C-Section Recovery Guide
A Cesarean section is a major abdominal surgery, and there is often little guidance in the early days after a c-section. Can you imagine someone had an ACL surgery and was given zero guidance on how to rehab properly? Although I have sourced evidence based information and recommendation, this cannot be considered medical advice or treatment. Please reach out for an in-person or online individualized assessment for a plan tailor to your unique needs.
0 -2 Weeks
Rest and pain management are the most important part of these early weeks. Stay on top of prescribed pain medication, be mindful of nursing positions that create discomfort across your incision, use good toileting postures (hello squatty potty) and consider an ab wrap or compression garment for support. I would recommend Bellies Inc Ab Wrap, SRC Compression shorts, or KnixCore Love High Rise.
Begin breathing exercises to link your breathe with your deep core and pelvic floor systems. INHALE with your belly and relax through your pelvic floor muscles and stomach. EXHALE and "ramp" up to engage your pelvic floor and notice how this slightly engages your deep core muscles as well. If you find yourself "bracing" through movements due to pain or fear, try exhaling with movement. For example, exhale to pick up the car seat, or exhale when you get out of bed.
If you are experiencing symptoms during this early phase, such as pressure, incontinence or pain, this can be normal, but your pain should slowly be getting better every day.
2 - 4 weeks
This phase is focused on mobility, recovery and range of motion, as well as continuing with pain management. You might start to feel like you want to get back to activities soon, but go slow mama. Slowly progress your walking, and listen to your body for symptoms such as pain, fatigue, bleeding, incontinence or pressure. Continue with the breathing exercises, and when you are ready to progress, try adding in movement. For example, try ball presses in the dead bug position. Lie on your back with your knees at 90 degrees and your feet flat on the wall. As you exhale, engage your pelvic floor and deep core and press a small ball (or pillow) between your knee and your opposite hand. Inhale and relax your belly and your pelvic floor. It's not so much about what exercise you choose during this phase, it's more about how you do it, and if you are breathing correctly and going slow and being mindful of how your body feels.
During this phase, we also want to start creating mobility in the thorax and gently through the incision. Try "W wall slides" or a half kneeling hip flexor stretch.
4 - 6 weeks
You do not need to wait 6 weeks to visit a pelvic floor physiotherapist, please come in sooner whenever you are ready. Wondering when you can get back to your regular exercise? Let's have a chat! During this phase, I would suggest you start with some body weight exercises that mimic what activities you would like to return to. For example, if your goal is to hike the Chief, start with some body weight step ups. Again, the most important thing still being quality, breathing and respecting how your body feels. If you have questions, please connect with me (or another pelvic floor physiotherapist).
6 weeks +
This is the phase where you can gradually start to return to some of the activities you love, while continuing to strengthen your pelvic floor and core. Start some gentle scar massage. Hopefully by now, you've had an assessment to tailor a plan to your specific goals and activities. Start slowly, listen to your body, and enjoy feeling a bit like yourself again. Have questions about when to start a specific sport or activity? Let's chat, it depends on what it is and what your background is.
12 weeks +
We do have some research on returning to running in the postpartum period, and it's not recommended to start running before 12 weeks. There is also some research to help us determine return to run readiness, and I can carry out a series of tests and assessments to determine if you are ready yet. Keep in mind, true postpartum rehab is more like 18 months for tissue healing and connective tissue to come back to it's pre-pregnancy tensile strength. In this phase, keep strengthening and keeping increasing the weight if it feels good to do so. Don't be afraid to lift heavy if you have built up to it. Continue to slowly progress getting back into your activity and sports.