I have had a few people ask me about exercising after a c section.
In order to answer their questions, I headed over to a fellow fitness professional, Jago Holmes, who has been training ladies that have been recovering from a c section for years to see if he could share some tips on exercising after a c section.
Here are some tips from Jago…
C (caesarean) section births are becoming more common these days for a wide variety of reasons ranging from:
- a fear of the pain of delivery
- designing the perfectly timed birth
- emergency birth
The c section technique was originally developed for emergency births because the baby may have to be removed as quickly as possible to avoid potential harm to either the mother or baby.
There are certain things that can be done to help promote recovery and repair the damage after a c section but unfortunately many women do the wrong things when it relates to exercise.
Damage to the Abs Is Not As Bad as People Think
The damage and injury caused to the abs after c section isn’t as bad as most people think because the incision used during a typical c section doesn’t normally cut through the muscles, it’s just the outer sheath covering the abdominal muscles (aponeurosis) which is affected. After the incision into the sheath, both sides of the rectus abdominus muscles are pulled apart.
When the baby has been taken out, the rectus sheath is repaired and then the muscles are realigned. From this point onwards the recovery of the abdominals is exactly the same as for a vaginal birth.
For both types of delivery, the muscles will start to realign themselves within three to four days.
During this time only pelvic tilting exercises should be performed which will help to further tighten, strengthen and realign the abdominal muscles.
Within about six weeks the abdominal muscles should have fully recovered however this could take much more time if they were weak before the c section or the pelvic tilting techniques have not been practiced on a regular basis.
When to Start Pelvic Tilting Exercises after a C Section?
Pelvic tilting exercises should start immediately after delivery.
Pelvic tilting exercises are gentle movements which can be done seated, standing or lying. They don’t require a lot of effort, but can make a huge difference in the speed of recovery, but also the firmness of the abdominal area.
An Exercise You Should NOT Do if You Have Had a C Section
UNDER NO CIRCUMSTANCES should you do sit ups or curl ups after a c section until the abdominal muscles have realigned and recovered.
Doing this could lead to potential damaging of the stomach as the gap between the muscles may be forced apart, possibly stretching the muscles wider, leading to long term damage.
9 Things to Remember When Exercising After a C Section
- It is quite normal to feel numbness around the abdomen and a tingling or tightening around the scar, but you should be fine to do the pelvic tilting exercises.
- If you do have any concerns about exercising after a c section, please do contact your primary medical provider.
- Trying to stay mobile and routinely performing pelvic tilting and pelvic floor exercises will help speed up your c section recovery time and allow you to be more active much sooner.
- After a c section delivery, doctors recommend that you should wait 8 – 10 weeks before doing any formal or more intense exercise. This will depend on your fitness level prior to the c section and how you have recovered from the c section. Consult your primary medical provider on what exercise intensity if best for you at this time.
- You must protect your scar and abdominal area as much as possible and you should use caution whenever moving around or getting up and down from sitting or lying to standing.
- GREAT CARE should be given to certain everyday tasks and activities such as getting out of bed, getting up off the floor, climbing out of the bath, lifting heavy objects and walking up and down stairs etc.
- Take your time getting up, roll on to your side for support and then push with your arms to avoid placing extra stress on the weakened back and abdominal muscles. ALWAYS AVOID A FULL MOVEMENT from lying or sitting to standing. Instead break the movement down in to three parts.
- The essential factor in working your stomach muscles is to always tilt the pelvis backwards and pull the muscles in tightly throughout the entire exercise.
- Pelvic tilting exercises are not the same as pelvic floor exercises, but can be performed at the same time with a little practice.
That is it.
I hope this gives you a start on what to do when exercising after a c section.
Here is a little information on Jago.
Jago Holmes is a certified personal trainer with over 10 years experience working with moms who have given birth by c section. He has created an easy to use and highly effective system that every new mom can use to tone and flatten their baby belly and safely speed up their c section recovery.
CLICK HERE to find out more about Jago’s exercise after c-section program.
It is Rick again. Thanks for reading this guest blog post.
Please do share your experience with c section and exercise or if you have some tips of your own, please do share in the comments below.
Excellent information. I have this conversation with a patient at least once a month. I will make sure to pass this post on. Thanks again for sharing your expertise!
Dr. O
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Rick Kaselj Reply:
June 21st, 2011 at 8:39 am
Thank you so much Dr. O.
