Case Study: Immediate Improvement in Leg Mobility After Treating an Old Hernia Scar

Sometimes, the cause of limited leg movement lies far from the leg itself.

(Fascial Counterstrain Treatment – 30-Minute Session)

Disclaimer: The following case study is based on a real treatment session. Identifying details have been changed to maintain patient confidentiality.

The Background

The patient had been living with persistent right hip and lower back pain for several years. Walking more than 30 to 50 metres would bring on pain, and repetitive bending or picking up items from the yard made the symptoms worse.

While these hip symptoms were the main concern, the patient also had a complex history — multiple surgeries including two hernia repairs (the first was 13 years ago), a left total knee replacement planned, and long-standing arthritis in the spine. Despite numerous interventions, the discomfort around the left hernia site never fully resolved.

The Hidden Link

During the initial assessment, the patient’s straight leg raise (SLR) on the left side was limited to about 45 degrees, reproducing deep groin discomfort near the old hernia scar. Traditional musculoskeletal testing did not fully explain this persistent limitation.

Palpation revealed that the tissue around the hernia scar was firm, tethered, and accompanied by fascial tension extending toward the lower abdomen and upper thigh. These findings indicated that fascial adhesions and neural tension from the scar region were restricting normal nerve mobility — contributing directly to the hip and groin symptoms.

Treatment: Gentle Fascial Release Around the Scar

Treatment focused on the hernia scar using a combination of indirect osteopathic techniques and Fascial Counterstrain (FCS).

The indirect technique involves gently guiding the tissue toward ease, allowing the body’s inherent tension patterns to release without force.

Fascial Counterstrain was then used to treat the surrounding visceral, neural, and vascular structures, helping restore normal fascial mobility and circulation. The entire approach was gentle, non-invasive, and deeply relaxing for the patient.

The Result: Immediate Change in Movement

By the end of the session, the left straight leg raise improved dramatically — from roughly 45 degrees to nearly 90 degrees — with less discomfort and stronger leg lift.

The patient was surprised at the immediate change, especially given that the scar had been present for more than a decade.

This result demonstrated how deep fascial restrictions from old surgical scars can influence the nervous system, muscle activation, and overall movement for many years.

Structure governs Function: The Osteopathic Perspective

One of the core principles of Osteopathy states that structure and function are interrelated.

When the structural architecture of the body — such as the tissue around a hernia repair — is altered by fibrosis or scar formation, normal function becomes compromised.

To cope with this disruption, the body creates compensatory patterns. These patterns are intelligent and protective, helping us maintain balance and survive daily demands. But as they accumulate, certain regions begin to work harder than intended — leading to overuse, inflammation, and pain.

This downward spiral gradually reduces our capacity to move efficiently.

Manual therapy and Fascial Counterstrain aim to restore structural balance by removing obstacles that prevent the body from healing itself. Inflammation is one of the most significant obstacles.

In his paper, “Impaired Lymphatic Drainage and Interstitial Inflammatory Stasis in Chronic Musculoskeletal and Idiopathic Pain Syndromes”, Brian Tuckey explains how fascia can trap inflammation inside the tissues, perpetuating dysfunction. FCS is one of the few manual techniques designed specifically to release these inflammatory restrictions and restore healthy movement.

However, treatment is only part of the bigger picture. To maintain long-term improvements, we must also minimise new sources of inflammation — such as repetitive strain, trauma, sustained poor posture, and poor dietary habits.

Exercise also plays a critical role in maintaining health, but it should be simple, sustainable, and pain-free. The phrase “no pain, no gain” refers to mental discipline, not physical pain. When the body’s alignment and fascial balance are restored, exercise becomes more efficient and enjoyable.

Although psychological factors can influence inflammation and pain perception, my clinical focus — as a physiotherapist — is on the physical and structural contributors within my scope of practice.

Ongoing Plan

Subsequent treatments focused on addressing residual compensatory patterns in the pelvis and lumbar spine, improving core activation, and incorporating gentle breathing and mobility exercises.

The patient also began preparing for knee replacement surgery with greater mobility and confidence.

Key Takeaway

This case highlights the importance of looking beyond the site of pain.

A well-healed scar can still act as a hidden source of tension, altering nerve mobility, blood flow, and muscle activation.

Gentle techniques such as Fascial Counterstrain and indirect scar release can restore comfort and movement where conventional methods fall short.

By improving structure, we restore function — and when function improves, the body can truly begin to heal itself.

Frequently Asked Questions

Q1. Can old surgical scars really affect movement?

Yes. Even when a scar appears healed on the surface, deeper layers of fascia can remain restricted. These adhesions can affect nearby nerves, blood vessels, and muscles — limiting mobility and causing pain.

Q2. What is Fascial Counterstrain?

FCS is a gentle, hands-on technique that identifies and releases restrictions within the fascia. Restoring normal fascial tension helps decrease pain, improve mobility, and support natural healing.

Q3. How can treating a scar improve leg movement?

Old scars can restrict how tissues glide and transmit force. In this case, the hernia scar created tension that irritated nerves feeding into the leg. Releasing the scar’s restriction immediately restored nerve mobility and improved the SLR.

Q4. Is this treatment painful?

No. Both FCS and indirect osteopathic techniques are gentle and non-invasive. Most people find them calming and surprisingly effective.

About the Author

Kenneth Yuen, APA Titled Musculoskeletal Physiotherapist

Certified Fascial Counterstrain Practitioner (USA)

Founder, Fascial Release Clinic, Glenelg SA