Your surgery healed.
Your body still hasn't.
Unexplained pain, tightness, fatigue, or digestive changes after breast, abdominal, or pelvic surgery may not be mysteries at all. They may be the part of your recovery nobody told you about.
Symptoms women often carry for years after surgery
If you've had a C-section, hysterectomy, mastectomy, or any breast, abdominal, or pelvic procedure, the symptoms below may be connected to that surgery, even if your incision healed long ago and your doctors say everything looks fine.
The part of your surgery nobody saw
Think of the Titanic. The part of the iceberg that caused the damage wasn't visible from the ship's deck. What lay beneath the surface was far larger, and far more consequential, than what anyone could see.
Your surgical scar is the tip. Beneath it, in the tissue layers no one can see from the outside, your body has been doing what bodies always do after injury: forming scar tissue. That scar tissue can adhere to surrounding structures, travel along fascial connections, and create tension that shows up as pain, restriction, or other symptoms in places that seem completely unrelated to your surgery.
Scar tissue doesn't stay put. Imagine a snag in a sweater: pull on one thread and the tension travels across the entire fabric. That's how a pelvic scar can eventually create shoulder tightness, how a C-section from ten years ago can be at the root of hip pain, and how a mastectomy can contribute to breathing difficulties that no one connects to the chest wall surgery.
"I always thought of my symptoms as separate problems. The low back pain was one thing, the digestion issues were another. It took years before anyone suggested they might all trace back to the same place." Client, C-section 2014
This isn't rare. It's the pattern we see again and again in our practice. And the reason it goes unrecognized is that most post-surgical care focuses on the incision site, not on how the body reorganizes itself around that disruption.
Healing is not a straight line
After surgery, most of us expect to feel steadily better over time. When that doesn't happen, it's easy to assume something is wrong. The reality is that healing — particularly the kind that involves scar tissue and the nervous system — tends to move in waves. Better days, harder days, apparent setbacks that are actually part of the process.
If you have had days where you felt almost normal, followed by days where the tightness, pain, or fatigue returned and felt worse than before, that is a recognizable pattern. It does not mean you are not healing. It often means your body is still working through something that has not yet been fully addressed.
of patients who undergo abdominal surgery develop internal adhesions. Most are never told this, and most providers aren't looking for it when symptoms appear months or years later.
Your surgery may qualify, regardless of how long ago it was
The effects of scar tissue can be present and active years, even decades, after a surgery. If you have had any of the following, your current symptoms may be connected:
Laparoscopic and "minimally invasive" procedures are not exempt. The instruments still enter through the abdominal wall, the anesthesia still affects the nervous system, and scar tissue still forms.
What you may be wondering
Some people notice differences after the first session. Limbs may feel lighter, balance more confident, or breathing a little easier. Others notice something more subtle — a sense that things feel slightly different, even if they can't quite name it yet.
The best outcomes come from clients who are consistent with the self-care we recommend between sessions. That may include modifying or temporarily discontinuing certain activities while we work together, so that the information going into your nervous system is as clear as possible. The changes are often quiet at first — a client mentioning she was able to lift something off a high shelf without pain, or that she slept through the night for the first time in months. Those moments accumulate.
Depending on your history and goals, we generally recommend planning for 6 to 18 months to see long-term, consistent change.
Why breathing matters after surgery
Surgery affects the way you breathe, often without your awareness. When the abdominal or chest wall is disrupted, the natural three-dimensional motion of the breath tends to shift. The body braces around the incision, accessory neck muscles take over, and the ribcage loses its full range of motion. Over time, this altered breathing pattern contributes to fatigue, neck and shoulder tension, pelvic floor changes, and digestive difficulty.
Restoring full breathing mechanics is often the first and most foundational step in post-surgical recovery. Here is the progression we use:
Abdominal breath
Restoring the diaphragm's downward excursion and allowing the belly to rise and fall naturally, without guarding.
Lateral rib expansion
Bringing breath into the sides of the ribcage, where post-surgical bracing most commonly limits movement.
Posterior rib expansion
Encouraging breath into the back of the ribcage, which supports spinal decompression and pelvic floor coordination.
This three-part breathing practice can be done lying down or seated. Many clients notice a meaningful shift in how they feel within the first few sessions, simply from restoring the breath pattern the surgery interrupted.
Learn this with usSara had a C-section in 2002. The answers came much later.
Sara Fisher was a professional dancer when she had her cesarean section. The surgery went well, her incision healed, and by all external measures she recovered. But in the months and years that followed, things that had been effortless became difficult. She noticed tightness, changes in how she moved, and symptoms she couldn't make sense of. She mentioned them at appointments and was told she was fine.