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I sure wish this information had been available to me after my c section many,many, years ago! I feel that had I known the correct way to pelvic tilt is different to the pelvic floor exercises I would have had less recovery issues. I know this guide will help ladies to recover quickly from their c section. Thanks Rick.
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Rick Kaselj Reply:
June 21st, 2011 at 9:24 am
Thank you so much Sue.
Rick
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Hi Rick,
Not sure if you remember me. I contacted you about meeting some years ago when I was coming to see how Canadian perinatal business were run (I run a perinatal studio in Spain) and you gave me some great contacts in your area (you were out of town). Anyway, I am concerned about your friend’s advice about pelvic tilts. Actually pelvic tilts are contraindicated postpartum due to the risk of uterine retroversion (due to postpartum pelvic asymetry and uterine involution). It is essential that your friend change this recomendation in his book because a uterine retroversion can give heaps of problems, especially if the women want more children.
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Rick Kaselj Reply:
June 21st, 2011 at 9:46 am
Kaisa,
I am so glad I could help you.
I will see if Jago can chime in and comment on the pelvic tilt.
Rick
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It is a very widely used in fact universally used technique, it’s unfortunate that it doesn’t often get done correctly. The main benefits are that you can strengthen and reallign the rectus muscles without the flexion usually used therefore the damaged area is given the minimum amount of disruption.
The technique is endorsed by most health organizations and world renowned physiotherapists have developed and promoted the movements to new mothers.
However, never let it be said a lone voice can’t be heard. Could you let me have a look at the studies you have read to give me a better insight in to your theory?
Warmest regards
Jago
@Kaisa -
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Kaisa Reply:
June 22nd, 2011 at 2:38 pm
Hi Jago, thanks for your response. I know it’s widely used, I myself use to use it too. But now after studying with Marcel Caufriez, in my opinion the best postnatal urogyno physio in the world, I no longer use this technique. The problem is the pelvic asymetry postpartum (the left iliac goes into antepulsion and retroversion to allow the uterus to turn to the right in preparation for birth and stays that way postpartum) which when you add posterior tilt causes such tension on the uterine ligaments that there is a danger of the uterus going posterior as it goes back to normal size. Do you read french or spanish? Currently his work is only in those languages…
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Rick,
Thanks so much for covering such a pertinent topic. I would like to add several suggestions as my wife (myofascial therapist) and I see many patients who present to our office with back pain, hip pathology, and even neck and shoulder complaints that is directly linked to C-sections, hysterectomies, and other abdominal surgeries. And many of these patients have even had laprascopic surgery that is supposed to be relatively less invasive than traditional types of surgery. It is important that your readers understand that all surgeries – invasive as well as non-invasive surgeries – are a big deal. That is why one of my first questions to a patient when they present is to find out what type of injuries and especially surgeries they have had. All surgeries – especially abdominal surgeries – cut through multiple layers of fascia and this is what creates the problems. The scar tissue that results from all surgery is the problem in that it can pull and restrict vascular and neural tissue as well as viscera. Additionally, these patients will demonstrate muscle inhibition months and even years post-surgery. In the last 2 months we have seen 3 patients who had surgery to remove abdominal fascial scar tissue that had strangulated these women’s intestines from C-sections and hysterectomy. I suspect these are not isolated situations. Any one who has had surgery – especially abdominal or pelvic floor surgery – should be evaluated for scar tissue adhesions and taught how to re-stabilize their thoracoabdominal canister including the abdominal wall, pelvic floor and diaphragmatic breathing. Thanks for letting me share and keep up the great work.
Evan Osar, DC, CMT, PES, CSCS, ACE-CPT
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Rick Kaselj Reply:
June 21st, 2011 at 4:15 pm
Thank you for adding to the discussion, Dr. Evan Osar.
Very helpful material.
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I also often suggest for my pregnant clients that they can begin “abdominal compressions” right after birth (c-section or vaginal), in addition to pelvic tilts and kegels. It can be a bit elusive if the neuromuscular connection isn’t well established, but basically involves activating the transverse abdominis. (This I gleaned, I believe, from the Vancouver-based Fit to Deliver folks.)
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Rick Kaselj Reply:
June 21st, 2011 at 4:16 pm
Thank you Lisa.
I do know the two people that created the F2D material. Great people.
Rick
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After months off most female fitness freaks are desperate to get back into their routine. It seems like everyone has a theory about this one, so it’s nice to hear what a trust worthy source has to say on the subject.
Take care,
Matt
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