Adhesions are a side effect of almost any surgical procedure or tissue trauma (planned or not). They are basically just scar tissue that isn't in exactly the right spot, or which is a little more "enthusiastic" than necessary... instead of just re-connecting the injured tissue, an adhesion connects two things that weren't orginally connected. So you get binding and pulling and pain.
There is a lot of nice info on the International Adhesions Society website here
, and this
site has a nice overview as well. The abdominal area is actually the most common place for adhesions to form so it's thought that most women who have had a c/s do have adhesions even if they never have any symptoms.
Scar massage can help loosen, break down, or even prevent adhesions... although it's best to start scar massage as soon as the skin layer is healed, you can start it at any time and expect results. There is info on post c/s scar massage in the Natural Family Living C/S Resource sticky here on mdc, in books like Lose the Mummy Tummy or Bounce Back After the Baby, or google the term (though most websites are not discussing c/s healing but instead focus on breast surgery or hip surgery or burn therapy or just about any other surgical procedure out there... my personal soap box is "why don't OBs tell women about scar massage following a surgical procedure on a body part prone to adhesions?" but that's a different thread
Also look into Maya Massage when preparing to TTC or for general wellness... it can help get things moving again.
In terms of future pregnancies and vbacs... adhesions can become more painful during pregnancy (as everything shifts and pulls and grows) so some midwives suggest keeping a journal/diary recording your "normal" level of sensations, especially as the pregnancy continues, so that during labor you have a better feel for sensations that are unusual (re- uterine rupture). And adhesions can interfer with vaginal delivery... it depends where they are/how big they are. In my vbac dd2 was lined up perfectly between contractions but would twist sideways during a contraction so pushing took a loooooong time and required a lot of hands-on assistance to keep dd2 pointed down and out. One theory for why this happened was that perhaps the c/s had resulted in adhesions that were preventing one side of my uterus from contracting as powerfully/smoothly as the other side, or that during contractions an adhesion might be "pushing" dd2 sideways sort of like a speed bump. However, adhesions are generally not a "big deal" in terms of future births.
However... if the sore spot on your incision gets swollen, or red, or hot to the touch, or if you're running a fever and feel funky, or just don't feel "right"... give your current care provider a call. One of my friends developed a cyst under her incision almost a year after her c/s and it needed to be lanced and treated with abx.