If you’ve had surgery, an infection, suffered trauma, or have undergone radiation, you will have adhesions or scar tissue which can sometimes be painful. Once you feel pain, you need to consult your doctor and one of the treatment options that may be recommended for you is Manual Adhesion Release.

What is Manual Adhesion Release?

Manual Adhesion Release of MAR is a form of soft tissue treatment that reduces and removes adhesions within the body. MAR involves generating tension directly on the adhesion. It is the most effective non-invasive treatment for eliminating adhesions. 

What are soft tissue adhesions or scar tissue?

Manual Adhesion: Abdomen and Pelvis

  • Adhesions are bands of scar tissue that bind two parts of your body that are usually separate. The soft tissue and organs inside your body have slippery surfaces that enable them to shift easily as you move. Adhesions cause your tissues and organs to stick together.
  • They can occur in any part of your body but they often form after abdominal surgery. Most people who have undergone surgery on the abdomen will have adhesions. 
  • Adhesions are one of the main causes of muscle and joint pain after degeneration and arthritis. 
  • They are like glue that stick muscles, tendons, ligaments, fascia, and nerves together.
  • They can prevent you from moving correctly and may lead to secondary injuries such as nerve entrapment, if not treated.

How do Muscle Adhesions or Soft Tissue Adhesions Form?

When your body goes through surgery, trauma, infection, or radiation, its natural response is to try to repair itself. As this happens, adhesions may form within your body. Repair cells inside your body cannot tell the difference between one organ and another. When an organ in your body is going through repair and it comes in contact with another part of itself or another organ, adhesions may form to connect these two surfaces in your body.

What are the Symptoms of Adhesions?

Adhesions can form on any part of your body but most scar tissues form after surgery on the abdomen. Most adhesions show no symptoms and go undiagnosed. However, people who experience pain will feel it on where an adhesion forms and what it may disrupt. Adhesions cause pain by pulling nerves either within an organ tied down by an adhesion or within the adhesion itself.

The following are some common symptoms associated with adhesions:

  1. Pain with deep breathing (adhesions above the liver)
  2. Pain during exercise or when stretching (intestinal adhesions – obstruction due to blocking the passage of intestinal contents like food or liquid)
  3. Pain during intercourse (adhesions that involve the vagina or uterus)
  4. Chest pain (pericardial adhesions)
  5. Cramp-like pain in the stomach which can last seconds to minutes, often getting worse when you eat; vomiting; stomach becomes tender and progressively bloated; high-pitched bowel sounds over the stomach usually accompanied by loose stools and increased gas; fever (intestinal blockage due to adhesions)
  6. Weakness
  7. Tension tingling
  8. Loss of strength
  9. Loss of flexibility

When Should You Seek Medical Care?

You must see your doctor if you experience abdominal pain, pelvic pain, or unexplained fever. If you have a history of illness, discuss any changes in your condition with your doctor. If you’ve had surgery, discuss any changes in your recovery.

How are Adhesions Diagnosed?

Diagnosing the chronic pain of adhesions correctly may be difficult for your doctor. Routine diagnostic tests such as blood tests, X-rays, MRIs, CT scans, and ultrasound will not help diagnose adhesions. However, hysterosalpingography (an x-ray that can view the inside of the fallopian tubes and uterus) may help to diagnose adhesions inside the fallopian tubes and uterus.

Your doctor will order diagnostic tests based on your symptoms to rule out other medical conditions that may have similar symptoms. If the results of the tests are normal or negative for other medical conditions, he or she may conduct a diagnostic laparoscopy. This is the only test that can reveal the presence of adhesions. 

What Treatments are Available for Adhesions?

  • Surgical treatments

    • Open adhesiolysis

This type of treatment is best for serious problems such as bowel obstruction since it is highly probable that more adhesions will develop after certain surgical procedures. You need to discuss the benefits, risks, and alternatives to this surgery extensively with your doctor before making your decision.

    • Laparoscopic adhesiolysis

This procedure involves performing a small incision during the surgery. This is particularly helpful among women with chronic pelvic pain due to adhesions. However, the procedure may take two to four hours. It is technically difficult for doctors and involves some risk.

  • Non-surgical treatments

For those who do not want to undergo an invasive procedure, no matter how simple or quick it may be, there are non-surgical treatments available:

    • Medication for the pain

    • Lifestyle changes (eat healthily, stop smoking, get enough rest)

    • Exercise

    • Manual Adhesion Release

What is the Difference between Manual Adhesion Release and Instrument Adhesion Release? Instrument adhesion release on the arm

As stated earlier, Manual Adhesion Release is a soft tissue treatment that involves generating tension directly on an adhesion to reduce and eliminate it.

Instrument Adhesion Release (IAR), on the other hand, involves using a specialized instrument designed to remove adhesions without damaging the overlying healthy tissue. 

There are three components needed for this treatment to be effective:

  1. A complete and accurate assessment of the condition
  2. The IAR instrument with the correct size, shape, edge, and material
  3. Intensive hands-on training of the physical therapist


Manual Adhesion Release vs. Active Release Technique

Activity Release Technique (ART) is a soft tissue treatment that combines manipulation and movement. ART treats entire structures whereas MAR treats adhesions. MAR creates much more tension against the adhesion compared to ART.

What are the Benefits of Manual Adhesion Release?

The main benefit of MAR is the reduction of pain and limited range of motion that comes with adhesions.

Adhesions, particularly abdominal adhesions occur in up to 93% of people who have abdominal or pelvic surgery. However, abdominal adhesions also occur in approximately 10% of people who have never had surgery.

Adhesions that are removed through surgery tend to come back because the surgery itself causes adhesions.

For this reason, manual adhesion release is the most effective treatment that will reduce and ultimately eliminate adhesions.

You don’t have to live with the pain and discomfort that adhesions bring. You don’t have to undergo an invasive procedure to get rid of adhesions. You need to undergo manual adhesion release at a physical therapy practice with highly-skilled and experienced therapists.

Vigor Physical Therapy and Rehabilitation is owned by Dr. Igor Voloshin, Doctor of Physical Therapy (DPT) who also serves as its director. He, along with his colleagues have several extensive expertise and experience in physical therapy. They can develop a unique treatment program for you that includes manual adhesion release.

The whole team is adept at providing highly-personalized care for each of their patients. They pair each patient with his or her own therapist who focuses on the patient’s recovery and continued good health beyond treatment.

If you would like to know more about Manual Adhesion Release or if you would like to speak to Dr. Voloshin, you can contact us here.