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Abdominal Scarring, Back, Hip, and Knee Pain... How These Are Connected

I have been privileged to work with many women who have had abdominal surgery. They would come to me with all manner of complaints, from hip pain to knee pain and back pain and anything in between. But so often, during taking of their health history, past abdominal procedures are quickly highlighted to my attention.

And it can be anything from a C-section a few decades ago, a recent hysterectomy, to an appendix surgery when quite young.

It’s not something that immediately comes to the top of one’s mind - after all, surgery might have been carried out decades ago, the scarring has long paled into insignificance for many… (not always, of course. I have seen quite deep and complex scars that are impossible to ignore even now). But the significance of these traces for the rest of the body is not something that we think of often - if at all.

Therein lies a challenge for me - it is to gently inform the women who come to me that this scar can be the root cause of their back, hip, or knee pain. For many, it goes against the grain of reassurance given to them by their original doctors: "when the immediate healing is done, you are back to your normal self".

Unfortunately, it is not that easy. I so wish it was.

Every time we have surgery, and tissues are cut and have to do healing afterwards, the smooth flow of connective tissues is disrupted. The body lays down scar tissue during the repair process that changes how the pull from one area during movement transmits itself to another area. There is a snag that is created.

The body does not like snags.

But even more importantly, the tiny nerve endings and receptors in our body tissues have been sensitised. The body knows this area is no longer intact, compromised to some extent, and potentially having a “neurological fault” compared to perfectly normal, "un-messed-with" areas.

Add to it the snagging in the previously smooth pull of tissues across the belly, and we have INHIBITION of abominal muscles.

This happens every single time - to varying degrees - when we have belly surgery.

Add to it the potential of internal adhesions created as repairs are carried out internally, adhesing other muscles and even internal organs to the scar area, and we have deep-seated biomechanical trouble.

The problem is slow to manifest itself in most cases, unless scarring is very deep and severe - but often, some years down the line, we have increased tension, tightness, and eventually, pain.

The change in how mechanics of the body work alters how we can engage the core muscles. HINT: less effectively!

And other areas start to compensate, or maybe also become compromised.

If the back is overworking to compensate for inhibited abdominals, we might have back pain.

If hips are tightening because of a change in how belly muscles interact with hip muscles, we might have long term tension changing into hip compression, grinding of the thigh bone in the socket, and the onset of arthritis.

Or, if the abdominals are inhibited - hip muscles get weakened, the areas around the knees migth start to grip for extra stability as they start trending inwards, and we can start getting knee pain.

In so many of these cases, the original culprit is scarring from belly surgery.

And, in so many cases, work can be done to unwind some or a lot of the layers of compensations that the body had laid down.

This needs scar work skills that I use alongside Neuro-Kinetic Therapy. I test various areas of the scar and see which portions of it are neurologically happy, and which are not. And we then normalise the scar and activate the abdominals.

We need the body to stop seeing the scar as an active threat, become just a bunch of cells, maybe with some scar tissues - but not a hotspot of dysfunction. Then we can move forwards with rehabilitation. Not before.

If you have had abdominal surgery and are experiencing back, hip, knee pain, get in touch and I can asses the whole area to see what can be done to start restoring good function.

To your health,


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