Midline Abdominal Surgery (Linea Alba) How to MAKE it heal?

[Shahab.Fardhal]

Greetings, I checked the forums and found these 3 very helpful (Might be helpful for others to have these all here)

Wife Training After Appendectomy
Diastasis recti and barbells?
Can one ever fully recover from abdominal surgery?

I know from way back and also from revisiting the forum that "you don't LET things heal you MAKE them heal." However I just want to ask to make sure I am on the right track and my problem is the same as the other ones mentioned here.

To summarize: Appendix Rutured Monday night, I thought it was a stomach ache and slept it off for 2 nights, until after around 72 hours it became critical and they rushed me to the operation room where they did "Exploratory laparotomy", checked each organ until they found the appendix "Severely inflamed, necrotic and perforated" was hospitalized after for 8 days and it took 5 days post surgery to be able to pass my first gas finally.

I believe Rip had a similar problem back in 1989(?) and he had the "Classic" appendix surgery. Not sure if it is the same as the one I had.

Mine, they cut the linea Alba open, I checked the surgery example on YouTube and believe it is called a Midline Abdominal Incision. There are sutures inside holding the linea alba together. Can provide images if needed. The midline scar feels to the touch as if there is something hard under the scar.


QUESTION: Unfortunately, as always, it is the doctor. He told me I should not train for 6 months and at 6 months my abdominals will gain 80% of their prior strength and will stay at that forever, which I think (and hope) is BS. After my insisting, he allowed me to do planks from my knees for 5 seconds, starting 1 month post op, and keep adding 5 secs everyday. It has been a month now and reading the forums I am worried that I have already allowed scar tissue to form.

Should I start the barbell movements light, with belt on all sets as Rip recommends, despite the pain, and run a conservative NLP?

All time high numbers: SQ: ~560X1 - PR: 175x1 - BP: 315x1 - DL: 550x1 @ around 210BW
Pre-Surgery numbers: SQ: ~405x5- PR: 135x5 - BP: 200x5 - DL: 450x5 @ around 210BW

I also compete in BJJ and want to go back to training ASAP while not being a retard and actually rushing and hurting myself. Since I AM a retard, I hope y'all will stop me if I am being stupid with my approach.

Thanks a lot!

[Will Morris]

The soft tissue healing will be complete in 6-8 weeks. The return of muscular strength takes longer than that, because, in general, people are far too conservative with their return to activity after surgery. Now, here's the rub....what's the worst thing that can happen, if, after tissue healing has occurred, the linea alba splits open? You just have diastisis recti, which is something about 40% of post-partum women have anyways. Women seem to be able to train at very high levels with diastisis recti. Ronnie Coleman had a massive case of DR. Get you a good, velcro Rehband belt and wear it snug under your lifting belt and get back to work as you described at the 6-8 week mark.

Also, not totally directed at you, but to the board in general since this is so prevalent.....for the love of all things holy......stop fucking worrying about scar tissue. You fucking have to develop scar to heal from these things. Preventing the collection of unnecessary scar in a muscle belly tear is one thing.....worrying yourself to sleep at night because surgery caused you to develop scar in the vicinity of the incision is a totally different situation. You have to have the scar development for the damned thing to heal. Scar is not public enemy number one. Humans have made it to the modern age because we have the ability to scar.

My wife had a ruptured appendix when she was 10. She was very close to being septic and dying when they opened her up. She had exactly the same findings in the surgical field. She's had three fairly large children, all delivered naturally, and yet she still squats and deadlifts twice per week and hasn't had a single problem with it. She's close to lifetime PRs in both lifts, even at the age of almost 45. She's trained BJJ, she has lifted consistently for years, etc. My money is on the fact that you will be just fine.

[Shahab.Fardhal]

The soft tissue healing will be complete in 6-8 weeks. The return of muscular strength takes longer than that, because, in general, people are far too conservative with their return to activity after surgery. Now, here's the rub....what's the worst thing that can happen, if, after tissue healing has occurred, the linea alba splits open? You just have diastisis recti, which is something about 40% of post-partum women have anyways. Women seem to be able to train at very high levels with diastisis recti. Ronnie Coleman had a massive case of DR. Get you a good, velcro Rehband belt and wear it snug under your lifting belt and get back to work as you described at the 6-8 week mark.

Also, not totally directed at you, but to the board in general since this is so prevalent.....for the love of all things holy......stop fucking worrying about scar tissue. You fucking have to develop scar to heal from these things. Preventing the collection of unnecessary scar in a muscle belly tear is one thing.....worrying yourself to sleep at night because surgery caused you to develop scar in the vicinity of the incision is a totally different situation. You have to have the scar development for the damned thing to heal. Scar is not public enemy number one. Humans have made it to the modern age because we have the ability to scar.

My wife had a ruptured appendix when she was 10. She was very close to being septic and dying when they opened her up. She had exactly the same findings in the surgical field. She's had three fairly large children, all delivered naturally, and yet she still squats and deadlifts twice per week and hasn't had a single problem with it. She's close to lifetime PRs in both lifts, even at the age of almost 45. She's trained BJJ, she has lifted consistently for years, etc. My money is on the fact that you will be just fine.

Thanks for the response Sir.

About the scar tissue, my (Probably misplaced) understanding about "scar tissue" comes from listening to Rip years ago. So I will put it here for me and all the board to clear any misunderstandings.

My understanding was, if you "let" a muscle belly tear heal without working it, you develop "scar tissue" (don't REALLY know what that is) which to my understanding was, you are left with a non-contractile tissue inside your muscle belly which will hinder performance in the future because you let the injury heal in a lazy way so now you have a maladaptive tissue whereas you could MAKE the injury heal and it would be replaced by healthy muscle tissues. Now it is also my understanding that muscle tissue has a lot more blood supply so it is easier to MAKE it heal. By what I read in your response, now I think my understanding was completely off? Could you correct me if it was actually off?

Also, again my assumption was since the Linea Alba is connective tissue, it might be a different process to MAKE it heal and also, I have zero understanding about what, if anything, will happen if scar tissue (which I also have no actual clue about but still throw the word around as an uneducated person) develops on it.

To make it completely clear, I attach zero importance to what it will look like, as long as I know I am doing 100% of what I CAN do, painful or not, to make sure I retain the maximum amount of performance potential that I can.