it seems to help some. My biggest concern is that I keep getting a ripping feeling in my lower left pelvic area..she thinks it is scar tissue and has been massaging and stretching that area. Is it normal to have this ripping feeling at this stage? seems once I get this feeling the nerve pain kicks in. Like I said I have a wonderful PT, but I only have one more visit with her and am a little afraid of what’s in store for me in the future. I am very glad I chose the pelvic floor PT route. Thank you for all you do to help those of us that are suffering from pelvic pain.

    1. Dear Judy,

      I’m so glad you chose to see a pelvic floor PT and you’re feeling some relief! That was definitely the right decision. It’s very difficult to tell what that ripping sensation is without completing an evaluation of your pelvic floor. I suppose it could be scar tissue, it could be tight pelvic floor muscles, or maybe it’s still the sling? I’m not really sure. Can your PT replicate the sensation during treatment? Since I don’t know where it’s coming from it’s hard to say if it’s normal for this stage in your treatment. If your PT is still finding muscle and tissue dysfunction you should really continue treatment. You may be able to achieve more relief with continued treatment.

      All my best,

      1. Hi I have been having ongoing pain on the right side of my c-section scar which is 6 years old for about four five months now and with out the correct pain relief it reaches labour like contraction pains. it all started a year and a half ago I went to a&e with labour like pains but was not pregnant and I was misdiagnosed with appendicitis.
        every thing subsided till 4/5 months ago and the ache is constant even at rest and increases with activity of any kind such as walking, hoovering ect.
        I have been told by a doctor today that it is likely to be adhesions from past and possible bowel obstruction and there’s nothing they can do and I need to move on and get on with my life ? Which isn’t possible, my concern is that I had a laparoscopy nine days ago and was told that the surgeon could see absolutely nothing and that the surgery only lasted ten minutes because there was nothing to see, is it possible that scar tissue can not always be seen during surgery ? Thankyou

        1. Dear Laura,

          It is possible that scar tissue could cause these kinds of pains. However, given your concerns and the length of time between your C-section and the onset of your symptoms, it would be prudent to look into all possible causes of your symptoms. A gastroenterologist could evaluate the possibility of a bowel obstruction and discuss treatments if that is the cause. A skilled physical therapist could evaluate you for possible muscular or fascial restrictions due to scar tissue or other causes. You are also entitled to a second opinion if you would like to verify your doctor’s assessment. It’s always a good idea to have a comprehensive work up if you are still feeling unsure of what’s going on, and if you feel that something was missed.

          All my best,

  25. Oh my…I have all of these symptoms and have had every test you can think of…everything coming back normal/negative…I’ve had 3 abdominal surgeries, 2 c-sections…one lap/dnc 3 months after the first c-section in 1997…the pain is increasingly worsening over time…

    Any Pelvic Floor PTs in Ohio? I’m in Columbus.

    Thanks so much for your hard work and research and for posting this article and for all of the comments! Phew! Thank you guys for sharing your stories…I feel a little better today, just knowing that I’m not alone 🙂

    1. Dear Julie,

      I’m so sorry to hear about all that you have gone through! It sounds like you could really benefit from an evaluation from a pelvic floor PT. I’m sorry, but we do not have a referral in Ohio. However, here is a blog post that is full of some good tips on finding a good pelvic floor PT in your area: Also, we do see out-of-town patients if that is something you would like to consider.

      All my best,

  26. ive had regular pain in my lower abdomen and upper legs as well as rectal pressure since my csection in december 2008. a month or so after the surgery, i was sitting on my couch and twisted only to hear a snap and had an alarming amount of fluid coming from a hole in my incision. i did go to the hospital and was told i had a pocket of fluid that was beneath my incision. it took 16 weeks for the incision to finally heal. i
    i have had ultrasounds, internals, etc. and no one seems to know where the pain is coming from. i can feel a rope (thick round hard thing under my incision)….but my doctor doesnt seem convinced its that. im so frustrated.

  27. I am given vagifem to treat vaginal scar after episiotmy which was torn is it going to work??

  28. I am given vagifem to treat vaginal scar after episiotmy which was torn is it going to work??plz rpl me soon

    1. Dear Shaheen,

      I’m sorry, it’s impossible for me to say whether Vagifem will repair your torn episiotomy scar. We have never heard of a doctor giving a patient Vagifem to treat an episiotomy scar. You might want to ask him what his thought process is in prescribing it.


      1. But can vagifem help in any way for healing of scar or granulation tissue??

        1. Dear Shaheen,

          I’m sorry, but as I said in my previous response to your question, I have never heard of a physician prescribing Vagifem for scar healing. So I can’t answer your question.


  29. i have a toxic liver injuries 5years ago and doctor was cut off some of the liver pieces to examine it but since that, i usually have a pain where they cut those pieces. is there are a scar tissue?

    1. I’m sorry, but without evaluating you I can’t answer your question.


  30. Hi,

    I recently pulled a muscle in my pelvic floor and have been seeing a pelvic floor therapist. At the same time, my IT band on the right side seems to get inflamed if i go running or even if i walk for a long time and have to go uphill. I am wondering if pelvic floor issues can affect the IT band. Is it connected? I am moving to San Francisco and i am worried as the two times i have been there, because of the hills, i have not been able to walk very well. If you know of a PT in the SF area that would be great too.

  31. Is there any good pelvic floor PTs in the Sarasota, Fl area experienced with things going wrong from a c-section

    1. Dear Samantha,

      Hart Mary Sarasota FL (941) 536-4290 is a PT who has taken our course.

      All my best,

  32. Hi,

    I am a 21-year-old female who had extensive bowel surgery to remove my appendix and clear an infection due to peritonitis. It is now over 3 months post-surgery, but since the surgery every time my boyfriend and I try to have sex he can no longer get inside me all the way due to a hard blockage. When he pushes as deep as he used to, it feels like he hits a hard wall inside me and I get a severe shooting, throbbing pain that hurts for days afterward like a really bad bruise. Could this be from pelvic floor scar tissue and are there exercises that can help work down this scar tissue?



    1. Dear Reader,

      To me, your situation sounds like what occurs when the pelvic floor tenses up in response to pain or injury, and as a results gets bulky and creates what seems to be a blockage that is painful to the touch. I would recommend seeing a pelvic floor PT who can assess whether this is the case and if so, can offer treatment. Here is a blog post about what a good pelvic floor PT session is like, which I believe will help you find the right PT for you: In addition, if you tell me where you are located, I might be able to refer you to a pelvic floor PT in your area.

      All my best,

        1. Here are the PTs that we refer to in WI:

          Sherese Hildenbrand in Mequon: 262 240 1202

          Colleen Walz in Onalaska: 608 775 1840

          Beth Bartelsen in Nashotah: 262 641 5771.

          All my best,

  33. Hi I have a 6 year history of pelvic pain issues starting with painful bladder urge frequency feeling of needing to pee and not feeling empty afterwards.
    After a couple years of unsuccessful treatsment (many docs lots of PT etc)
    pain with sitting began in sit bones and perineum. I again was treated aggressively, but they couldn’t find a reason for my sit pain (I was told I was too skinny. Believe me I saw many folks and can’t believe that the beginnings of possible PN was missed.
    By now my doc suspected PN but various treatments and blocks etc. only made things worse. By 2011,in desperation I had a nerve resection surgery to 2 nerves (inferior cluneal and posterior femerol cutaneous in an effort to rid me of the pain in those areas. The surgeon had thought these nerves were causal.
    A few months later I developed severe anal/rectal pain that has continued to get worse to the point where I am bedridden. Now I can’t even stand without pain and its reached the point where we are thinking of a pain pump trial(quite an aggressive treatment after years of brutal pain).
    I have had PT with a very well-known gal, but asked her to be gentle in the anal area as I don’t have good pain control and am afraid of how worse I may feel after.
    Through research -and talking to docs and other patients I’ve learned that scar tissue from this surgery may be the reason for this incredible pain i.e. (myabe a new neuroma grew in.) Meanwhile my bladder symptoms still exist. My PT says I am very tight in the anal/buttock area (the surgical area) as well as the abdomen/Psoas. The latter I feel may be causal in the bladder emptying/ pressure issue.
    Could further PT help me with this crippling anal rectal pain and my other issues? My first concern is of course pain relief.
    Thanks for any suggestions!

    1. Dear Kathy,

      Physical Therapy can help you. It is not uncommon for people with persisting pain to think that it may be scar tissue. However, I caution against this because many times there are myofascial reasons that may be the problem. It is critical for your medical team to differentially diagnose you to determine which impairments are causing which symptoms and come up with a plan to treat the sources of pain. Your treatment should begin conservatively (PT) and then progress into medical interventions/injections if necessary. Surgery should only be considered if every person on your team is sure that there is scar tissue and that it is a significant contributor to your pain.

      All my best,

  34. Hi! I just had a hysteroscopy for what my gyno thought would be removal of fybroids in my uterus. What she discovered was scar tissue was causing the severe pelvic pain I’ve had in the past year. I would like to try your method but don’t know anyone in Mountain View, CA. I would appreciate your advise/help. Thanks.

    Maria H,

    1. Dear Maria,

      Our clinics are located in the San Francisco Bay area with one in San Francisco, one in Oakland and one in Los Gatos. So we are actually very close to you. Check out our website at for more information or if you would like to make an appointment.

      All my best,

  35. I have been experiencing pain on my right side below
    My c section scar for over a year. I had a c section
    Eleven years ago. I have been to gynecologist
    Gastro doctor that doctor gave me colonoscopy
    Ct scan and now sent me for MRI of back saying
    I could have nerve damage to my back radiating
    To my side. I all along believed it had to do with
    My scar. I work out heavily and now experience
    Extreme pain doing any abdominal work. Do you
    Think I possibly would benefit by seeing a PT. I am
    In pain all the time and have not received any diagnosis

    1. Hi Lisa,

      I definitely think you could benefit from seeing a PT who is knowledgable about treating postpartum C-section scars and the pelvic floor. The PT should also be knowledgable about identifying abdominal trigger points and connective tissue restriction. Also it sounds like the abdominal work you are doing is detrimental to your symptoms.

      All my best to you,

  36. Dear Adm. over the past 20 years I’ve had 4 Cesarian births all with a vertical incision or up and down scar.During one pap smear years ago I was told during examination that I have a lot of scar tissue when I jumped due to the physician’s fingers.I’m now 38 yrs old newly married for 4 yrs now but I think I can feel the scar tissue during intercourse and that’s what’s led me to your page.I’ve never been able to enjoy intercourse like others and now thanks to your site I know why.I live in Fort Worth TX, can you recommend a PT clinic for me?

    1. Dear Carrie Lynn,

      Woerner Marie PT Fort Worth TX (817) 735-2100 is a PT that we refer to in Ft. Worth.

      All my best,

  37. I am 32 years old I had a hysterectomy 2 years ago and sling placed to correct a rectocele , cystocele, mobile urethera, I also had stitching of the vaginal wall, vaginal opening, and perineum. I had PT before my surgery for almost 5 months and it was very helpful. I am experiencing nerve pain in rectum, vagina along with severe pressure in pelvic are that spreads down to my thighs along with my tissues pulling, and pain during sex. It hurts to stand and walk and move certain ways at times. I almost feel like I did not have the surgery. It has stopped leakage and I was able to pass a bowel movement better until a few weeks ago I started to have trouble with that as well. I also have deep infiltration endometerosis, undifferiated connective tissue disease, small fiber neuropathy, secondary fibromyalgia along with other health issues as well. I finally called my surgeon and I can not get in until May 28. I am so frustrated I was wondering if I should do PT again I just can’t imagine having that done with the way it feels. If this were you what would you do? This is really altering my life.
    Thank you,

    1. Dear Elizabeth,

      My recommendation is that you put together a comprehensive treatment team of GYN, Pain mangement, and PT. PT should absolutely be a part of this multidisciplinary team. Please read the other posts on this blog to become better informed about pelvic floor PT.

      All my best,

  38. I am 49, I live in the Lafayette, LA area. I believe I have injured my hips, groin and thighs over exercising and being flexible, over stretching. I started having IT band pain in my early 30’s. The pain started in my right leg and then in my left. By age 40, I was hurting in both hips, my outer thighs, hip flexor area and now I experience pain all the time from mid back all the way down to my knees. The pain has progressed to the groin area and I have pain during orgasm. It starts off good and then becomes painful even in my outer hips. I have had a range of PT over the years, been diagnosed with Fibromyalgia twice. The last PT I had was about 9 months ago with Phyllis Comeaux who works with the pelvic floor. I was sent to her because of a internal muscle spasm. She did external work for 6 months. I felt better, but it comes back. I am now taking muscle relaxers and experiencing ongoing inner and outer thigh pain. I used to be very active and every exercise I try gets taken away b/c of the pain. I am very interested in learning more about scar tissue and breaking it up. Can scar tissue be seen on x-rays or mri’s? I noticed in one of your earlier replies to someone that you recommended Bravo Jacqueline PT in Lafayette. I just looked online and could not find any thing about her except a phone number and address. Is there anyone new in my area that you could recommend? Someone that could break up scar tissue?

