Returning to exercise after C-section can be daunting. We are here to help guide you on your way.
Childbirth is an extensive process that affects every woman differently. For those who have undergone a Caesarean section (C-section), the recovery process is even more critical. C-section is considered a major surgery, which means the body needs ample time to heal before returning to regular activities, including exercise. This article, compiled by a leading women’s health physiotherapist in Singapore, provides an in-depth look at the dos and don’ts of getting back into exercise after a C-section.
Understanding C-Section: Is It a Major Surgery?
A C-section is indeed a major surgical procedure. It involves making incisions through the mother’s abdomen and uterus to deliver the baby. As it is an invasive procedure, it requires a lengthier recovery period compared to vaginal births. Moreover, it can result in complications like infection or slow healing at the incision site, making it essential for new mothers to follow post-operative care instructions diligently.
The 6-Week Wait: Why Is It Necessary?
The common advice is to wait for at least six weeks post C-section before resuming exercise. This timeframe is not arbitrary but rather based on the body’s natural healing process. During this period, the body works to repair the surgical wound and restore function to the affected areas.
The six-week mark is often the minimum wait time suggested, but it does not imply that every woman will be ready to exercise at this point. The readiness to return to physical activity varies significantly among individuals, depending on their overall health, fitness level, and the course of their recovery.
Before then, breathing exercises, calf stretches, ankle-toe movements, active exercises of the upper limb, and walking can be done.
The Green Light: When Can I Start Exercising?
Before you lace up your sneakers and hit the track, it’s crucial to get a green light from your doctor or health professional. They will assess your recovery progress, check for any complications, and determine if you’re ready to start exercising post C-section. This approval typically comes during the six-week check-up, but it can be earlier or later based on your personal recovery journey.
Best Exercise After C-Section: Where to Begin?
Once you’ve received the go-ahead from your healthcare provider, you might wonder where to start. The key to resuming exercise after C-section is to begin gradually and increase intensity and duration over time. Here are some recommended exercises to incorporate into your routine:
Walking
Walking is a low-impact exercise that can be started relatively soon after a C-section. It helps in improving cardiovascular fitness and aids in weight loss. Start with a gentle, slow-paced walk and gradually increase your speed and distance as your strength and endurance improve.
Pelvic Tilts
Pelvic tilts are excellent for restoring lumbopelvic motion and strengthening the abdominal and pelvic muscles. They can be performed lying down, sitting, or standing, making them a versatile exercise for new moms.
Abdominal Bracing
Abdominal bracing involves pulling in your lower tummy towards your spine, holding for a few seconds, and then relaxing. This exercise helps to activate and strengthen the deep abdominal wall muscles, which play a crucial role in core stability and posture.
Pelvic Floor Exercises
Pelvic floor exercises, also known as Kegels, are essential for strengthening the muscles that support the bladder, uterus, and bowels. Regular practice can help in managing incontinence and promoting overall pelvic health.
General Guide:
The best exercises to do after a C-section are those that promote healing and gradually strengthen your muscles without causing discomfort or straining your abdominal area. Here are some exercises you can undertake at different stages of your postpartum recovery.
Weeks 1-3: Wound Support
This phase is about movement and breathing that supports your wound healing. It includes:
- Diaphragmatic breathing with a soft belly
- Gentle pelvic tilts to restore the loss of lumbopelvic motion due to pregnancy
- Walking, starting with short distances and gradually adding time each week
Weeks 3-6: Wound Mobilisation
At this stage, the focus is on range of motion movements and activation of the deep abdominal wall muscles. It includes:
- Range of motion movements such as cat-cow, thread the needle, overhead arm stretch, or modified cobra poses
- Activation of the deep abdominal wall muscles through exercises like zipping up your tummy muscles
- Bodyweight exercises such as bridging, lunges, and squats
Weeks 6-12: Core Connection
This phase focuses on the activation of the inner core. It includes:
- Specific postnatal exercise classes with instructors trained to support postpartum women
- Walking up to 45-60 minutes, and if comfortable, reclined or seated cycling or elliptical trainer
Week>12: Graded Return to Exercise/Running
This is the phase when some mothers might be ready to increase the intensity of their exercise routine. It includes:
- Exercise-specific strengthening, such as glute and quad strengthening for runners
- Increasing the abdominal challenge with more intense exercises
Exercises to Avoid After C-Section: What Should I Skip?
