Postpartum Exercise & Mobility After a C-Section

After an emergency c-section in July 2019, I wasn’t sure where to start with my postpartum exercise and recovery and how long it would take me to get back into a fitness routine. Obviously going for a run immediately after giving birth wasn’t my first priority or even feasible, but I’m the type of person that likes to know what to expect in the days, weeks, and months ahead.

Throughout my pregnancy, I worked out and moved my body as often as I could. Towards the end I mostly went on walks (because hello short Minnesota summers). While I was pregnant, I especially missed having fitness goals to challenge myself, so I knew I’d want to create a plan for fitness postpartum.

Since labor and delivery didn’t go quite the way I thought it would, I needed to do a little more research to know how to best plan for movement and fitness after a c-section (c-section mamas, see Emergency C-Section: 20 Tips for Recovery). I felt a little discouraged to see some of the misinformation available to people. A c-section is still considered a major surgery. The primary goal after a c-section is healing and recovery. Light movement, such as walking, is encouraged in the healing process, but other exercises such as sit ups and twisting movements may do more damage than good in the beginning.

Our bodies change so much throughout pregnancy to make room for a growing baby. Our muscles relax and our ligaments and joints loosen from the hormones relaxin and progesterone. This is one of the reasons why it is so important not to overdue it right after birth. No matter what type of birth you have, it’s important to evaluate your muscle strength when considering exercise postpartum, specifically abdominal muscles. Abdominal muscles may shift to make room for baby and shifting organs. They may also shift during child birth. The shift, or separation of the abdominal muscles, is known as diastasis recti.

Diastasis Recti

You, or your doctor, can determine if you have diastasis recti by laying on your back with knees bent and feet on the floor. Raise your head and shoulders up slightly to create tension and begin with placing two fingertips right above your belly button. Feel for the sides of your rectus abdominis muscles to the left and right. You can measure how many finger widths of separation there are in between. You want to feel for separation at, above, and below your belly button. A gap of more than two and a half finger-widths when your rectus abdominis is contracted is a sign of diastasis recti. If there is separation, this will provide a baseline for determining progress you make moving forward.

Diastasis recti is not necessarily permanent. Many women can do targeted exercises to strengthen their abdominal wall. It’s important to work to build those muscles back together since our core supports so much of our movement. Strengthening the abdominal wall will also help with any lower back pain and it’ll help if you decide to have any future pregnancies.

Here are some resources I found helpful with improving diastasis recti:

• Two simple exercises you can do (video by Abs, Core & Pelvic Floor)

• 10 minute breathing exercise every day for at least 12 days

• 10 Best Exercises to Treat Diastasis Recti by stylecraze.com

• 15 minute diastasis recti workout by BodyFit by Amy

Exercises to avoid when working to strengthen your rectus abdominis:

• Sit ups/crunches

• Bicycle crunches

• Push ups

• Front facing planks

• Downward dog

• Swimming

After 6 Week Follow Up Appointment

I started to create postpartum exercise routines after my doctor gave me the all clear at my 6 week follow up appointment. I specifically wanted to work on strengthening my muscles and doing exercises that were more gentle for a c-section mama.

Side note: You would think most doctors would be helpful with providing appropriate exercises or recommendations, but don't rely on that. My doctor said to just go ahead and go back to your normal exercises and the gym. There's so much more to postpartum healing. It's important to listen to your body, strengthen your pelvic floor, evaluate your abdominal muscles, and to slowly start back. In some cases it may even be best to seek additional help from a physical therapist.

After some research, I decided I would wait at least 6 months before starting back with running. I stayed away from high intensity, high impact workouts until I felt stronger, and even then I modified workouts when needed. I continued walking throughout my recovery, but I slowly began adding in strength training exercises. Starting out I did many of the BodyFit by Amy postnatal videos on youtube (they’re free!). Most of her postpartum exercise routines use your body weight and optional weights.

Many of the paid workout programs also have workouts specifically for postpartum (i.e. Beachbody and Daily Burn). For me, consistency was the reason for results. I set a goal to move my body 4-5 times per week for at least 30 minutes. After I felt a little more confident exercising, I started following along with a workout program.

One of the biggest reasons for me to not work out is time. These tips help me when I’m not feeling motivated:

• Commit to just 30 minutes of some kind of movement

• Find workout clothes that fit your new mom bod and get you excited to work out. Thankfully a lot of athletic clothing is stretchy, so some of your old clothes might still fit you when you’re first starting out.

• Pick a time of day to work out. Working out over my lunch during the week has helped me stay consistent.

• Set fitness goals for yourself that are not solely based on weight loss

Pelvic Floor

No matter what type of delivery you had, it’s important to work on strengthening your pelvic floor after birth. Throughout pregnancy, the pelvic floor is weakened from supporting extra weight. Pelvic floor muscles also loosen due to hormone changes.

More than a year postpartum? Had multiple babies? There’s no great time like the present to work on strengthening your pelvic floor. No one wants to struggle with incontinence or worry about the next time they need to sneeze.

To see improvements, most people will need to do pelvic floor exercises consistently for 1-3 months.

Here are 5 exercises you can start doing today by Joyful Messes

Scar Massage

For all you c-section mamas, I have read a lot about the benefits of scar massage. After reading more about the long-term impacts of c-section surgery, I wanted to do what I could to avoid scar tissue and adhesion. Similar to the pelvic floor exercises, there is no time like the present to work on scar mobilization. As long as your incision is healed, you can begin scar massage (wait until at least 6 weeks postpartum).

There are many tutorials online. A physiohealth office out of California created a “C-Section Massage Beginner’s Guide”. Many women report improved muscle function and tissue mobility as results. The recommendation is to massage the incision for 5 minutes at least 3 times a week.

Progress

All of this to say, I continue to remind myself daily that I’m striving for progress and not perfection. I love my baby and what my body went through to bring her into this world. I can feel all of that and also want to work to make improvements for the sake of my health. It’s helpful to look back on your full term pregnancy belly photos and see the journey your body has taken you on. Also, make sure to take progress photos along the way as a reminder of the changes you’ve made, because the scale isn’t always the best indicator.

**I am not a medical professional. If you have any health concerns, don’t hesitate to consult your doctor