Years later, Sara connected with our practice. When we began assessing her, we found what her surgical history had left behind: layers of scar tissue, altered movement patterns, muscles that were compensating for structures that had never fully returned to function. Once we addressed what was beneath the surface, her symptoms began to resolve.
Sara is now the co-author of What Lies Beneath, the book that became the foundation of this work. Her story is not unusual. The only unusual part is that she found out what was causing her symptoms and what to do about them.
The Wellness Approach for Women
Our clinical approach addresses post-surgical symptoms through three interconnected areas. No single piece works in isolation; the change comes from addressing all three together.
Awareness
Understanding that your symptoms may be connected to your surgical history — including procedures from years ago — is often the first shift. Most clients arrive having never been given this context.
Education
You will understand what scar tissue is, how it behaves, where yours may be affecting you, and why your body has been compensating the way it has. The education is not separate from treatment; it runs alongside it.
Empowerment
You will leave with practical tools, including breathing practices and self-assessments, that you can use between sessions. The goal is for you to return to the activities you need, want, and love to do.
In their own words
"I had a hysterectomy six years ago and have been dealing with back and hip pain ever since. I had seen multiple providers who told me there was nothing structurally wrong. After two months of working with Jenice, the pain I had accepted as permanent began to clear. I wish I had found this years ago."
Client, hysterectomy"My C-section was twelve years ago. I never would have connected it to the shoulder tightness and the breathing issues I have had for the past several years. Once the connection was explained to me and the tissue was treated, things shifted in a way nothing else had been able to produce."
Client, C-section"After my mastectomy and reconstruction, I had constant tightness across my chest and neck. I was told to do stretches, which helped a little. The work here was completely different. It addressed the layers of restriction underneath, not just the surface tension."
Client, mastectomy and reconstruction"I had abdominal surgery after a car accident in my twenties. I am in my forties now and spent years not understanding why I had chronic digestive issues and low back pain. The explanation I finally received here made everything make sense."
Client, trauma surgeryThe people behind this work
Chicago Integrative Movement Specialists is located in Chicago's Lincoln Park neighborhood and sees clients both in person and online. We work with people throughout the Chicago area and with clients nationwide via virtual visits — so wherever you are, getting started is possible. Many clients find their way here after exhausting other options — after being told their tests are normal, their symptoms are unrelated, or that they simply need to adjust to a new baseline. That is usually where this work begins.
Jenice Mattek
LMT, IMS · Co-owner, CIMS
Jenice specializes in post-surgery manual therapy and wellness for women and men whose bodies still carry the effects of surgery, often years or even decades after the fact. Her clients come to her after Cesareans, hysterectomies, mastectomies, hernia and appendectomy repairs, joint replacements, and other procedures, frequently surprised to learn that the pain, restriction, or "off" feeling they have been living with traces back to scar tissue and the under-recognized changes surgery leaves behind.
Her path into this work began in occupational therapy, deepened through massage therapy, and has spanned more than 25 years of hands-on practice. She is the co-author of What Lies Beneath: The Under-Realized Effects of Breast, Abdominal and Pelvic Surgeries and co-owner of Chicago Integrative Movement Specialists. She also teaches massage therapists and health and fitness professionals worldwide through the Integrative Movement Specialist Certification.
At CIMS, Jenice's focus is to help you see what has been hiding in plain sight, give you the strategies to move beyond it, and get you back to your life.
Sara Fisher
ACE-CPT, IMS · Co-author, What Lies Beneath
Sara began her professional career as a dancer and went on to earn her personal training certification from the American Council on Exercise in 2002. She has since added certifications in perinatal fitness and as an Integrative Movement Specialist, and her continuing education has increasingly focused on hypermobility spectrum disorders and perimenopause and menopause.
Early in her career she co-founded Woman Centered Fitness, where she designed and taught fitness programs for women. She has been published across books and newsletters on posture and movement, and in 2017 she and Jenice released What Lies Beneath, the book that grew directly out of Sara's own experience tracing years of unexplained symptoms back to her C-section.
Sara sees private clients in the Chicago and Lincolnwood clinics and also assists in teaching other health and fitness professionals about the Integrative Movement System approach to identifying and addressing the patterns that contribute to tightness, pain, and decreased performance.
We would be glad to hear from you
If you've been carrying symptoms since a surgery and haven't been able to get answers, we're a reasonable next step. You can call us directly, or fill out the form below and we will follow up within one business day.
Reach us directly
Chicago Integrative Movement Specialists1030 West North Avenue, Suite 302
Chicago, IL 60642
773.343.4012
assistance@osarconsulting.com
imsinchicago.com
We see clients in person in Chicago and the surrounding region, and we work with people online from anywhere. Virtual visits follow the same approach as in-person sessions. Please mention in your note whether you are local or would prefer to work remotely.
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