Effect of Myofascial Release on Menstrual Pain Post Caesarean Section

Egypt has the highest cesarean section (CS) rate that has increased from 20% in 2005 to 52% in 2014. This exceptionally high CS rate without a corresponding improvement in maternal and child mortality suggests that although CS is available for populations at risk, numbers of medical unjustified CSs are on the rise.

The CS scar is assumed to be related to adverse clinical gynecological symptoms such as intermenstrual bleeding, dysmenorrhea, dyspareunia and chronic pelvic pain.The incidence of postpartum dysmenorrhea was significantly higher in the cesarean section delivery than in the vaginal delivery.

Cesarean scars have direct links to the perineal fascia and its connection with the transversalis fascia. These scars can interfere with fascial load distribution, which create adhesions to neighboring tissues, the abdominal and pelvic viscera and surrounding anatomical structures are then potentially disrupted, causing inadequate nutrition and inappropriately distributed tension among the various structures affected.

Fascial restrictions obviously decrease blood flow by vascular compression. When the dermis and fasciae are affected by a scar, the sliding structure of the fasciae is altered and when the scar tissues are not capable of adapting to the new stressor, their function is impaired.

MFR procedure lead to vasodilation by increasing capillary permeability. MFR directs force to fascial fibroblasts, as well as indirect strains applied to nerves, blood vessels, the lymphatic system and muscles. There is lacking of studies at this point, so the aim of the study is to investigate the effect of myofascial release on menstrual pain post CS.

Inclusion criteria

• Women complaining of menstrual pain post - caesarean section (CS).
• Their age will range from 20 to 35 years.
• Their body mass index will range from 20-30 kg/m2.
• Women who gave birth once or twice.
• Women who had C-section 6 weeks to 6 months ago.

Exclusion criteria

• Active infection/ infectious skin disease, burn or scars.
• Less than six weeks after CS.
• Any abdominal surgeries other than CS.
• Any spinal deformity as scoliosis or kyphosis.
• History of cancer or radiation to the abdominopelvic region.