  39. I am moving to St. Petersburg Fl and would love a PT recommendation. I was just about to finally start PT for my pelvic dysfunction in Chattanooga (6 months on the waiting list) but now I have to move for work before it starts! I was really looking forward to finally getting another sort of relief! Any recommendation is appreciated.

    1. Dear Marie,

      No, I’m sorry, but we do not have a referral for St. Petersburg, FL. Is there another nearby city that you would consider traveling to. If so, perhaps we have a referral for that area.

      All my best,

  40. Hi

    I had 2nd vaginal delievery in January with 2nd degree tears. I still have pain while sitting or standng for long. I always feel lot of pressure in the vagina and slight pain in there. My OB says that scar tissue is not streching so she asked to use vaginal creame Estrace and do message in that area with oil. She mentioned that if it doesnt feel better in 4 weeks then she will reopen and restitch. I am under pain and really scared as its been a while since delivery and still have issues.
    I live in West hills, CA, USA, please do tell me what should be done as I am so miserable at times.


    1. Dear Reader,

      You should see a good pelvic floor PT! She will evaluate your pelvic floor and tell you what is causing your symptoms. It may be issues with your scar tissue, but it might also be issues with your pelvic floor muscles. Please read this blog post about pregnancy and pelvic pain, it will give you more info about what occurs with the pelvic floor postpartum:

      Having your tear re-opened and restitched will likely NOT help your pain and might cause it to become worse.

      Julie Guthrie is the PT in LA that we refer patients to. Here is her info:

      All my best,

    2. Hello khush
      I can relate with you. I am going through exact same problem. And I live in west hills CA too. I am looking for a PT too. I delivered my baby in apr 2013.
      Let’s connect so we can talk and find out some options.
      Please please contact me so I can find if you healed and fully recovered and how ? My # is 8189329403

      I look forward to hearing from you.

  41. Wow am i happy to find this site and am very impressed with both your knowledge and obvious passion for helping people with their pain.

    I am actually seeking help and ideas for preventing possible sequele to a recent surgery.

    I am just 10 days post op from a laproscopic oopherectomy for left ovarian cyct. I have also had a c-section at age 45 seven years ago.

    I may have benn overdoing activity during this immediate recovery period, but i am beginning to experience a hard knot like swelling above my c-section scar which is very near my lower lap scar (still healing).

    Is there any type of therapy i can do or have done during my immediate (starting at 6 weeks out) post op period that may help reduce or minimize scar adhesion formation before it forms and causes a problem?

    Does physical movement and early return to work and excercise tend to make adhesion formation more or less liekly?

    Do you provide phoe consultations and can you recommend a good therapist in the Salt Lake City area?

    Thanks for your help.

    1. Dear KR,

      We do do phone consults. Please contact our office to set up an appointment.

      The PT that we refer to in the Salt Lake area are:

      Schwemmer Ines PT Salt Lake City UT (801) 520-4710
      McLaughlin Susan PT Salt Lake City UT 8015072050

      Also exercise/return to work does not make adhesion formation more likely.

      All my best,

  42. I had an appendectomy about 10 years ago that was quite serious, it resulted in a scar from my belly button down to my pelvic bone. I have been experiencing for the past ten years all sorts of problems and recently had a laparoscopic procedure that shows scar tissue behind and in front of my uterus surrounding my left ovary and left fallopian tube it has twisted my right fallopian tube so that it is now blocked, it also surround my bowels as well as my bladder. My question is that after that many years and that much scar tissue can pt make a difference for me?

    1. Hi Marrissa,

      The answer to your question is that yes, even after all this time, PT can help.

      All my best,

  43. I had adhesions after my second child and had to get them surgically removed…I just had my 3rd and don’t want to go through that pain again, do you know of a pelvic PT in alabama!? Thanks so much for all the info!

    1. Dear Angie,

      A PT we refer to in AL is: Butler Rachel Birmingham AL (205) 298-9101.

      All my best,

  44. Hi,
    I had five major surgeries consisting of 2 c-sections, tubal cysts removal(twice) and finally Hysterectomy. My doctor has confirmed major scar tissue problems causing immense pain most times. After minimal work out I’ll be in terrible pain for weeks. I am in pain 24/7, some days are tolerable. I am relieved to find out that I am not alone. Please give me information of PT for pelvic Floor in my area. La Mesa/San Diego CA.

    Thank you

    1. Dear Christine,

      I’m sorry to hear about all that you are going through. Unfortunately we do not refer to any PTs in SD; however, you might contact Sarton Julie Tustin CA (714) 770-8222 as she is very well-connected in the pelvic floor arena and may know of someone to refer you to.

      All my best,

  45. So if scar tissue builds up, that would mean when a product like ESSURE is placed into the fallopian tubes which has PET fibers wrapped around them to induce chronic tissue growth this too could cause pelvic scar tissue and pain.??

    1. Dear Maria, I’m sorry, I need more details from you to consider your question. Best, Stephanie

  46. Hi I have had two C-Sections one was almost eight years ago that one wound up being an emergency because I went into labor the day before it was scheduled. The other one was a little over a year ago it was a scheduled one. Both of my babies were a little over 9pds. I use to love having sex with my husband now it’s very painful and burns sometimes it even feels like he’s tearing me. Also my periods are more painful and very very heavy just wondering if this could be caused due to scar tissuing?????? Live in Texas in Collin County

  47. I forgot to mention I have recently been to GI DR and OBGYN and was tested for everything it all came back good and clean.

  48. I would like to find a pelvic floor pt in phx arizona.
    Any names that you could send me would be great.


    1. Dear Debra,

      We recommend Munger Diana PT Phoenix AZ 6022643369.

      All my best,

  49. I wish I had seen this sooner! I just started perineal massage for my second pregnancy and realized that I have quite a significant amount of scar tissue from the 2nd degree tear I experienced with my firstborn 3 years ago. When he was 6 months old, I was still having pain and my OB said I had granulated scar tissue which he treated with silver nitrate. That was a painful solution, but it did greatly improve my overall comfort (intercourse was no longer excruciating). Judging from your post, doing the perineal massage should help but I’m obviously terrified that I’ve got so much scar tissue and I know that that will not stretch to accommodate another delivery. Would PT be possible for me at this point or am I doing all I can probably do for now? I’m in the Sacramento area and wondering if you refer to anyone up here. Thank you!

    1. Dear Jennifer,

      PT is possible for you at this point. Here is a PT that we refer to in Sacramento:

      MacDonald Risa PT Sacramento CA (916) 457-8802

      All my best,

  50. I have had 4 c-sections and just had a full hysterectomy due to problems in the uterus, etc. They found a lot of scar tissue from the c-sections and removed some and I am two days post op. I would like to know if there is a pelvic PT near West Nyack, NY which is in Rockland County so I can work on any scar tissue that will form from the hysterectomy to try to avoid similar problems in the future. Thank you.

    1. Dear Dawn,

      I’m sorry but we do not know of a PT in your exact location; however, below is a list of PTs that we refer to in New York state. Perhaps one of them is nearby?

      All my best,

      Johnson Lisa PT Hauppauge NY (631) 232-5350
      Kafka Diana DPT New York NY 2123542622
      Van Alstyne Linda OT Schenectady NY 5183819166
      Futterman Stacey PT New York NY (212) 226-2066
      Stein Amy PT New York NY (212) 354-2622

  51. Hi from the uk,
    I’m hoping you could help two years post partum and still have tummy pain.had a c section and the pain is across my tummy above the is a dragging burning kind of pain that gets bad when I’ve been standing or lifting all day.ive had a scan which showed clear and examinations.i haven’t had an one can seem to tell me what is causing the pain but its been suggested it could be a hernia.please could you give me any advise.should I request a MRI to get it looked at further or live with the pain.ive been told its probably weak muscle or scar tissue which they can’t do much with!!cant go on another two years with this!!

    1. Dear Sarah,

      Your pain could very well be due to the scar tissue from your C-section. I suggest you read this additional blog post on postpartum pelvic floor pt: My advice to you is to make an apt. with a PT who is knowledgable about treating post-partum women and the pelvic floor. We know of one such PT in the UK. Maria Eliot is the one PT referral that we use in the UK because we know that she practices along the same lines that we do. Here is her info:

      All my best,

    1. Dear Tee,

      Below is a list of PTs that we refer to in MD:

      Devine Stacey PT Eldersburg MD 4104044772
      Marshall Marci PT Frederick MD 3016989214
      Graham Miriam PT Rockville MD 3018819313
      Ortiz Jennifer PT Columbia MD 4432832018
      Reinhardt Melissa PT Columbia MD 4432832018
      Dommerholt Jan PT Bethesda MD (301) 656-0220

      All my best,

  52. Hi, I am British but I now live in France mainly for health reasons Raynaud’s disease. I had my 3 children and then because of a prolapse I had to have a hysterectomy and one ovary removed at 41yrs. I felt fine until about 15yrs ago when sex started to really hurt.Recently it is unbearable at times, like a sharp knife inside of me. I saw a gynecologist here in France who gave me cream and globules to put inside my vagina. It seemed to help initially but the globules gave me belly-ache. The gyne told me it is old scar tissue from my hysterectomy which is dry inside me causing the pain but it is getting worse and really putting me off sex! I have just recently finished with flushes etc after nearly 20 yrs but am desperate to stop this terrible pain in my vagina to allow me to have pleasurable sex. Just as an added problem when I had sex I had a sensation inside my vagina like a nerve ticking or trying to get going – very strange. However, about 15 months ago I was diagnosed with Transverse Myelitis and I wonder whether this can be associated with the same pain and sensation inside my vagina as you mention about nerves so much and after sex I still have this same sensation which is similar to that associated in my feet and legs, like nerves trying to get going from the Myelitis? apparently the nerves are trying to knit up again? Would the PT help me and do you know of anyone who can help me please in France.(I’m nearly 63yrs now) Thank you.

    1. Dear Brenda,

      I am so sorry to hear about all that you are going through. I would advise that you seek out a qualified pelvic floor PT for an evaluation; however, I do not know of anyone to recommend in France. Would you considering traveling to the UK? If so, Maria Eliot is a colleague that we recommend patients to. Her contact info is:

      All my best,

  53. I just have a question for you. I had my son about a year ago now and still have trouble being intimate with my husband. Every time we try to be intimate I have a lot of pain and discomfort and after trying I still have scar tissue come out when using the bathroom just like I did right after I had my son. I’ve tried getting help for it and the gynecologist still cannot find anything wrong. I am just wondering if there is anything I can do to relieve this pain or is this just normal after having a baby?

  54. Thanks for this info. If anyone lives in the Midwest the MAPS Pain Clinic in Edina, MN is a great place to go for PT. The PT’s always go to classes on pelvic pain dissorders and MY PT (her name is Irene) is spectacular! I’m gonna go back and see her for I’m having another one of those ‘setbacks’. I recently had an MRI and they found some scar tissue. I also had pudendal nerve decompression surgery (both sides) about 6 yrs. ago. I wish I would have tried PT FIRST…B4 I decided on surgery, but, it is what it is. Thanks again, and will try the scar tissue manipulation therapy. All the best to everyone. Also, I try not to ‘fight’ or tense up against the pain (i.e. stress) it just flares it up.


    1. Hi Erik!

      Thank you so much for the recommendation! AND the GREAT advice! I’m so happy to hear that you are in the hands of a qualified and knowledgable PT!

      All my best,

  55. Hi, I am a 3 year Ovarian Cancer survivor, Had a total hysterectomy and an abdominal port for chemo…. Recently I have been experiencing sharp burning pains that are to the right of the incision scar where I have hard lump that formed near the scar when healing. The pain seems to come when exercising, walking or with extended standing. It radiates to the right or up toward the navel. I seem to want to push on the area when it happens. The pain will subside when I sit or lay down, but often will feel sore/bruised afterward. My medical person seems to think it could be adhesions and is less worried that it goes away when I sit/lay down… I had no Idea adhesions continue to form and change even years after healing… Is that true? How can you tell if it is adhesions/scar tissue?

    I would be ever so grateful for you input. and suggestions as to who/how to diagnose and treat this.

    Thanks so much,


    1. Dear Lois,

      Your symptoms could be myofascial in nature or a result of adhesions. Unfortunately, symptoms of these two things can mimic each other and we cannot determine the answer without a thorough evaluation. I suggest you see a pelvic floor physical therapist and a gynecologist for thorough workups. You are welcome to contact us if you need referrals.

