Abdominopelvic Fascial Release for Post-Cesarean Menstrual Pain and Scar Mobility

Abdominopelvic Fascial Release for Post-Cesarean Menstrual Pain and Scar Mobility: A Randomized Controlled Trial

The goal of this randomized controlled clinical trial is to determine whether adding abdominopelvic fascial release to a standardized stretching exercise program is more effective than stretching exercises alone in reducing menstrual pain in women following cesarean section. The study will enroll women aged 20 to 35 years with moderate to severe dysmenorrhea after cesarean delivery. Researchers will compare the effects of abdominopelvic fascial release combined with stretching exercises with stretching exercises alone on menstrual pain and scar mobility. Participants will be randomly assigned to one of two treatment groups, undergo assessments before and after the intervention period, and receive the assigned treatment according to the study protocol.

Study Overview

• Status: Not yet recruiting
• Conditions: Dysmenorrhea, Cesarean Section, Postoperative Adhesions
• Intervention / Treatment: Other: Abdominopelvic fascial Release

Detailed Description

Cesarean section is one of the most commonly performed obstetric surgical procedures worldwide. Although it is frequently necessary to improve maternal and neonatal outcomes, postoperative healing may result in scar formation and fascial adhesions that can contribute to persistent menstrual pain, chronic pelvic pain, reduced scar mobility, abdominal tenderness, and impaired physical function. Fascial restrictions may alter tissue mobility and biomechanics, leading to pain and functional limitations.

Abdominopelvic fascial release is a manual therapy technique that applies sustained, low-load pressure to restricted fascial tissues to restore tissue mobility, improve fascial gliding, reduce pain, and enhance tissue function. Previous studies have demonstrated beneficial effects of fascial release on postoperative scar mobility, pain, and functional recovery; however, evidence regarding its effectiveness in women with menstrual pain following cesarean section remains limited.

The purpose of this prospective, randomized controlled trial is to evaluate whether the addition of abdominopelvic fascial release to a standardized stretching exercise program provides greater clinical benefit than a stretching exercise program alone in women with post-cesarean dysmenorrhea. Participants will be randomly assigned to one of two parallel groups and evaluated before and after completion of the intervention period using predefined clinical outcome measures.

The findings of this study are expected to provide evidence regarding the effectiveness of abdominopelvic fascial release as a non-pharmacological physical therapy intervention for reducing menstrual pain and improving scar mobility following cesarean section. The results may support the integration of fascial release techniques into postpartum rehabilitation programs and contribute to evidence-based physical therapy management for women with post-cesarean pain and scar-related dysfunction.

• Study Type: Interventional
• Enrollment (Estimated): 58
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Amira I. Hassanein; Email: ahassanein@horus.edu.eg

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Females aged 20 to 35 years.
• History of at least one cesarean section.
• Moderate to severe primary or secondary dysmenorrhea following cesarean section.
• Regular menstrual cycles (21-35 days).
• Body mass index (BMI) between 18.5 and 29.9 kg/m².
• At least 6 months post-cesarean section to allow complete scar healing.
• Presence of restricted cesarean scar mobility on clinical examination.
• Willingness to participate and provide written informed consent.

Exclusion Criteria:

• Pregnancy or planned pregnancy during the study period.
• Previous abdominal or pelvic surgery other than cesarean section.
• Endometriosis, adenomyosis, uterine fibroids requiring treatment, or other diagnosed gynecological disorders associated with pelvic pain.
• Active pelvic inflammatory disease or genitourinary infection.
• Neurological or musculoskeletal disorders affecting pain perception or mobility.
• Systemic inflammatory, autoimmune, or connective tissue diseases.
• Current participation in another physical therapy or manual therapy program targeting the abdomen or pelvis.
• Use of corticosteroid injections or other invasive treatments to the abdominal or pelvic region within the previous 3 months.
• Contraindications to manual therapy.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental Group; Participants assigned to the experimental group will receive abdominopelvic fascial release in combination with a standardized stretching exercise program. Abdominopelvic fascial release will be administered for 30 minutes per session, twice weekly for 2 weeks, and the stretching exercise program will be provided for 45 minutes per session, three sessions per week for 4 weeks.	Other: Abdominopelvic fascial Release; Abdominopelvic fascial release is a manual therapy intervention designed to restore mobility of the abdominal and pelvic fascial tissues by applying sustained, low-load pressure to fascial restrictions. The treatment targets the cesarean scar, abdominal fascia, diaphragm, and psoas muscle to improve fascial mobility, reduce tissue restrictions, alleviate pain, and enhance tissue function. The intervention will be administered for 30 minutes per session, twice weekly for 2 weeks by a licensed physiotherapist.
Active Comparator: Control Group; Participants assigned to the control group will receive a standardized stretching exercise program for 45 minutes per session, three sessions per week for 4 weeks.	Other: Abdominopelvic fascial Release; Abdominopelvic fascial release is a manual therapy intervention designed to restore mobility of the abdominal and pelvic fascial tissues by applying sustained, low-load pressure to fascial restrictions. The treatment targets the cesarean scar, abdominal fascia, diaphragm, and psoas muscle to improve fascial mobility, reduce tissue restrictions, alleviate pain, and enhance tissue function. The intervention will be administered for 30 minutes per session, twice weekly for 2 weeks by a licensed physiotherapist.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Menstrual Pain Intensity	Menstrual pain intensity will be assessed using the Visual Analog Scale (VAS), a validated 10-cm scale ranging from 0 (no pain) to 10 (worst imaginable pain). The primary outcome is the change in VAS score from baseline to the end of the intervention period.	Baseline and immediately after completion of the 4-week intervention period.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Cesarean Scar Mobility	Scar mobility will be assessed using an adheremeter. Greater mobility values indicate improved scar tissue mobility.	Baseline and immediately after completion of the 4-week intervention period.
Change in Dysmenorrhea Severity	Dysmenorrhea severity will be assessed using the WaLIDD Score.	Baseline and immediately after completion of the 4-week intervention period.
Change in Pressure Pain Threshold	Pressure pain threshold will be assessed using a pressure algometer over the abdominal region.	Baseline and immediately after completion of the 4-week intervention period.

Collaborators and Investigators

• Sponsor: Cairo University

Study record dates

Study Major Dates

• Study Start (Estimated): July 18, 2026
• Primary Completion (Estimated): August 18, 2026
• Study Completion (Estimated): August 18, 2026

Study Registration Dates

• First Submitted: July 16, 2026
• First Submitted That Met QC Criteria: July 16, 2026
• First Posted (Actual): July 21, 2026

Study Record Updates

• Last Update Posted (Actual): July 21, 2026
• Last Update Submitted That Met QC Criteria: July 16, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Pathologic Processes; Pelvic Pain; Menstruation Disturbances; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Dysmenorrhea
• Other Study ID Numbers: P.T.REC/012/006452

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No