With regard to getting back to exercise after C-section, it’s crucial to avoid exercises that put a lot of stress on the abdominal muscles and hip joints. While many exercises are beneficial post C-section, some should be avoided, especially in the early stages of recovery. These include:
Sit-ups, Crunches, and Planks
These exercises place a lot of pressure on the abdominal area and can potentially interfere with the healing process, especially if you have diastasis recti (separation of the abdominal muscles). It’s best to avoid these exercises until your healthcare provider clears you for them.
High-impact Activities
Exercise after C-section should not include high-impact activities like running, jumping, or any exercises that involve intense bouncing or jarring. These exercises can put excessive strain on the pelvic floor and abdominal muscles. It’s advisable to avoid these activities until you have fully healed and regained adequate strength and stability.
Heavy Lifting
Lifting heavy weights can exert significant pressure on your incision site and the pelvic floor muscles. It’s recommended to avoid lifting anything heavier than your baby for at least six weeks post C-section.
Starting Too Soon: What Are the Risks?
While the eagerness to return to your pre-pregnancy fitness level is understandable, starting too soon can pose risks. Exercise after C-section should be gradual and at a safe pace once your body has time to heal. Beginning intense exercise too soon can lead to complications like:
- Increased risk of injury to joints and ligaments due to the lingering effects of pregnancy hormones
- Delayed healing of the C-section wound
- Increased risk of incision site infection
- Exacerbation of postpartum complications such as incontinence or pelvic organ prolapse
How Can Physiotherapy Support the Recovery of C-Section Surgery
Physiotherapy plays a vital role in C-section recovery, and it’s highly recommended to consult a physiotherapist post-surgery. A physiotherapist can assess your abdominal and pelvic muscle tone and strength, suggest appropriate exercises, and guide you on the correct techniques. They can also help manage conditions like diastasis recti and offer guidance on a tailored exercise protocol suited to your needs and physical status.
As a C-section delivery scar heals, the different layers of skin and fascia can adhere to each other, limiting your range of motion. These adhesions might cause future problems like urinary frequency, hip or back pain. Physiotherapy, including scar tissue massage or scar tissue release, can help break up these adhesions and aid in proper tissue healing.
Physiotherapy after a caesarean section reduces low back pain, improves posture, and prepares the body for future pregnancies. It also helps with pain management, early functional activities, ambulation, and bowel activity during the post-operative period. Physiotherapy addresses postural imbalances and pain caused by childcare activities. A recommended time for the first postnatal physiotherapy session is 6 weeks postpartum to assess pelvic floor activation, abdominal wall healing, separation, strength, and readiness for exercise.
Pelvic Floor Therapy: Is It Necessary After C-Section?
Even though a C-section bypasses the birth canal, it does not mean the pelvic floor muscles are unaffected. Pregnancy itself puts significant strain on these muscles. Therefore, regardless of the mode of delivery, pelvic floor therapy can be beneficial for all new mums. It can help in managing issues like incontinence, pelvic pain, and organ prolapse and promote overall pelvic health. There is still wear and tear that happens from carrying the pregnancy, so pelvic floor therapy can benefit C-section Mums too!
The Bottom Line: Your Body, Your Pace
A C-section is a major surgery that requires a significant recovery period. During this time, physiotherapy and controlled exercise play crucial roles in ensuring optimal healing and restoring the body’s strength and function.
Every woman’s postpartum journey is unique, and the same applies to getting back into exercise after C-section. The key is to listen to your body, respect its healing process, and progress at your own pace.
Remember, the ultimate goal is not just to get back in shape but to promote overall physical well-being. So, give yourself the grace and patience you need during this time.
Your body has done a remarkable job bringing a new life into this world; it deserves to heal and recover at its own pace.
So if you are recovering, and need help to get back to exercise after C-section, or are having back pain, hip pain, urinary incontinence or any other delivery related issues contact Core Fitness now to start your recovery. It will be our pleasure to help you get back to doing what you love!