      All my best to you,

  56. I wish I had seen this post sooner. I am about one year post surgery to repair diastasis symphysis pubis sustained in childbirth. (Long story, check out my blog for more info if interested. He’s 18 months and doing great!)
    Do you know of anyone trained in this type of massage located in Kansas?
    Thank you for your time.

    1. Dear Michaela,

      I’m sorry about all that you are going through.

      The PT that we refer to in KS is below. All my best, Stephanie

      Voight Lindsay PT Overland Park KS (913) 317-7341 [email protected] Saint Luke’s Hospital South

  57. Hi,
    I found this article somehow related to my problem. i had surgery late last year from a femoral fracture i sustained. Presently, the fracture failed and another surgery. the surgery was successful but i found out that two days after the surgery i started having pain. The pain got increasing everyday. each time i wanted to sit well the pain will come, i could not bend to touch my toes with my finger again. the annoying thing is that i cannot feel the pain with touch, at times i couldn’t tell if the pain comes from bone or muscle of the pelvic. If i want to open my mouth wide i would feel the pain. what can i do?

    1. I would recommend that you see a physical therapist. Where exactly is your pain? From your description I am not sure if you are referring to pelvic pain or pain elsewhere; therefore, I do not know whether a pelvic floor PT or an orthopedic PT is the right fit for you.

      All my best,

  58. Hello Melinda
    I am a 71 yr old male having a lot of pain for two months now. I have lost 12 lbs. I live with pain and constipation plus testicle and penile pain and burning urination. I have been to 2 urologist and 2 gastroenterologist with cystoscopy and ct scan with contrast up the rectum. All the test were negative. I had ruptured appendicitis when I was 8 yrs old, a hernia at 9 yrs
    old and bilateral tumers in my kidneys. They took 5% of my right kidney in
    October 1999, removed my left kidney in November 1999. I had pne 2 yrs ago. Can my problem be scar tissue or adhesions now. I have seen a pelvic floor PT. but getting another appointment is 3months away. Can you recommend any PT . I live in Holmdel New Jersey 07733
    Thank you for your time. You can call me at 732-671-0704 or email at [email protected]
    Thank you again,
    Henry D’Alessandro

    1. Dear Henry,

      I’m sorry about all that you are going through!

      I’m also sorry that I can’t tell you whether your pain is from scar tissue or adhesions without examining you. I do recommend that you give pelvic floor PT a real try. Please read this post about “good” pelvic floor PT:

      and this post on male pelvic pain:

      Here are all the PTs that we refer to in NJ; I’m sorry, none are in Holmdel. (Many folks have to travel for good PT, unfortunately:

      Besante Jamie PT Beachwood NJ
      Dela Rosa Michelle DPT Columbus NJ
      Ryan Angela MD Englewood NJ
      Ely-Maskal Nancy PTA Englewood NJ

      All my best,

  59. Do you have a referral for a pelvic floor PT in the Tampa, FL or LAnd O lakes, FL (Pasco county) area?

    Thank you,


    1. Dear Kathy,

      I’m sorry but we do not know of a PT in your area; however, a wonderful PT in Florida that we often refer patients to is Tracy Sher in Altamonte Springs (close to Orlando). Here is her contact info: 4072571403.

      All my best,

  60. Hi
    I’ve been suffering with pelvic pain, testicles, perineum, penis and glutes for couple of years now. I’ve done physio and been to the Dr wise clinic with some success but still have ongoing pain. I had surgery for an infected pilonidal sinus but that was 20 years before any pain. I’ve never even thought this could be an issue until I read this interesting blog. Do you think this could have anything to do with pelvic pain with this much time elapsed


    1. Dear Nick,

      The thing about pelvic pain is that more often than not, it’s not “one” incident that causes it to kick in. Aside from pain that shows up immediately after a patient has surgery in the area, most pelvic pain occurs due to a confluence of factors, such as a trauma to the area (surgery for instance), congenital skeletal issues (such as scoliosis, or having one leg shorter than the other), extensive time spent sitting, extensive time spent bike riding, etc. And then one day or gradually pain will kick in, so while your past surgery might have been a drop in the barrel that eventually overflowed to become full on pelvic pain, it’s highly unlikely that it’s the “cause” of your pain.

      Now, the most important focus for your providers, especially your pelvic floor PT should be to ascertain what your specific impairments are, and treat them accordingly. Pelvic pain PT is a process and it does typically take several months-years to fully heal/rehab the pain-causing impairments. That said, it’s also worth mentioning that not all pelvic floor PTs are created equal and that it’s key to find a qualified pelvic floor PT, and especially in your case, one that is experienced at treating male patients.

      Please take a look at the two blog posts below: the first specifically discusses male pelvic pain and the second discusses exactly what you should expect from “good pelvic floor PT”:

      Please feel free to contact us with any additional questions or let us know if you would like a PT referral for your area.

      All my best,

  61. Hi.
    I had my third C-section August 4, 2013. Since day 1, I have been experiencing searing nerve pain just beneath my incision on the left side with the same searing burning in my left groin. My OB suggested an entrapped nerve due to scar tissue formation & administered a steroid injection beneath my scar. That was yesterday so I won’t know if it worked for a few days. My question is: how soon can I start seeing a PT for treatment? Also, I have heard that heat can help bring blood to the area but then I’ve read that ice packs are best for breaking up scar tissue. Which would be better since I am so recently post-op? Thanks so much!!

    1. Dear Leyla,

      Sometimes nerves can get irritated due to surgery, and scar tissue formation. I would say it would be appropriate to see a PT for scar mobilization 8 weeks after surgery, if the scar has healed completely. It takes about 6-8 weeks for normal tissue healing, so once that time frame has passed and the scar has closed and healed, it would be appropriate to seek treatment. Heat is good for vaso-dilation, which in deed brings blood to the area and helps loosen up tissue. Heat is helpful for no more than 10 min or so prior to manual techniques to help mobilize scar tissue. It is better after the 6-8 week healing process. Ice may be better to help decrease swelling and inflammation in more acute cases (before 6-8 weeks). I think if you are 6-8 weeks out, heat would probably feel better. Of course, you want to be careful to not burn the skin, only use it for 10 min or so, and make sure there is a barrier between the heat pack and the scar. If you do have a nerve issue, you may not be able to tolerate a heat pack. My advice is to seek an evaluation before trying anything. A warm bath is a good place to start, and then go from there. Good luck!

      All my best,

  62. I am a 45 year old single woman, with lichen sclerosus and scar tissue has completely covered the clitoris. Is there any way of removing the scar tissue?
    Thank you.

    1. Dear Lorrie,

      Surgical interventions have been used to help this issue. To my knowledge, Dr. Irwin Goldstein in Southern California may be able to help you treat this.

      All my best,

  63. I have a different location of pain. The ligament that runs from pelvis to the femor had a ruptured cyst next to it that got removed. It is just along the panty line and the scar tissue (as per the dr who removed the cyst) feels like it runs deep into the skin going to the ligament. How can I get PT for that senstive area or what can I do at home? I have to be very careful of what underwear I have on because it hurts if it puts too much pressure there. Help!

    1. Dear Erin,

      It’s likely that the reason your skin is hypersensitive in that area is scar tissue and dysfunctional connective tissue. A PT can manipulate this tissue to normalize the connective tissue mobility as well as minimize scar tissue. This should dramatically decrease your sensitivity. At home, don’t be afraid to touch, move, and massage that tissue often, even if it hurts.

      All my best,

  64. Hi there – wondering if you can recommend any PT in the California Bay Area? My partner has had some myofascial release done at a clinic across the country for adhesions resulting from years-ago trauma to his duodenum and subsequent surgery for small-bowel obstruction. This type of work has changed his life! Hoping to find recommended therapists in the Bay Area for regular maintenance work?
    Thanks for your time!

    1. Dear Reader,

      We (the Pelvic Health and Rehabilitation Center) have three locations in the Bay area: one in San Francisco, one in Berkeley and one in Los Gatos. Please take a look at our website for more info:

      All my best,

  65. 10 years after a rather brutal Total Hysterectomy, removal of both ovaries (one healthy) and well everything and a ‘scrape down’ for endometriosis i am in agony. The burning sensation in the vagina and all exterior ‘parts’ , difficulty with bowels, bladder, the intestines collapsing down into the pelvic cavity.. and what feels like a rope being snapped inside over and over and over then telescoping in the worst cramp in the world… there are days sanity is held onto by my teeth! Abdominal, not vaginal procedure. the scar is hard and tears at the ends, the vagina, what’s left of it and the ‘cuff’ are almost sharp and hard, tear and bleed on their own and well there’s not a nerve or blood vessel left intact so there is no sex either. 10 years of living death. I was blown away when PT was suggested to me. I get the idea of stretching muscles. Is there a site or literature that explains HOW this is done? and is it available in Montana? Is there a special training or board that certifies this? I had a board certified surgeon and was well.. not given medical treatment i’d allow on a stray cat so I am beyond skeptical of ‘professionals’ in this state. Thanks for any help.

    1. Dear Granny,

      I’m so sorry to hear about all that you are going through.

      I would recommend that you read more of the posts on this blog; they will give you a better understanding of how PT helps with pelvic pain. For instance this post will explain what good PT is:

      Also, this post gives tips on finding a PT in your area.

      I’m sorry, but we don’t know of a pelvic floor PT in your area. It may be that you will have to travel for PT. We offer a free-15 minute phone consult if you’d like to give us a call.

      All my best,

  66. Thanks for your posts – clear and helpful info.
    My situation and Q: after no known incident but menopause and several years’ nonuse, I now have a penetration barrier, a thick scar band (3.5cm), fully separate from muscle, transversely at entroitus (part of a circle), not adhesion. 8 months’ pelvic-floor PT in NYC (where I have great resources to recommend if needed) and steroid injections have improved other bands and tightnesses, but this one has not responded. Gyn now recommends cutting the band in a few spots (5 and 7 pm) via partial vestibulectomy with vag flap advancement. Some respected sources have told me that’s a no-brainer, others have said it’s to be avoided. Do you know any other solution or any words of caution or counsel before I undertake this? Thank you!

    1. Dear SF,

      I’m sure you’ve been told this already, but what you’re experiencing is a vaginal constriction ring. I’ve had several patients with very similar situations as yourself and I’ve spoken to several gyns and urogyns about treatment options. Everyone that I have spoken with says to start with estrogen, PT and dilators, but unfortunately, in my experience that’s not usually enough. Usually it has to be surgically cut and then followed up with very consistent PT and/or dilator use to keep it open. I think this may be your best option at this point.

      All my best,

      1. Liz – thank you so much for this reply – and the perfect timing: when i didn’t hear back from you i went ahead with the surgery – on the very day you wrote me this to say it’s probably the best option! so now i’m healing and intending that it works and waiting until i can resume PT and a sex life.

        in this process i’ve encountered some gifted PF PTs in the NYC/LI area – glad to provide names if desired – and have had highly recommended to me by an esteemed source the specialist clinic in gainesville FL known as clear passage – could you tell me if you’re familiar with their work and whether you can recommend them?

        thank you again!

  67. this is amazing and insightful, and I found myself nodding along as I read. thank you for providing me with some answers to why I feel so broken after open abdominal surgery – and letting me know that I’m on the right track by doing PT. but man. it sucks!

  68. I had an umbilical hernia repaired about 13 yrs ago, about a year later I developed severe pain near the incision site which felt like the hernia was back. After a few more visits to find no hernia, I was sent to our local pain clinic which really had not made a difference in any pain relief, so I had just decided to deal with it since I had no success in getting any good answers or treatments. After reading thru the blog this seems to be the best news I’ve seen in years. I have been getting severe cramps or spasms along with dull pressure along with being really sensitive to touch in the area for years.
    I’ve also noticed when these flare up I have an area above the incision that is like a hard ball of tissue that you can feel under the skin that is really sensitive and lessens after the flare up.. Do you recommend seeing a pt or that I would see relief by doing so? If so are there any in the Pennsylvania area ?
    Thanks Joel

    1. Dear Joel,

      I do think that a PT might help you. Below is a list of pelvic floor PTs in Penn:

      Bryant Janice Pittsburgh PA (412) 422-4775
      Curtis Cheryl Erie PA (814) 877-3215
      Patterson-Avery Martha Charleroi PA (724) 489-8111
      Woods Christine Pittsburgh PA (412) 967-9229
      Garges Lauren PT Bethlehem PA (484) 854-2251
      Snowden Karen PT Allentown PA (610) 402-9712
      Sheth Hina PT Philadelphia PA 267-282-1301
      Haring Lori PT Allentown PA 6104376975
      Rejba Amy MSN, CRNP Philadelphia PA 2158638100

      All my best,

  69. Ever since I had my son 9 years ago, via c-section, I have experienced an increase of UTI’s and cystitis type issues and intercourse is slightly uncomfortable. I have had a ultra sound of my kidneys and bladder with a clean bill of health. I have been strengthening my pelvic floor and abs over the last few years but it’s very frustrating. After exercise or heavy lifting my abdomen becomes slightly swollen and I sometimes have to ice it. It becomes harder to control my bladder at that time.I also have tenderness a round both my ovaries, but more one over the other. I’ve changed my diet to include vinegar to keep my ph under control and the UTI’s have slowed, but the cystitis issues catch me off guard and come most often after intercourse. Could this type of PT help? Do you have any recommendations for PT’s in Spokane, Wa?

