Abdominal and Inguinal Fold Scars — Observed Functional Progression Over Multiple Sessions

Overview

This example describes observed changes in scar tolerance, mobility, and functional movement over a five-session series of massage therapy treatments following abdominal and right inguinal fold surgery.

It reflects one individual presentation across a defined treatment period and is provided for educational purposes only.

Presentation

Background

  • High pre-surgery physical capacity, including endurance running and strength training

  • Scar pattern

  • Three interconnected vertical abdominal scars

  • One horizontal suprapubic scar

  • One right inguinal fold scar (lateral to the suprapubic region)

  • Initial postoperative presentation

  • Severe pain with movement

  • Extreme hypersensitivity to touch

  • Significant guarding through the abdominal and inguinal regions

  • Difficulty with basic movements including sitting, standing, walking, rolling in bed, and bending

  • Stair climbing required physical support and was described as extremely painful

Treatment Overview

  • Massage therapy was provided over five weekly sessions, each 60 minutes in duration.

  • General approach

  • Gentle, progressive soft-tissue contact

  • Gradual exposure to scar tissue as tolerated

  • Focus on reducing global guarding and improving tissue mobility

  • Progression matched to nervous system tolerance

  • Functional movement integration introduced once tolerated

  • No deep abdominal compression, forceful techniques, or interventions outside Ontario RMT scope were used.

Observed Progression Across Sessions

Sessions 1–3

  • Tolerance limited to extremely light contact

  • Marked hypersensitivity and guarding

  • Gradual reduction in protective response

  • Transitional movements slowly became less difficult

  • Walking steadier; stairs still required assistance

Session 4

  • Able to tolerate moderate pressure

  • Scar tissue palpated with increased mobility

  • Independent movement improved

  • Returned to personal training, though movements were unstable and limited by weak core engagement

Session 5

  • Tolerated regular therapeutic pressure

  • Scar tissues felt less reactive on palpation

  • Active movement integration performed during treatment

  • Following this session, the patient demonstrated:

  • Stable, coordinated core engagement

  • Pain-free functional movement

  • Ability to perform squats, lunges, planks, bridges, and curl-ups without symptom reproduction

Clinical Context

Multiple abdominal and inguinal fold scars may influence pain sensitivity, tissue mobility, and functional movement, particularly in the early postoperative period.

Responses to massage therapy vary and are influenced by factors such as surgical history, nervous system sensitivity, activity level, and time since surgery.

This example documents observed changes only and does not establish causation or predict outcomes.

Important Note on Case Examples

This scenario reflects one individual’s presentation and observed progression over a defined treatment series.

It does not represent typical outcomes and does not guarantee similar results for others.