Returning to Exercise after a C-section
Approximately 29% of births are via C-section (NZ MOH 2019) and can be either planned or unplanned due to birth complications. A C-section is delivery of a baby through surgical incision in the abdomen and uterus involving an epidural, spinal anesthesia or general anesthesia.
How soon can I return to exercise post C-section?
Generally, women will be given the all-clear to return to their normal exercise programme at six weeks postpartum - as long as there are no complications. If you’ve been here a while you’ll know how we feel about that!
Musculoskeletal injuries may take between six months to a year to fully heal - and that’s exactly what a C-section is. A C-section is not a minor surgery, it’s a major abdominal surgery that requires healing across several layers of tissue. It blows our mind that many are told it’s okay to go back to their normal fitness after just six weeks. On the surface, your C-section scar may look healed but the deeper down layers still need time.
Whether you birthed your baby via C-section or vaginally, six weeks is the starting point with exercise - the point where you can slowly start the functional movement and the rehabilitation process. It’s not a “Go full steam ahead’ even though this is not often communicated.
Everyone is different…
Everyone’s postpartum journey is different and unique! Some women will heal rather quickly after a C-section and others will take much longer due to a range of different factors such as; birth complications, birth trauma, sleep (or lack of it), age, stress, energy levels, amount of support at home.
As you read this, please remember that postpartum time frames vary and often in the postpartum phase of life unexpected things come along! Cue; mastitis, reflux, colic… just to name a few!
It’s so important that you don’t compare your healing journey to anyone else. Below is a recovery guideline that starts from birth through to 42 weeks postpartum. If you don’t feel like starting until 12 weeks, 24 weeks or longer that’s okay just be sure that when you do start back you don’t skip a phase. Treat this as a guide rather than a must-do, remember that nothing is set in stone and be kind to yourself!
Phase 1 Weeks 0-6 = Rest and Rehabilitation
In the early days and sometimes even months rest can be more important than exercise! Your body has been through an absolute marathon event of pregnancy and birth. Slowing down and resting where you can is so incredibly important.
In today’s society it can feel like we need to “just get back into normal life” but if you have the means to go slow, take it easy and get help then do it!
Obviously, there will be a lack of sleep with a newborn but any amount of rest you can get is great. Even if it’s not sleep just getting off your feet and getting horizontal is great. Netflix up a storm! The housework can wait and so can the exercise.
If you are feeling up to some movement here are a few great options to start with as long as you are not experiencing pain and your midwife has said it’s okay.
Best rehab exercises 0-6 weeks
Breathing patterns: Often during the postpartum period mums can develop upper chest breathing due to stress and in the case of a C-section wanting to avoid pressure to the lower abdomen. It’s important to take time to connect back in with deep diaphragmatic breathing moving the breath away from the chest and into the belly. This not only helps mums to calm their nervous system but also starts connecting back in with their core. Meditation is awesome for this!
Pelvic floor activations
Gentle stretching
Posture and alignment
Gentle walking (Short bursts)
She Moves Class Recommendations:
Meditation
Phase 2 Weeks 7-18 = Returning to Exercise
At this point, you might feel ready to get moving in a more structured way.
Ideally, now is a great time to book in to see a Women’s Health Physiotherapist for a postpartum check up of your scar, core and pelvic floor. You can read more about why we think this is essential here: https://bit.ly/3UUiXHk
Many women ask us “Why do I need to get my pelvic floor checked if I had a C-section?” even though your baby wasn’t born vaginally there has still been significant pressure placed on your pelvic floor for approximately nine months. Your pelvic floor has been doing a lot of work and naturally, there will be some damage to it.
Having a postpartum ‘warrant of fitness’ will also provide you with more a individualised pelvic floor plan. You’ll also get a really good indication of abdominal separation - depth and width.
Best rehab exercises 7-18 weeks
Continue with breath work - Now connecting the pelvic floor and transverse abdominals to the breath
Individualised pelvic floor activations prescribed by a women’s health physio
Transverse abdominal activation exercises in a supine position such as toe taps, single-leg foot scoops and dead bugs
Stretching and mobility
Cardio - This should start slowly and build with time as long as there is no pain or urinary incontinence, heaviness or bulging in the pelvis. Walking or a stationary bike are great options to start with.
Low-impact strength such as squats, clams and glute bridges, lunges
She Moves workout recommendations:
She Restores - Pelvic Floor & Core Restore
She Starts - Entry level workout
She Flows - Stretch & meditation
She Tones - Low Impact maybe added towards the end of this phase (approx 14 weeks) as long as no symptoms of pain, heaviness, dragging, incontinence, bulging or doming of the abdomen.
Phase 3 weeks 19-42 = Bulletproof your body
At this point you’ll hopefully be starting to feel like you have a little more energy, you might even be starting to get a little more sleep (or not) and if you’ve been working through the above phases you’ll be feeling like you have built back some baseline strength and cardio fitness. Yay! You might even feel up to increasing the frequency, duration and intensity of your sessions.
At this point, you also may feel ready to introduce some high-impact exercises to the party. If you are ready to do so make sure you do slowly introducing 1-2 high-impact exercises at a time and listen to your body - if you have any symptoms please modify, email us, or speak to your PT or your physio.
A note on Pelvic floor - Pelvic floor exercises often get lumped into something that you do for a short period of time after having a baby. But your pelvic floor is just like any other muscle group, if you don’t keep using it won’t function optimally. So keep your pelvic floor exercise as part of your exercise programme from here on in.
We hope this was helpful!
Ren & Jen xx
Helpful links
Join the She Moves membership and get access to 4 weekly postpartum workouts - Just $16 per month
Listen to the podcast: “Postnatal Depletion chat with Nutritionist, Jessica White”
Listen to the podcast: “Unlocking Workout Progress - Tips to Break Through Plateaus”
The above is a guide on returning to exercise post C-section this has been pulled together from our studies with Jen Dugard Safe Return to Exercise Training, Well College Global and Girls Gone Strong.