    1. Dear Donna,

      Yes, I do think you should get an evaluation from an experienced and knowledgable PT. I’m sorry but we don’t know of a pelvic floor PT in Spokane, but below are three pelvic floor PTs that we refer to in Washington state:

      Khadduri Lucie PT Lacey WA (360) 456-3300
      Vora Sagira PT Bellevue WA 4256885900
      Allen Tina PT Seattle WA 2065982889

      All my best to you,

  70. Dear Melinda:

    I have keloid in several parts of my body due to pressure I put on pimples. I knew I am prone to keloid. I had vaginal delivery with episiotomy 4 months ago and since then, I feel sharp pain like razor cut when urinating, tears in the anus when defecating regardless of the texture of the stool, painful and bloody intercourse due to a small keloid formed at the entrance of the vaginal area and the perinum.

    can PT work on this? how is massage possible in that area?

    1. Dear Reader,

      Your symptoms may or may not be caused by scar tissue. You also might have too tight muscles in your pelvic floor, and or trigger points. I would recommend that you see a qualified and experienced pelvic floor PT. Fourteen muscles make up the pelvic floor, which is a hammock-like group of muscles that are accessible from the vagina or anus. Please read this blog post about pelvic floor PT to get a better sense of it:

      In addition, this is a great article that was recently published in Elle Magazine about pelvic floor PT:

      All my best,

  71. I find this topic, as I am once again in pain. Every month since I have had my daughter over three years ago, I get what feels like laboring pains in my lower pelvic area. My mom said she had similar pressure after her second child. However, I labored vaginaly, but with preeclampsia, it came down to forceps or emergency c-section. The thought of forceps made me so queasy, I opted for the c-section. I never returned to my old stamina or body weight, and I have become accepting of that, but the intense monthly pressure before I menstruate is unbearable. We also have not been able to conceive again in over the last two years. Just about a year and half ago, we tried chlomid, and I ended up with even more pain….the docs ran a dye ct scan and stated it was multiple ovarian cysts. We were already off the chlomid, and have never returned to it. The pain got better for almost 6 months, and when it was last back, I went to the doctor, and they did an transvaginal ultrasound and did not find any cysts. But I am still having the pain. Scar tissue makes sense to me. However, getting insurance to help to pay for any visits concerning my reproductive system has been disappointing. I can’t imagine they would consider assisting with PT? Also, one doctor had said my inability to conceive is more than likely due to scar tissue. I have had a chemical pregnancy two months ago…I guess I’m thankful first to know I’m not alone. Secondly, does any insurance assist with PT? And thirdly is there a way to see scar tissue inside unintrusivley?
    Lastly, I do not expect that you could diagnose this to necessarily be scar tissue issues, but maybe some of the logistics are there for it??? Thanks for any advice.

    1. Dear Jennifer,

      Most insurance companies cover PT. I would recommend giving your insurance company a call and asking what your coverage is. As for your second question: there aren’t any tests that can detect whether someone has either abdominal or pelvic floor scar tissue.

      If you’d like a referral for a pelvic floor PT in your area, just let us know.

      All my best,

  72. I have a four month old daughter, vaginal delivery, and had a 2nd degree tear. I am still having significant pain during intercourse! It is near the opening, not deep inside. I went back to my obgyn and she said I have some scar tissue and am having spasms. She gave me some cream to apply, and showed me some exercises. I am supposed to do them for two months and if I am still having problems, she is going to send me to a PT. Do you know about how many times a day and how long I should be doing these exercises? Is it possible for me, alone, to get this pain to go away?

    1. Dear Marci,

      Scar tissue and muscle spasms after a vaginal delivery can definitely cause pain during intercourse. I can’t comment too much on the exercises your MD gave you, since I don’t know what they are or what you are presenting with. I can tell you,however, that if there is restricted scar tissue present accompanied by muscle spasms, it would be a good idea to see a trained pelvic floor physical therapist so she can evaluate and work on the tissues manually. I would suggest trying to see a PT to see if there are additional things you can be doing to help the healing process along. I think at 4 months post delivery it’s perfectly acceptable to begin physical therapy.

  73. This is a little different from me, but can scar tissue from an appendectomy cause a lot of right lower quadrant pain? I also had a 5 cm mesenteric cyst adjacent to my right colon. That was removed too. All benign, but now having pain on that side.

    1. Dear Carina,

      Scar tissue from any kind of surgery, including an appendectomy can cause pain. I recommend that you see a qualified pelvic floor PT to assess whether scar tissue is the reason for your pain.

      All my best,

  74. Melinda,

    I have had two C-Sections about 25 years ago or so. I notice that behind where my scar is (both in the very same area) I have a lot of tenderness behind the scar but I always thought it to be IBS. Do you think this is more from the scar tissue? It’s interesting reading how pain else where can be the cause of scar tissue because years ago I went to an internist complaining of some of the pain you described and the Dr. had no clue what could be causing it and what you describe made so much sense in my case. Thank you for the article.

    1. Dear Lynn,

      I’m so sorry, but I can’t answer your question without examining you. But I do recommend that you see a qualified PT to evaluate whether or not your pain is indeed coming from scar tissue.

      Where are you located; perhaps I could refer you to a PT in your area.

      All my best,

  75. Searching for answers! I had my third csection on June 26, 2013. I was in much more pain this time then my previous csections. I’m still feeling some pain around my scar and especially my clitoris. Almost like it’s bruised. I cannot enjoy sex at all. Which is not normal at all! No pleasure what so ever. Just feels like pressure and actually hurts myclitoris to touch it! This did not happen with either of my previous csections. I’m beginning to worry and can’t help but feel depressed. I am 36 and live in Raeford, NC, which is right next to Fort Bragg. Please give me some insight and point me in the right direction on how to fix this.

    1. Dear Nichole,

      I would definitely recommend that you see a qualified pelvic floor PT. There are many pelvic floor impairments that could be causing your symptoms, and a qualified PT will be able to figure out what they are and how to treat them. The two PTs we refer to in NC are below:

      Wegmann Emily PT Raleigh NC (919) 571-9912
      Young Wilda PT Greensboro NC (336) 275-6380

      Also here is a blog post we wrote about finding a PT in your area:

      Lastly, take a look at our post about postpartum pelvic floor rehab:

      All my best,

  76. Hi, I had a total hysterectomy 2 months ago. I am experiencing pelvic pain on the left side. The pain radiates to my left leg. The pain is not great, I would say from 1 to 10 maybe a two. Do you think it is scar tissue?

    1. Dear Carol,

      I’m sorry but without examining you I can not tell you whether the pain you are experiencing is from scar tissue or not. I recommend that you see a qualified physical therapist for an evaluation. Where are you located; perhaps we could recommend someone in your area.


  77. Hi there, I am 43 years old – I have 3 children ages 15 20 and 27, the youngest and the oldest were normal births with a small amount of tearing and the middle was a caesarian. When I was a teenager I had my appendix out and in my 30’s I had a prolapase which resulted in having a TVT for my bladder and a pelvic floor repair to the posterior wall. Also had 2 laparoscopies during my 30’s, so as you can imagine there must be quite a lot of adhesions? Over the last year or so I have been getting excrutiating mid cycle pain to the point that I would become clammy and feel i would pass out – could feel the pain in lower abdomen and up inside the top of the vagina to the point I could not put any pressure on the underneath by sitting down. I have been on 2 lots of 6 monthly treatments of prostap to shut the womb and ovaries down to check if this is what is causing the pain. Have been put on HRT to eliminate any menopausal symptoms resulting from this. The cause of the pain does appear to be caused by ovulation and the consultant has suggested a complete hyserectomy accross my old caesarian scar- which I understand may be a bit more technical owing to the tvt and the amount of previous surgery. I am now on the waiting list for surgery which should be in December this year. However, since being on the waiting list I have noticed a cystocele and went to see the GP who felt there is slight vaginal prolapse and suggested that I do some pelvic floor exercises- each time I do them I get shooting urethra pains and pain high up in the vagina and in the abdomen going almost as far up as my belly button. It can last around half a day to a full day- am I likely to be causing any damage by doing the pelvic floor exercises? Should the consultant be made aware of these further problems and is there anything I can do to fix the cystocele and strenghen the area prior to my hysterectomy? Would really value your advice- thank you Tracey

    1. Dear Tracey,

      If doing Kegels, or pelvic floor exercises, are causing shooting pain I would absolutely stop doing them immediately. Your muscles are likely too tight, which is why they are causing pain when you contract them. If your muscles are too tight, that also means they are not strong which may be contributing to the cystocele. I would mention this to your MD, but he/she may not be familiar with this concept. As far as strengthening your pelvic floor, yes, that is completely possible with the correct guidance and treatment from a pelvic floor physical therapist. As far as the cystocele goes, it really depends on how severe it is and how affected the rest of your pelvic floor is from your complicated surgical history. I can’t really hypothesize on this without completing an examination.

      All my best,

  78. Hello,

    I had revision laser lipo done on my abs 3 weeks ago. I have some hard lumps that seem to be scar tissue and I also seem to have some fascia adhesion. I have been getting lymphatic massage and ultrasound. Do you have any other suggestions? Can you please recommend a good PT here in Chico, CA. Your help would be greatly appreciated:)

    Thank you,


    1. Dear Jeanne,

      I’m sorry to hear about all that you are going through. Below is the name of a PT from Chico that has taken our class. Best, Liz

  79. I am blessed to live only 30 minutes from Wilda Young, PT — an outstanding pelvic floor PT here in NC. QUestion: I am 2 weeks post cystocele repair, rectocele repair, urethral sling, hysterectomy including ovaries. No bio or synthetic transvaginal mesh was used. I basically have a long anterior and posterior vaginal incision. I am a PT as well and understand the benefits of early scar tissue intervention for external skin incisions but unfamiliar with internal vaginal scar formation. When is the optimal time to begin treating scar tissue so that it lays down in a more uniform fashion?

    1. Dear Becky,

      Typically patients can start PT 6 -8 weeks after surgery, following the surgeon’s recommendations.

      All my best,

  80. Have you treated mittelschmerz with this kind of therapy?

    I am very suspicious that I have scar tissue left over from a laparoscopy D&C but the pain seems to come and go with my cycles. It very much originates from the areas where the connective tissue/ligaments holding my ovaries would be. I have been massaging it which can be painful when it “flares up.” Seen lots of Dr.’s, they seem to be guessing.

    Can you recommend any one close to Montana? 🙂

    1. Dear Lynette,

      Pelvic floor PT does not treat mittelschmerz directly, but if a woman’s pelvic floor or abdominal muscles tense up because of it (guarding) and for that reason cause pain, then pelvic floor PT can help relax the muscles. In your case a pelvic floor PT might help. I’m sorry but we don’t know of any qualified PTs in your area. I would recommend reading this blog post, which will give you tips on finding a PT in your area:

      All my best,

  81. Thank you for the opportunity to ask questions here. I am a 51 year old female. I have had abdominal adhesions removed but not before they pulled my sacrum out of position. My tailbone also was affected. The chiropractor I’m now seeing is trying to align my sacrum and told me that I had scar tissue on the tendons in my hips. He is doing his best to help me and I’m getting cold laser therapy as well. Is there anything I can do at home to help myself at home? I have a hard time sitting, walking and even laying on my back. Would be so happy if there is something that could speed up the process, without costing me a lot of money. I read about some thumper vibrator but worried I might cause more adhesions. Anything you can offer would be great. Thank you kindly for you time.

    1. Dear Shawn,

      Without evaluating you I can not recommend at home exercises. I actually think it would really benefit you to see a pelvic floor PT. Where are you located; perhaps we can recommend one to you.

      All my best,

  82. Hi,

    I had a c-section nearly 7 years ago, and after 2 1/2 years started having bladder pressure-type feelings. I thought originally that it was just a uti, but it did not resolve with antibiotics. I feel almost constant pressure to my bladder urethra that is not relieved at all by urination. I was diagnosed at one point with interstitial cystitis, but that didn’t really fit since my problem was not with urinary frequency or being unable to hold it. I had laparoscopy several months later during which the doctor spent 90 minutes clearing out scar tissue. I thought, “awesome, now I know what was causing all this.” But the symptoms did not improve. Instead, I ended up with the additional problem of painful bowel movements. So now I dread having a bowel movement because within minutes after, my bladder symptoms are aggravated and remain so until after a full nights rest. (So I try not to have bowel movements in the morning, lol). I have been to 2 different PT’s, the doctor above-mentioned, chiropractors, massage therapists, tried ignoring the issue (which, incidentally is the best thing I’ve come up with, since any kind of treatment seems to make things worse), etc. could scar tissue still be my problem? Or might I just have a really tight pelvic floor leftover from dealing with scar tissue that no longer exists? My husband and I really want more kids, but I am unable to even be intimate! I am in the logan, UT area if that helps.

    Any advice appreciated.



    1. Dear Cara,

      I’m so sorry to hear about all you are going through. I honestly can’t tell you whether scar tissue is your issue or not. There are SO many things that can go on with the pelvic floor and surrounding area that can cause symptoms like the ones you are dealing with. One of the best ways to know exactly what (usually more than one thing when dealing with the pelvic floor) is causing your pain is to see a good pelvic floor PT. You mentioned that you have tried pelvic floor PT. Are you sure the PT you received was appropriate. Unfortunately, not all pelvic floor PTs are created equal.

      I recommend that you read this blog post about what to expect from a “good” pelvic floor PT session to make sure you got adequate PT.

      If you would like to give PT another try, below is the name of a PT in Salt Lake City that one of our patients saw. Also, we do see out of town patients if you would like to explore that option.

      Monson Bonnijane DPT Salt Lake City UT (801) 587-7005 [email protected]

      All my best,

  83. Please recommend me someone in Portland Oregon
    Thank you. I need some relief.

    1. Dear J,

      Below is the name of a PT in Lansing that has taken our pelvic floor PT class. All my best, Liz

      Mahoney Janet PT Lansing MI 5179133949 [email protected] Capitol Physical Therapy

  84. In 2007 I had a fistula between bladder and colon. Partial colectomy. Now having problems, particularly with bladder, and reading all these posts I’m pretty sure that I must have scarring in this area. I did have a bowel adhesion a year and a half ago. Will an MRI or ctscan show up scar tissue? And is there a pelvic floor PT in the Palm Springs area? Thanks

    1. Dear Lee,

      The tests you mention do not always show scar tissue. As for a PT in the Palms Springs area: the only one we know of is in Redlands. Her info is below. All my best, Liz

      Hickman Debbie Redlands CA (909) 307-0155 [email protected]

  85. I am so thankful for having come across this information. I developed a very large hematoma on the muscle wall right after my cesarean 7 years ago. Just 1 hear ago I had a d&c after a miscarriage and i have never been the same since then. I have been dx with fibromyalgia; I do have a bulgkng disc on the lower back L4 and I cannot feel my lower ab. I get horrible pain on my lower ab and pelvis 1 week before my periods and it lasts for 2weeks. Recently; i began rolfing and i have noticed good relief. Would the pt work you are referring to be similar to rolfing? If not; any recommendations in the los angeles area.? Finally: can my nerve pain be actually caused by scar tissue from the d &c vs it being fibromyalgia?
    Thank you so much for your time and valuable information.

    1. Dear Aileen,

      There are many pelvic-floor related issues that could be causing your pain, scar tissue is just one of them. If your pain presented after the pelvic floor traumas you mentioned than it is highly likely you have a pelvic floor issue and not fibromyalgia. Pelvic floor PT is nothing like rolfing. If you want to know more about it, please read the following two blog posts:

      A PT that we refer to in LA is Eileen Johnson at USC; (323) 442-2900 or you can email her at: [email protected].

      All my best,

  86. I had a keloid scar pretty badly from the time of my c section. I have been using the Dr max Powers Scar Serum twice a day on the scar, and 18 weeks later the scar is very small and the right side is starting to fade. 

  87. I am looking for a PT for pelvic pain that I have been suffering with for ten years now, Tried everything from Accupunture to lazering out endo and adno to hysterectomy to stil constant pelvic pain, I am told its due to scar tissue and nerve damage, Can you recommend a PT in the area of Long Island Ny? Thankyou!

    1. Dear Linda,

      I’m sorry but we do not know a PT in Long Island. However, we do refer many patients to the following PT in NYC; perhaps you can travel to see her or she will know of someone in your area.

      Futterman Stacey PT New York NY 212 2262066 Four Points Physical Therapy

      All my best,

      1. After a year of intensive research and sessions here and afield, i have an extremely gifted pelvic-floor PT on Long Island, as well as others I’d definitely recommend in NYC, Austin, Miami and Gainesville FL, plus a specialist MD in NYC (my condition eventually required surgery, from which I am now rehabbing through more PT). I don’t know what’s appropriate to post here since you don’t know all these people yourself, so please advise. I’d be so gratified to be able to share the excellent resources I’ve found in my own challenging journey.

        1. Hey I was wondering if you could share with me the pelvic floor pt in miami. i would greatly appreciate it. thanks!

          1. Dear Stephen,

            The PT that we refer to in Miami is:

            Downey Pamela PT Miami FL (305) 666-3232


  88. I had a cesarean section in june 2010. I went on to suffer with severe debilitating pain for 18 months to finally getting a second surgery. I had facial shearing and was repaired with a mesh. My pain is different, more manageable. However, at times it becomes all I can think about.

    Do you have a PT referral for me in Montreal, Quebec?
    Thank you

  89. Looking for a PT for Pelvic and lower abdominal pain in Florida. I live near Daytona but am willing to travel. Thanks

    1. Dear Michele,

      Below is the name of two PTs that we refer to in Orlando; hopefully one or the other will work for you. All my best, Liz

      Arango Ashley Orlando FL (407) 303-8280 [email protected] Florida Hospital Pelvic Health Rehab
      Marsh Katherine Orlando FL (407) 303-8280 [email protected] Florida Hospital Pelvic Health Rehab

  90. I had a vaginal birth in 2005 & C-section in 2008. Both times I had severe bleeding. My uterus would not contract on it’s own. With my C-section it was worse. Soon after my incision became badly infected. I still have numbness on the right side of scar. I just got back from the dr because for the past month I’ve been having burning sensation & pinching in my vulva, groin pain & now constant nagging where my incision is. Pain near my right ovary. The burning is bad at night. Worse when I sit down especially if I sit cross legged. My dr said it’s scar tissue from my C-section & that ibuprofen & warm compresses is all I could do & that it’s just something I have to deal with. The nurse there told me she had same thing & it finally went away after menopause. The thought of having to deal w/this for the next 10-15 yrs is too horrible. Can you pls refer me to someone in the Rochester, NY area. Thank you so much!!!

    1. Dear Tracy,

      I’m sorry to hear about all you are going through. You are smart to NOT listen to your doctor and his/her nurse. We treat symptoms like yours often. Below is the name of a PT in Rochester who has taken our class. All the best, Liz

      Featherstone Wendy PT Rochester NY 5854731290 [email protected]

  91. I had to have an emergency c-section 8 months ago and for the last 2 months I have had irregular heavy periods with spotting in between. I also have had extreme lower back/spine pain and pelvic pain in ovaries area and uterus area (guessing of course)I do not have health insurance and I’m pretty sure it is just pain from internal scar tissue but I can’t explain the spotting and bleeding. I thought it may have something to do with my extreme blood loss after the surgery (had to have blood transfusions. Is there ANY insight you can give me? God bless you for helping all these women gain knowledge that you put time and money into learning. You are a blessing to the world:)

  92. Have just come across your article. Have had pain over my c-section scars and other forms of pelvic pain over the course of many years. Like many of the above readers, it’s never determined what’s the cause after all kinds of tests/scans. Can you recommend PT for pelvic pain in the Kansas City area (zip code 64113). Thank you.

    1. Dear Liz,

      We refer to two PTs in KS; however I’m not sure if they are near you. There info is below:

      Simon Susan OT Leavenworth KS (913) 682-6103 [email protected] Saint Luke’s Hospital

      Voight Lindsay PT Overland Park KS (913) 317-7341 [email protected] Saint Luke’s Hospital South

      All my best,

  93. Hi, I just wanted to say thank you so much for posting this. I had a C-section 6 years ago and recently over the last year just under my scar Im having pain come and go. If I relax my pelvic floor muscles it really helps. But I had no idea that massaging it will help as well. I am so happy you wrote this and explained. Thank you very much!!!! I wish I knew how to do this 6 years ago. I knew the pain was all related but its nice to confirm my thoughts.

  94. Thanks very much for this informative article! I had a rough childbirth and am recovered now but have some scar tissue. Do you know of any PT’s that specialize in treating postpartum women in Maui, Hawaii (zip code 96708).

    Thanks !

    1. Dear Danielle,

      I’m sorry but we are only familiar with one PT in Hawaii, in Honolulo; her info is below:

      Ogino Kathy Honolulu HI (808) 599-0045 [email protected] Renew Physical Therapy


  95. I have read with interest all of the above mailings. I believe I could benefit from a pelvic floor massage therapist or someone qualfied to break up my scar tissue. I have lower pelvic pain often now. I feel better when I lie down, but that is it. Gynecologist said it could be scar tissue. She felt around but found nothing of consequence. My back has been hurting as well. Internist asked if my back pain and lower pelvic pain are related. I do not know. Appears from reading that maybe they are? Looking for someone to assist in the Champaign County area in Illinois. Thanks! Carle Clinic or Christie Clinic are two
    clinics I visit.

    1. Georgine,

      We know of many PTs (I believe you meant physical therapist as opposed to “massage therapist, right?) in Il. Could you please let us know what major cities are around you as we are not familiar with towns in particular counties in your state.

  96. Hi,
    I had a c-section and cyst removal in jan 2012. Even today I still have pain in my pelvis especially on the right side where the cyst was.I was away, and had sexual intercourse after 4 months. And I noticed I am bleeding after that.I am just worried for what is happening. Is it because I am not fully healed….and is it normal???PLEASE HELP…
    Thank you

    1. Dear Susanna,

      I’m sorry about all that you are going through; however, without evaluating you I can not tell you what is causing your pain. There are countless things that can cause pelvic pain. I recommend that you see a physician and if you don’t have any infectious agent, that you see a pelvic floor PT.


  97. I have so much pain in groin, pelvis which I believe is related to scar tissue. No one seems to have had this experience. Do you know of anyone in Mississauga, Ontario or Toronto who would have experience. I am at my wits end and the pain is relentless. Physician has done ultrasounds, MRI’s and now forwarding me on to Gynecologist and Gastro for consult.

    1. Dear Lynda,

      Below is the name of a pelvic floor PT that we recommend in Ontario. All my best, Liz

      Thibault-Gagnon, Stephanie PT Kingston, Ontario Canada (613) 533-6000, ext 79009 [email protected] Queen’s University

  98. Hi I had a baby 18 months ago vaginal and had 2nd degree perineal tear. After delivery I always carried her on my right side and did some crazy things with my body to get her to sleep. Needless to say, when she was about 8 months old I was lightly jogging when my right hip locked up on me. After rest it went away but then a few weeks later I was doing sprints and it came back again to the point I was limping. A few months went by and it was a little uncomfortable but not enough to worry until I started getting groin and right buttocks (piriformis area) pain. My groin was uncomfortable when I would put pants on and have to support with one leg. I was working out and forgot to stretch prior to working out and that’s when I noticed the pain. So since then I have seen 6 doctors, neurologist, orthopedic surgeons, chiropractors and did an SI joint injection which didn’t help and had an MRI of the lumbar and si joint and a right hip MRI. I finally found a physical therapist who is doing myofacial realease internally and said I was in extreme muscle spasm down there. I have noticed the groin pain let up significantly, however, the buttocks pain is still slightly there which seems to be uncomfortable when I sit too long and I have bad knee pain especially on the left side. I am concerned that this is something more serious that no one has caught and wanted your feedback as to if all this is related? I am used to working out and haven’t in about 7 months and just wondering if maybe my muscles are weak. Any advice or help will be greatly appreciated. I just want to feel normal again. Oh and I have been wearing an si joint support belt and that seems to help my knees a little. Thanks again

    1. Dear Paige,

      I’m sorry, but without performing an evaluation on you I can’t tell you whether or not the symptoms you are having are related or not. What does your PT say?

      If you haven’t already, please take a look at the posts we’ve written about postpartum pelvic pain/dysfunction.

      It sounds like you are on the right track with pelvic floor PT; however, she should be able to answer your question about whether your symptoms are related based on her findings.

      All my best,

  99. Please recommend a PT in Milwaukee, WI. I had a hysterectomy 2/11 and a bad sports injury 8/11. I know that I have nerve stuff going on, as well as scar tissue. I’ve seen many medical professionals, both holistic and conventional. I am still experiencing pelvic pain, as well as sexual issues.

    1. Dear Barb,

      I’m sorry but we don’t know of a PT in Milwaukee; however, below I’ve included the list of all the PTs that we refer to in WI in the event that one of them is close to you. Best, Liz

      Hoffman, MD Donna MD Onalaska WI 6087751851 [email protected] Gunderson Lutheran Med Ctr
      Walz Colleen PT Onalaska WI 6087751840 [email protected] Gunderson Lutheran Med Ctr
      Bartelsen Beth PT Nashotah WI 2625696306 [email protected] ProHealth Care Musculoskeletal Institut
      LaBorde Linda PT Waukesha WI 4143020770 Spinal Dynamics of WI
      Hildenbrand Sherese OT Mequon WI 2622401202 [email protected] Continence and Pelvic Wellness Clinic
      Callif Debbie OT Mequon WI 2622401202 [email protected] Continence and Pelvic Wellness Clinic

  100. I had three herniated disks in my back from the fall. They have been gradually healing.

  101. Any physical therapist specializing in pre and post pregnancy care that you can recommend in the Orlando, fl area?

    1. Dear Paige,

      Below are the names of two PTs that we have referred patients to in Orlando. All my best, Stephanie

      Arango Ashley Orlando FL (407) 303-8280 [email protected] Florida Hospital Pelvic Health Rehab
      Marsh Katherine Orlando FL (407) 303-8280 [email protected] Florida Hospital Pelvic Health Rehab

  102. I don’t know if i am in the right place but I’m having this pain in the left side of my abdomen between my ribcage and pelvic. I’ve had 2 C-sections, first one was 8 years ago and second one was 4 years ago. The pain started back in Aug. 2013 and it only occurs when I am about to have my menstrual cycle. I’ve had CT scan but the doctor could not find anything. Also I feel burning sensation in urinating and I go frequently because it feels like my bladder is full all the time, having pain in sexual intercourse and back pain. There are times that when I gone up quickly I felt pain where my incision is. Reading all the post here I can relate to the pain so I think my issues would be pretty much scar tissues.

    Would you please, please recommend a PT pelvic floor specialist here in Indianapolis, Carmel, Fishers area. I would greatly appreciate it. Thank you.

    Mom of 2

    1. Dear Momof2,

      I’m sorry to hear about all that you are going through. It does sound like PT might be appropriate for you. Below is info for three PTs that we are familiar with in Indiana. Best, Liz

      Morrison Elaine PT Zionsville IN (317) 873-2033 [email protected] Zionsville Physical Therapy
      Robinson Amy PT Greenwood IN 3178843380 Tx: Team Therapy
      Campbell Tracy L. MPT Valparaiso IN 2194760377 [email protected] Dynamic Rehabilitation Services

  103. I had a c section 4 years ago. I am now 18w
    Pregnant and I have terrible pain over my scar and it
    Seems to be worse the further I get! I also get tested
    Every week for uti because of pain frequency
    And dr just says it is round ligament! After reading
    Your article I believe it’s scar tissue causing bladder
    Problems. Before pg I had issue with bladder during periods!
    Makes sense to me but dr dismisses me!!

    1. Hi Robyn,

      Where do you live? We may be able to recommend a pelvic physicial therapist and physician in your area.



  104. I’ve had one natural birth and two c-sectiins. I am not always in pain but when I am, it is overwhelming. One time I was experiencing pain during intercourse. I went to the ER and had two different ultrasounds. The doctor informed me that I had a cyst but when I should my Gyn the results, she said I didn’t have one it just looked like my cycle was about to start. She also informed me that my pain could possible be from scarring tissue since I had two c – sections. So I Googled scar tissue and your article came up! 🙂 Is there anything I can do for the pain? I don’t have a money for a PT and I am tired of taking pain killers. Thank you!

    1. Hi Cici,

      Scar tissue may be the culprit for your pain, but it is difficult to know for certain without an evaluation. If finances are an issue for you, I would advise that you still consider scheduling an evaluation with a pelvic floor PT. A PF therapist will be able to rule out any other factors contributing to your pain, and if appropriate, he or she can educate you on self-treatment techniques.



  105. I am a 33 year old female, 14 weeks post op from my second abdominal hernia surgery this year. I have also had 2 c sections in the last 6 years. 

    The day after surgery I started to have horrible pain in the SI joint, hip and right lateral thigh- in addition to my incision and groin. My surgeon said the majority of my pain could not be surgery related and referred me to a pain clinic a short 8 weeks after surgery for the groin pain. Not satisfied with his answer or approach, I saw an orthopedist to evaluate my hip. They think I may have possibly been positioned during surgery in such a way that my hip became inflamed. As I’m going through testing to confirm if I have FAI ( CAM ) and label tear, the pelvic pain is getting worse. I have a normal healing bridge under my scar, but another large hard lump in the lower abdoman that I suspect is scar tissue. I also have developed horrible tail bone pain which keeps me from sitting at all. I am pretty much a mess and was fine the day before surgery other than pelvic pressure/pain from the hernia. 

    Though I have been undergoing regular PT the last 7 weeks to build my core due to a leg length inbalance and weakness in my hip, I am worried that the deep pain in the abdoman and tail bone are getting worse each day and not being addressed. Can pelvic PT help with tailbone pain? No one wants to address the issue because the hip is the bigger target. 

    Northern VA, outside DC has a few pelvic PTs I’m aware of, but as you have said not all are created equal. The areas are Fairfax, arlington, Reston, Loudoun or Alexandria. Do  you have any reccomdations of someone who can give me a thorough evaluation? The pain is 24/7 and I keep getting pills thrown at me as the solution when I know there has to be a reason. 

    1. Hello Ruthy,

      Yes, pelvic physical therapy can address your tailbone pain. In fact, I would strongly recommend that you see a pelvic PT before continuing with your strengthening program. It is important to release any restrictions present before starting any exercise programs, especially one that involves core work. Below is the list of therapist recommendations in your area.

      All my best,


      Amanda Miller, DPT
      Richmond, VA
      (804) 270-7754
      Progress Physical Therapy

      Carrie Pagliano, PT
      Arlington, VA
      Georgetown University Hospital

      Camille Simmons, PT
      Alexandria, VA
      (703) 849-8142
      Select Physical Thearpy

      Clare Kalina, PT
      Fairfax VA
      Northern Virgina Pelvic Surgery Associates

  106. I had mesh sling surgery for bladder prolapse 3 years ago. I had some pain following the surgery but nothing too bad. In December 2012 the pain became much worse. My insurance had changed since the surgery so I went to a new obgyn…. she told me to take motrin for the pain. Frustrated, I tried to live with the pain until last summer when I couldn’t take it any more. I began looking for a specialist to have the sling checked out. I found out that the mesh had erroded and was advised to have the erroded portion remov. I had surgery in December but the pain has not gone away. The doctor said that she can not do anything else for me and said I should go back to my obgyn. So here I am looking for answers and came across your blog…. it sounds likesomethimg that I might benefit from… I don’t know what to do anymore… my quality of life is definitely suffering and so is my marriage. Please let me know if you think I would be a good candidate for PT. I live in the Sacramneto area…visiting your office is doable but someone closer to home would definitely be easier on me as it is painful to drive for too long.

    1. Hello Robin,

      I suggest that you contact Risa MacDonald’s office. Risa is a pelvic floor therapist, and is located in Sacramento.

      Risa MacDonald, PT
      East Sacramento Physical Therapy
      (916) 457-8802

      All my best,


  107. I was hit by car at the age of 12. I have scar tissue build up and a dent where I was hit. I’m in my 40’s now. I’ve had two c-section, I’ve had a uterine fibroid that caused great leg pain. It was removed. After that surgery, I’ve experience nothing but pain on my left side. Every month or if I work out by walking or sitting to long I experience the pain. I was told by 3 doctors one stated it was my IT band, the other told me it was a orthopedic issue, the orthopedic doctor stated I need to strength my core. I have issues because I can really bend my leg to put on panties, pants etc. I tried doing yoga and noticed my flexibility in the leg is gone. Could you refer someone in the Augusta, ga area please. Thank you

    1. Hello In Pain Regularly,

      We recommend that you contact the therapist below to schedule an evaluation.

      Lone Howell, PT
      Physiotherapy Associates Lawrenceville
      Auburn GA

      Jenny Hunt, PT
      Provenance Rehabilitation of the Greater Atlanta Area
      Alphretta, GA



  108. Hello

    My name is Payal and I found you online when searching for PT in area. I delivered a baby boy in Apr 2013 ( vacuum assisted delivery) and got a 3 degree tear. The wound opened and scar was formed so I had another surgery to fix the problem in July 2013. I finally healed but I still experience a lot of pain in perineal region if I squat or even touch there. Sex is painful and I feel really low due to all this problem. The doctor who delivered me told me that another scar tissue might have developed under the skin but is unsure. I tried steroid creams and what not.
    Do you think there is anything you can help with?
    Also I have blue anthem insurance. Does that work?
    Looking for a response soon.

    P mommy

    1. Dear P Mommy,

      Please call our office at (415) 440-7600 for more info about scheduling an appointment.


  109. I had ovary removed 15 months ago because if lagmrge cyst. Myvlife has never been the samem Chronic lower abdominalbpain, left round ligament hard and oainfulm Mons pubis swollen painful since the day I woe upm Inscional hernia developedv in 5 days, misdiagnosed , but 4 months later finally had hernia repaired. This created new problems, 9 months later mesh site is so painful and rd ligament pain returned in 2 weeksm I havent sat since mesh went in. My abdominal wall is painful, inside both legs, my pelvic fllor is hypertonic, also diagnosed with pubalgia, My vagina fell like some kicked me and broke pubis bone in halfm I tried 2 rds of PT in 13 now on my 3rd. Ive just done saliva tested, Estrone is 6 x highm Free testosterone 2x high and my Dhea is 2. Below low end of normal I just started PT at Core Plus Pelvic Floor therapyvin Mechanisburg, Pa. Any sugestions to ask them and who may help with my pubalgiav therapym Im full of scar tissue andvhave done at least 100 hour of miofascial under John Barnes trained therapists m Im currently trying Feldenkrais *2 sessions ( onevtomorrowm im drained finacicially, can no longer drive do to intense pain. Oh and was diagnosed with moderate rectecelem Im desperate at wits end, any therapist with good connective tissue skills within 1 hour of york, pam Willing to try, Thank youm
    normaolm Before ovary remival, I was actuve; flexible, hiked, played tennisz, yoga, stretched often. Now Im unable to walk , stand, longer . Than 10to. 29 minutes given the day or sit more than 5

    1. Hello Missy,

      I am sorry to hear about your situation. We can recommend a couple of therapists in your area, but they are about 2 hours away from York, PA. Good luck!



      Lauren Garges, PT
      Bethlehem, PA
      (484) 854-2251
      [email protected]
      Lehigh Valley Hospital – Muhlenberg

      Hina Sheth, PT
      Philadelphia, PA
      [email protected]
      Rebalance Physical Therapy

      Karen Snowden, PT
      Allentown, PA
      (610) 402-9712
      [email protected]
      Lehigh Valley Health Network

  110. Hello! Could you recommend a therapist in Colorado? We live very rural area and drs are limited, but i am experiencing many minor symptoms described here after 2 csections. Thanks!

    1. Hi Dani,

      Below is the list of therapists we recommend in Colorado.

      All my best,


      Hollie Neujahr, PT
      Denver, CO
      (303) 260-5092
      Nishimoto & Neujahr Physical Therapy

      Laurie Byrne, PT
      Ft. Collins, CO
      Colorado Physical Therapy

      Margaret Woodward, PT
      Littleton, CO
      Motion On Main Street

      Terri Nishimoto, PT
      DenveR, CO
      (720) 402-3801
      N2 Physical Therapy

      Amy Fife, PT
      Grand Junction,CO
      (970) 243-3061
      Western Colorado Rehab

      Laura Krum, PT
      LittletoN, CO
      Providence Physical Therapy

      Mollie Ressler, PT
      Fort Collins, CO
      (970) 377-1422
      Momentum Physical Therapy

  111. Hi!
    I love your posts as they are so informative. I need a good referral for Chicago- someone in the city. I have been doing Pelvic PT with internal work, not nearly as thoughtful and detailed as you described. I believe I have abdominal nerve wall damage, I have developed some serious scarring, and some endometriosis around the ovary that was problematic due to surgeries and an ovarian problem. I am having more pelvic pain these days and would like a really good Pelvic Therapist, not a one size fits all one. If you know of a good therapist, can you pass along the name? Thank you for wonderful and helpful posts.

    1. Hi Marie,

      We recommend Rhonda Kotarino’s practice in Oakbrook Terrace, IL. All the therapists are very qualified.

      Kotarinos Physical Therapy
      1 Trans Am Plaza Dr #170
      Oakbrook Terrace, IL 60181
      (630) 620-0232



  112. Hi. Thanks for your article. Any pt reccomendations in Nashville? I too have found difficulty in finding someone who can help.
    Thank you.

    1. Hi Carolyn,

      We do not have a PT recommendations in Nashville, but I do have a recommendation in Chattanooga. Her information is located below.

      Melissa Kubic, PT
      Chattanooga, TN



    1. Hello Carolyn,

      Unfortunatley, we do not have any recommendations for a therapist in Nashville,TN. However we do have a recommendation for a therapist in Chattanooga. I’ve included her information below.

      Melissa Kubic, PT
      Chattanooga, TN



  113. Hi,
    My name is Stephanie and I am constant pain everyday of every month except maybe 3-4 days. I had my last C-section 8 years ago and I noticed one day 2 or 3 years after that there was a lump the size of a small apple and was told by my OBGYN that it is scar tissue and if they removed it that it may come back bigger and that I need to suck it up and deal with the pain. Well I’m tired of dealing with the pain and went to get a second opinion and was told by this OBGYN that the only way he could help me was by putting on a medication that would shrink it down but also put me in early menopause, I am in my early 30s and is not ready for menopause. I don’t know what else to do and I’m tired of hurting, its gotten worse sometimes to the point where I just want to cut it out myself, please help me with any suggestions.

    1. Hello Stephanie,

      I am sorry to hear that you are experiencing so much discomfort. Where are you located? I may be able to refer you to a therapist in your area that can help you break down the scar tissue, and perhaps avoid hormonal medical intervention.

      All my best,


  114. Thank you, so very much for writing this.I have been really suffering for the past 11 years from a scar pain from an emergency episiotomy that my Gyno at the time had to do to get my son out. After his birth I continued having a lot of pain during intercourse and my Dr. said she could re-do the cut or we could wait and try to get to the root of the pain at the time I delivered my second child 3 years later. She opened it up and found a Bartholin’s gland cyst so she completely removed the gland. Now 11 years later, I am still really suffering from what I believe must be a trapped nerve at the site. It is still very sensitive/painful to touch and is really frustrating that it gets painful during intercourse. My hubby is super worried about causing any discomfort and I would love so much to find a PT that could help us!
    I would LOVE to come see you all, but since we don’t live close to Ca, would you by chance know of or be so kind to recommend anyone in the Nashville Tn area ? I will try anything at this point! This article was really enlightening! Thank you for helping and giving hope to so many that are just being told “tough, you had a baby and this is all part of it! “!
    Thank you so much in advance,

    1. Hello Heidi,

      I am glad to hear that our blog has been helpful to you! Unfortunately we do not have therapist recommendations in Nashville, but I can recommend you to a couple of specialists in TN that will still be closer to you than our office in CA. I hope this helps.

      Alfredo Nieves, MD
      Pelvic Pain and Reconstructive Surgery Center
      Chattanooga, TN

      Melissa Kubic, PT
      Chattanooga, TN
      [email protected]

      All my best,


    1. Hello Kathleen,

      Below is the list of therapist we recommend in Las Vegas.

      Tina Baum, PT and her associate Lindsay McGinn, PT
      Tina Baum Physical Therapy
      Las Vegas, NV
      (702) 877-2000



  115. My sister is having severe pain in the area where she had her gall bladder removed several years ago. Any time she bends slightly she has intense pain. Could this type help her ? Do you know of anyone in the Nashville or Clarksville Tn area?


    1. Hello Kathy,

      Pelvic PT may be a good treatment option for your sister, especially if there is scar tissue present at the incision site. Below is the list of therapists we recommend in TN.



      Alfredo Nieves, MD
      Pelvic Pain and Reconstructive Surgery Center
      Chattanooga, TN

      Melissa Kubic, PT
      Chattanooga, TN
      [email protected]

  116. Do you know of anyone in New Mexico- albuquerque or Santa Fe? I had a c section 10 years ago and have unexplained pressure in my uterus. Dr. Says it probably scar tissue. Also urinAry frequency and incontinence.
    Thank you.

  117. Hello,

    I am so happy to have found this site. I am absolutely desperate for any advice you can give me. I am a 35 year old female in with chronic pelvic pain. In 1999 I had keyhole surgery to remove many ovarian cysts and during surgery doctor told me I was likely developing endometriosis. I had two emergency C-sections four years apart (2007 and 2011). In 2008 I was hospitalized with severe pelvic pain and for some type of intestinal blockage which eventually resolved itself which then began years of chronic pelvic pain which after a colonoscopy, cat scan and many ultrasounds found nothing. Endo was their guess. My second pregnancy was painful and during my second C-section one of the surgeons told me there was “a ton of scar tissue”. Immediately following my c-section my pain worsened. More scans and ultrasounds which again showed nothing. Pain become severe about 10 months ago and I went to new gyno which because of the “suggestion” of endo in 1999 said I should have a hysterectomy. I had been doing a lot of research online and I asked her if she thought it could be adhesions and she said unlikely. At 34 and with two small children at home I went through with the hysterectomy (uterus and cevix removed, ovaries kept). After surgery I was shocked to hear that my endo “wasn’t that bad” but my uterus had adhesions as well as my bladder. It has been 5 months since surgery and my pain is almost exactly the same minus perhaps 5 percent. I greatly suspect abdominal adhesions as the pain generates from my C-section scar area and feel like a constant stabbing , pulling and burning. Also when I urinate it hurts as well as severe pain off and on when my bowels are moving. I have had a colonscopy, cat scan and blood work done-all negative. My surgeon wants to perform keyhole exploratory surgery as she now suspects adhesions-after telling me that wasn’t the problem. I am very depressed and desperate for relief. Do these symptoms sound at all like adhesions? Should I try physical therapy first to see how it goes before going through with the surgery? Will the surgery even help me? I sincerely appreciate any feedback you can give me. I wake up every day and start crying with levels of regret and remorse for going through with the surgery. I would do anything for resolution. I live in the Phoenix area but we are moving in 6 weeks to Raleigh. Thank you very, very much,


    1. Hello Chelsea,

      I apologize for the delayed response, your email was lost in the shuffle. I would recommend pelvic physical therapy before considering most surgical procedures, especially when there has been previous trauma to the area. Often times additional surgery will only present more problems if your muscles are still in spasm, and if not all the scar tissue is removed. Pelvic PT is much less invasive than surgery, with a qualified therapist, it may greatly reduce your pain. We recommend Emily Wegmann, PT, and Jennifer Briggs, PT in Raleigh, NC.

      All my best,


      Emily Wegmann, PT
      (919) 571-9912
      [email protected]
      Carolina Pelvic Health Center

      Jennifer Briggs, PT
      (919) 571-9912
      Carolina Pelvic Health Center

  118. I’m having an issue with my episiotomy scar. I had the surgery in 1990. I ran out of my usual pads and bought some different ones. This is the only thing I’ve done different lately. The scar is tender to the touch, so much so that massaging it is out of the question. Just wondering WTH? And how can I stop it?

    1. Hello Denise,

      I understand that your may be sensitive at the incision site, but breaking down the tough tissue will greatly reduce your discomfort. Without evaluating you, I can’t suggest much else, but I can recommend a therapist in your area. Where are you located?



  119. Hi, I hope I have found someone who can direct me or offer any suggestions other than surgery with regard to my left side pain (feels like an ice pick is stabbing into where my ovary would be and hurts through to my back and down my left leg)… I am a 54 yr old female who has had the following procedures: at age 19, I had a cyst on my left ovary, gyn performed lap surgery however all he found was cystic fluid. I have had 3 full term vaginal pregnancies; with my last one (1990) at which time I had a tubal ligation (2 days after giving birth). In 2003 I had a hysterectomy (lap) however gyn left both of my ovaries. In 2004, my right ovary was removed (lap) due to sharp pains and in 2012 my left ovary was removed (lap) due to severe left sided pain. Prior to the last surgery (2012) I had a colonoscopy and the MD advised my colon was like a check mark (scarred down) and I should make sure I drink Metamucil, eat a high fiber diet, drink 6-8 glasses of water and get plenty of exercise… When my gyn removed my right ovary, she said she snipped away some of the adhesions but warned me they would come back and boy howdy how they must have! I saw my gyn for my annual check up 3 weeks ago and she said she could do lap surgery to try and remove some of the adhesions however again she warned me that they will just grow back… I am in SO MUCH PAIN that I don’t know what to do! It does not hurt to have sex; it just hurts! I feel like an ice pick is stabbing in to my lower left side where I would presume my ovary would be… I go to a chiropractor for neck problems and the massage therapist who works there suggested that I find a massage therapist who works on the pelvic floor… My husband and I have some friends who suggested acupuncture…. I just don’t know what to do but I know that I have to do something because I constantly hurt and have to sleep with a sleeping pad… Thanking you in advance for any help you can offer!



    1. Dear Deb,

      You may benefit from pelvic floor PT. Please read this blog post, which describes pelvic floor PT in more detail. Where are you located, perhaps we can give you the name of a PT in your area.

      All my best,

  120. This is very interesting to me. I had a myomectomy in 2010 and then a hysterectomy in May of 2013. The hysterectomy was made more difficult by scar tissue and adhesions that had spread over my ovaries, colon, and bladder. Recently, I have been to the doctor for back and leg pain and constipation. I was told I have pinched nerves. I have not had an MRI, but am told if the pain worsens, that is the next step. I was seeing a PT for upper and lower back pain (which I have always had) and some pain in my left side due to dense breast tissue (more hysterectomy hormone changes, but stopped because I felt better. The doctor did an X-ray on my back to see if there was anything major wrong with my back, but found that my bowels were pretty backed up. I have had problems with appetite and nausea because of constipation. I have had no problems with urination, but it feels a little strange. Any suggestions? My friends keep telling me to go to acupuncture. I assume PT can help?

    1. Dear Maya,

      I’m sorry about all that you are going through. Without evaluating you, I can not be sure if you are a good candidate for pelvic floor PT for your constipation issues. I would assume you are considering an orthopedic PT for your back issues. But, it might be a good idea to get an evaluation from a good pelvic floor PT in your area. Where are you located? Perhaps we can give you the name of a PT we are familiar with in your area. Also, we have a blog post on constipation that you might want to check out here:

      All my best,

  121. Do you recommend any pelvic floor PT’s in Illinois near St. Louis, Missouri?

    1. Dear Stacie,

      Below are the PTs that we refer to in Illinois:
      Justice Jamie PT Dekalb IL (815) 785-5508 [email protected] Creative Therapeutics
      Markett Kristen PT Orland Park IL (708) 671-1971 [email protected] Flexeon Rehab
      Thatcher Judy PT, CFMT Cary IL 8474581722 [email protected] Sherman Hospital
      Kotarinos Rhonda PT Chicago IL (630) 620-0232 [email protected] Has not taken our course
      O’Keefe Maureen PT Evergreen Park IL 6306200232 [email protected] 1 Trans America Plaza Dr
      Karoghlanian Vonna PT Schiller Park IL 7732839800 [email protected] VK Physical Therapy
      Florendo Judith PT Evanston IL 3123378840 [email protected] Florendo Physical Therapy


  122. Melinda,

    I cannot even begin to express the gratitude that I feel for finding this article. I was injured on a bicycle last year “down there” – yes, ouch – and as I was away on vacation and am a nurse, I refused to go to the hospital. Stubborn much? Needless to say, a subtle scar formed inside. Normal activities didn’t affect it, though the same unfortunately could not be said for sexual intercourse. It’s been a constant struggle, and I find myself often feeling very negatively about my body and the issues I’m causing in that facet of my relationship. I cannot wait to try some self PT at home in hopes that this issue can improve to a state where I am comfortable in activities I once very much enjoyed. I thank you for this information and hope others can find as much benefit as I hope to find!

  123. I actually diagnosed myself with PN in 12/11- went to gyn who told me to have a total abdominal hysterectomy because she said I had a grade 1 rectocele- second gyn told me it was not possible i had PN because it takes at least 7 years to diagnose- when he examined he was shocked that I made the correct diagnosis- I did some research and went to Dr. Hibner in Arizona and had and interstim device last September with Dr. Ken Peters in Beaumont Hosptial in Michigan- I was in agony before the surgery. The device has recently , after 8 months of changing programs, decreased the pain from 20/10 to 4-7/10-in addition I have had bilateral botox multiple times. This helps but causes urinary retention. I think I developed this from an episiotomy that I had 24 years ago and the fact that I am a butt clincher. I see a great PT here- Lili Abbatte and have seen Pam Morrison and have been in Pt for 3 years. That being said, I am still on a lot of meds, still in a great deal of pain, spend days bed bound.
    Do you think that I should continue with PT- I do see results but they are not long lasting.
    I wonder after reading about scar tissue, if I should look into that aspect. I will discuss with my PT as I know you can not comment. If it is scar tissue from an episiotomy- which muscles are affected and would this cause pain in the obturator interns?
    I am in the medical field and I have to say that the pelvic floor Pts are so much more knowledgeable about this condition.. I wouldn’t let my MD do the botox unless he was directed by my PT as to which muscles needed to be injected! Both Dr. Hibner and Dr. Peters rely on PTs for treatment. So a big thank u for this blog and your website- very informative and helpful.

    1. Dear Ricki,

      It is important to continue PT as it will likely be the solution in the long run. I agree that is is reasonable to talk to the PT about if scar tissue is an issue for her particular case.

      All my best,

      1. Just wanted to update you- I have written about this somewhere on your blog-
        I had surgery to remove a neuroma of the pudendal nerve in my old episiotomy scar-my pain is almost completely gone.
        I think old scar tissue may not be as amenable to PT as a new one.
        Again, if a minimum of 3 months, maximum of 6 months for a patient who has scar tissue- they should consult with Dr. Lee Dellon in Maryland

  124. Hi, I too am suffering from pain on my incision from csection. I have had t csections one in 2004 and 2nd in 2011. After my first I never experienced any pain but did experience pain right away after my 2nd. At first I thought it was part of the pain from my csection recovery. I told my obgyn and she first diagnosed it as scar tissue. A year laterI went back and saw another doctor who said it was endometriosis. Ibam in such constant pain, but don’t want to go through another surgery. Your article helps a lot, you describe much of what I have been experiencing. Do you have any suggestions for a pt in Santa Maria, CA?

    1. Dear Angie,

      Below is the info for a PT who has taken our course who is located in Santa Barbara…I’m sorry, but we do not know of one in Santa Maria specifically.

      All my best,

  125. Hi Jamie, Hope I am in the right place. You are in luck, great PT’s in KC. I am sending you their info. I have had great luck with them and they are wonderful people to work with. I am probably 85% better if not more. Foundational Concepts 816 569 2802. 4700 belleview ave, ste 415 Kansas City Mo 64112. Hope this helps you.

    1. Dear Lisa,

      I’m sorry, but we do not know of a qualified pelvic floor PT in Houston. Check out this blog post we wrote about finding a good PT; it has a few resources that may help you find one in your area.

      All my best,

      1. Perhaps Jody Hendryx, and excellent PF PT in Austin, can make a recommendation in Houston.
        Best, SF

  126. Excellent article. Thank you so much. I am suffering from scar tissue caused by a fourth degree tear 10 years ago! Can you recommend a good pelvic floor therapist in NJ? Thank you.

    1. Dear Nancy,

      I’m sorry to hear that you are having to deal with pelvic pain. Below are the names of a few PTs who have taken our class in NJ:

      Herzig Niva MS,PT Englewood NJ 201-568-5060
      Besante Jamie PT Beachwood NJ (609) 978-3110
      Dela Rosa Michelle DPT Columbus NJ (609) 379-0900
      Ryan Angela MD Englewood NJ 2015672277
      Ely-Maskal Nancy PTA Englewood NJ 2015672277


  127. I have been suffering with pain along the incision after a partial hysterectomy in 2009! I am in worst pain now than when i had fibroids and the surgeon never mentioned this was a possibility but she wouldnt because she cut my urethera which caused urine to back up in kidney and 2 stents. The doctors I have seen and there have been many have told me that i would have to learn to live with it but it seems to have worsen causing pain around my entire trunk to my back. My sister just found info about PT for my condition so I asked my dr and his answer was i am not candidate because its been too long. Is there a PT in Las Vegas or California? Can i get help – this is no way to live. Appreciate your advice…. Thank u

    1. Dear Rose,

      I’m sorry to hear about all you are going through. We see many patients post-hysterectomy. As for PTs in California or Las Vegas; our clinic, the Pelvic Health and Rehabilitation Center has four locations in California, in Los Angeles, San Francisco, Los Gatos, and Berkeley. Check out our website here:

      All my best,

  128. I had a fall coming down my bedroom stairs a year and 3 months. I had a compression fracture of the T 11. Since then I have pain radiating from the back and going round the side to the front of my stomach on the right side. I also need to pee more often and sometimes constipated and other times have frequent bowel movements. I get pain in my fingers and numbness in my middle toes. I don’t sleep well because of the pain in my side and wake up sore, stiff and have a burning sensation in my body. What could be the cause? I have massage therapy.

    1. Dear Frances,

      I’m sorry about all that you are going through!

      However, without evaluating you I can’t tell you what may be causing your pain. I would recommend that you make an appointment with a qualified pelvic floor PT in your area for an eval.

      All my best,

  129. That painful “scar tissue” at the cesarean incision scar might be an endometrioma mass. Remember any painful scar tissue in synced with your menstrual cycle might not be “scar tissue”. From my experience and all of my research the pain increases during ovulation. It’s a progressive disease and pain can get worst with time. I encourage all women to have their “scar tissue” checked. Mine grew and attached to my abdominal rectus muscle. Surgeons had to remove 8 cm of abdominal muscle. You can read more about my story at and my reason for trying to raise awareness of this overlooked cesarean risk.

    Iatrogenic endometriosis is a form of endometriosis which is caused by any uterine surgery, in most cases a cesarean section. Iatrogenic endometriosis appears in medical literature, and is a well-established entity. It affects women with no concomitant pelvic endometriosis. It is also known as incisional endometriosis and abdominal wall endometriosis.

    1. Could endometrial tissue get sewn up in an episiotomy scar with resulting pain?RIcki

      1. Dear Ricki,

        I’m sorry, but I do not know the answer to your question. I would recommend you ask your ob/gyn. That said, there are many issues postpartum that can cause pain in the area of an episiotomy scar.


  130. I had a difficult time with a word catheter for bartholin’s cyst drainage over 10 years ago. since then, sexual intercourse is extremely painful, if not impossible. Since the treatment and trauma was so long ago, will the massage technique work? what other options do i have? thank you for your response.

    1. Dear Theresa,

      I would recommend that you visit a qualified pelvic floor PT. There are a number of musculoskeletal issues that could be causing your pain that were kicked off as a result of the trauma of the cyst drainage. We have patients like you whose pelvic floor issues were started as a result of issues with a bartholin’s cyst. So it’s not necessarily a scar tissue situation. Read our blog post on pelvic floor PT to learn more about it:


  131. Hi, I found your site I have had a syst removed on my right ovary when I was 6months preganet in 1987 an the scar is from neval down an in 1989 I had to have emergecy cc done they went same scar. An in 1996 had a stil-born birth had to deliver vaginaly an in 1997 had to get cervical sowed closed so I will not miscarry when I got ready to deliver had to get it removed. After that had a baby in 1999 natural an finally in 2008 had a total Hystorectomy an now having pain across my lower adoman, having pain when having sex is this from scaring pls help

    1. Dear Shari,

      There are several factors that could be contributing to your pain, and scar tissue may only be one piece to the puzzle. I recommend that you receive a thorough examination from a pelvic physical therapist in your area.



  132. Hi… my name is Amanda. I had a c- section 8 years ago. I never imagined having pain from the scar tissue this long. It still hurts to sneeze and certain days it hurts to even have my pants rub against it. I always thought the pain would eventually go away. I’m assuming this is nerve pain as well…..what do u recommend. Hoping for home remedies.

  133. Can you recommend a PT in Honolulu to help me. I am 38, 8 mos post pardum a classical csection due to a giant fibroid. It is taking me forever to get back to normal and pain free. I do have a PT and am on my second round. I am struggling with core strength, tight hamstrings, hip flexors, psoas, low back etc. very very frustrating. Thank you.

    1. Hi Laura,

      We recommend Kathy Ogino in Honolulu, HI. Her information is below.

      Kathy Ogino, PT
      Honolulu , HI
      Renew Physical Therapy
      (808) 599-0045



  134. Hi

    Since then birth of my daughter 3 years ago I have been suffering with a very stiff and painful back and pain on my ciserian scar and arround that area. Only now since I came across your website does it make sense that I have scar tissue from the ciserian which was never explained to me before nor was it explained to me that it would be in my best interest to mesage the scar to avoid scar tissue. Could you recommend a Pt in witbank south africa or explain to me in email on how I can manage this pain myself at home.

    Many thanks

    1. Hello Vilanda,

      Unfortunately, I cannot guide you on any self treatment because you have not been evaluated. I can however, recommend a few therapists in South Africa. Their contact information is located below.



      Christy Ann Berry,PT
      Bloemfontein, Free State South Africa
      [email protected]

      Trish Calvert, PT
      Parktown Gauteng South Africa
      [email protected]

      Bettina Moser, PT
      Parktown Gauteng South Africa
      [email protected]

      Cecilia Raath, PT
      Pretoria (East) Silver Lakes South Africa
      [email protected]

      Patricia Street, PT
      Edenvale Gauteng South Africa
      [email protected]

      Hester Van Haweren, PT
      Johannesburg West South Africa
      [email protected]

  135. So thankful I came across your page in my search for relief. Do you recommend any pelvic floor physical therapists in the Lincoln Nebraska area. Thank You!

    1. Hi Becky,

      Welcome to our blog! Yes, we have two therapist recommendations for Lincoln, NE. Their information is located below.



      Michelle Shellhaas, PT and Kelly Behney, PT
      Nebraska Methodist Hospital
      Lincoln NE
      (402) 815-2061

  136. Dear Melinda,
    I am 8 months postpartum, and i have been feeling pain around my c/section scar ever since i gave birth. Just yesterday, i went to a physio therapist who suggested what you just described but also using some heat on the scar (heat therapy she said). She did that for 45 minutes, it was very painful. This morning, the scar area has gone red and its sore, painful too. Is this normal? I am worried because i am supposed to go back again for another PT session, but i am in pain and the area is sore. Please help.

    1. Hello Monica,

      I suggest that you seek a second opinion from a pelvic floor physical therapist. Although heat therapy may help muscles relax and encourage bloodflow, it will not break down any scar tissue may be present, nor resolve any secondary issues you may be experiencing. Where are you located? Perhaps I can recommend a pelvic PT in your area.



  137. I have adhesions wrapped around my bowel which causes problems when I eat steak or red meat. Otherwise, I don’t feel any pain. 18 years ago they formed after a C-section the year before. My next pregnancy had to be delivered from a vertical incision due to the adhesions. I then started to hemmorhage because the adhesions had grown into my uterus and placenta which also caused placenta previa during my pregnancy so upon taking out the afterbirth my uterus tore into pieces. Many years later I had problems with what seemed like a partial bowel obstruction which was caused by the same scar tissue. I was told that surgery would or could just make more scar tissue. I always wondered if I had to just wait around for the adhesions to cause a life threatening situation or what. Great article and I hope it raises awareness of some hope for people in these same situations.
    Karyn King

    1. Hello Karyn,

      Although it is recommended to address scar tissue formation sooner rather than later, it is never to late to treat it. Waiting until it causes a life threatnening situation is never recommended. I suggest you schedule an evaulation with a pelvic floor therapist in your area.



  138. I’m thankful to have found your website. It has answered many questions for me. However; I was hoping for your opinion as to whether or not PT may help in my case. In 2001 I had a my uterus removed and transvaginal mesh tape implanted under my urethra (mesh sling). Soon after, it became apparent that the some of the mesh was bulging into the vaginal canal. It was painful. My gynecologist/surgeon excised the portion of the mesh tape which was bulging in the vagina. I have never been the same since. There is a “lump” which I assume is scar tissue in the vaginal canal. It is impossible for me to have intercourse with my husband without excrutiating pain. About 10 years ago I underwent PT, without much success. I was sent home with exercises. I was faithful to do the exercises with no reduction in pain. The exercises did not involve scar tissue manipulation mentioned in your article.
    I thought it was a lost cause until I found this website. I have complained for years to my gynecologist about painful intercourse. I was prescribed lydocaine gel, but it doesn’t touch the pain. Do you recommend another try with PT? I live near Portland, Oregon. Any advice or recommendation is most appreciated.

    1. Hello Kathleen,

      I would recommend that you consult with another physical therapist for a second opinion. Your last experience with PT was a long time ago, and did not seem to inlcude many of the procedures that can benefit you. We highly recommend Marcy Crouch, DPT in Portland. Her contact information is below.



      Marcy Crouch, DPT
      OHSU Kohler Pavilion
      7th Floor
      808 SW Campus Drive
      Portland, OR 97239