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Baby Bumps to Burpees: Returning to Exercise for C-section Recovery

Returning to exercise after a c-section isn’t just about getting back into your pre-pregnancy shape—it’s also a reminder of your incredible strength as a mum. Undergoing a c-section takes more recovery on top of your pregnancy journey, and going back into your fitness means you’re making great progress. As a new mum,  remember that taking care of yourself is just as important as caring for your family. More than the workouts and the fitness goals, this is about paced self-care and wellness.

Welcome to the much-awaited third part of our series focusing on C-section recovery. Let’s delve into the considerations of returning to exercise!

Find the first part here: C-section and scar tissue healing

Second part here: C-section and pelvic floor muscle recovery

RESPECT THE 4TH TRIMESTER

It’s important to remember the significance of the fourth trimester and recognise that during the initial three months, the focus is on laying the groundwork for a steady return to fitness goals.

Collaborating with a women’s health physiotherapist allows for a personalised plan aligned with your assessment, fostering a mindful and healing approach to postnatal exercise. Emphasising exercises that support your recovery, the postnatal exercise journey unfolds uniquely for each individual.

 

WEEKS 1-3: WOUND SUPPORT

Focus on movements and breathing for wound healing:

  • Diaphragmatic breathing: Practise gentle breathing.
  • Pelvic floor contractions: You can start doing this once the catheter is removed.
  • Pelvic tilts.
  • Wound support: Perform activities supporting your wound, fostering confidence and healing.
  • Cardiovascular exercise: Do light cardio gradually increasing duration by five minutes per week.

WEEKS 3-6: WOUND MOBILISATION

  • Postpartum scars may feel sticky, similar to the tension in your spine from contorting around your baby for feeding or co-sleeping.
  • Prioritise range-of-motion exercises when you’re comfortable. You can try the cat-cow, thread the needle, overhead arm stretch, or modified cobra poses.
  • Activate the transverse abdominis by ‘zipping up’ your tummy muscles from the pelvic floor to the breastbone. Exhale as if blowing candles for tension awareness.
  • Consider comfortable bodyweight exercises like bridging, lunges, or squats.
  • Take regular walks, gradually building endurance.

WEEKS 6-12: CORE CONNECTION

  • Check-in for a six-week postnatal assessment with your women’s health physiotherapist.
  • Focus on your inner core activation, crucial for overcoming muscle inhibition post-incision. Targeted, pelvic floor-friendly exercises aid in optimal nerve firing.
  • Abdominal muscles regain only ~50% tensile strength by six weeks, making assessment crucial before incorporating sit-ups or crunches.
  • Consider postnatal exercise classes with instructors trained to support postpartum women.
  • Walking up to 45-60 minutes. If comfortable, consider reclined or seated cycling or an elliptical trainer.

WEEK 12 AND BEYOND: GRADED RETURN TO EXERCISE OR RUNNING

  • Now could be the time to consider elevating the intensity and diversifying your exercise routine at this point.
  • Consider exercise-specific strengthening and proprioception. For running, focus on glutes, quads, thoracic rotation, and abdominal strength. The Couch to 5k app is a helpful resource.
  • Increase abdominal challenges, keeping in mind that by six to seven months, only 73-93% of original tensile strength is regained (Ceydeli et al 2005).

REMEMBER TO KEEP THE FOLLOWING IN MIND WHEN RETURNING TO EXERCISE:

  • Changes in bladder or bowel function (leaking, urgency, or pain)
  • Vaginal pressure or heaviness
  • Bleeding
  • Pain, especially over your scar
  • Breathing control during exercise (ensure comfortable breathing, avoid holding your breath)
  • A posture that supports muscle function and feels right
  • Doming or tenting of the abdominal wall (observe if your abdomen is forced out during exercise)

If you experience any of these signs—pause, reset, and retry. If problems persist, it might not be a suitable exercise for you at the moment. Consider seeking guidance from your women’s health physiotherapist for personalised advice.

A note on diastasis recti: Around 60% of women may experience an abnormally widened separation at six to eight weeks postnatal. The connective tissue can continue to remodel for up to a year post-birth. To learn more about diastasis recti you can read my blog here.

A note on strength training: Start with low weights, then gradually shift the balance depending on what you want to achieve whether strength or bulking.

A FINAL NOTE, SEEK HELP IF YOU EXPERIENCE THE FOLLOWING:

  • Pain when urinating
  • Pain relief is not working
  • Sore abdomen, upset stomach
  • Red, swollen, or painful wound
  • Discharge in wound
  • High fever
  • Vaginal bleeding is still heavy or foul-smelling
  • Feeling faint or racing heart
  • Chest pain or shortness of breath
  • Headache with nausea or vomiting
  • Pain, redness, or swelling in the calf muscles of one leg

Remember to focus on what you can do, not what you can’t. You only experience postnatal recovery once, so let’s maximise your well-being with the guidance of a women’s health physiotherapist. 

If you feel like you could benefit from specialised guidance and treatment for your c-section recovery or return to exercise, please call or WhatsApp us at 9780 7274, or get in touch by email at help@embracephysio.sg to make an appointment.

Feel free to look through our website, where you can learn about other women’s health conditions we treat. This is a safe space where we can discuss how we can help you with physiotherapy.

Note: While I am a physiotherapist, I am not your personal physiotherapist. The contents of this website are for informational purposes only and are not intended to serve as individual medical advice.

Reference:

  1. Goom, Tom & Donnelly, Grainne & Brockwell, Emma. (2019). Returning to running postnatal – guidelines for medical, health and fitness professionals managing this population.
  2. Ceydeli A, Rucinski J, Wise L. Finding the best abdominal closure: an evidence-based review of the literature. Curr Surg. 2005 Mar-Apr;62(2):220-5.
  3.  Find the first part here: C-section and scar tissue healing
  4. Second part here: C-section and pelvic floor muscle recovery
  5. https://www.embracephysio.sg/the-6-week-postnatal-appointment/
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I was seen by both Mary and Preet, and have had a wonderful experience at Embrace with both of them. Strongly recommend for all new moms as essential postpartum self-care!

tryphena chan Avatar tryphena chan
October 8, 2021

I had a fantastic experience visiting Preet’s clinic 6 weeks after I delivered my baby. The physio Alex was detailed, caring and thorough in her assessment of my pelvic floor, back and abdominal muscles. The clinic is a beautiful, calming place and perfect for new mums to get taken care of. Thank you and I would definitely recommend visiting Embrace not just for post-partum issues, but any issues to do with your physical well being particularly for women’s health. Keep up the good work Preet, Alex and the Embrace team!!

Ashima Taneja Avatar Ashima Taneja
February 3, 2022

Love EmbracePhysio team and Preet. From the initial physio sessions for my Dysmenorrhoea issue to current pre-natal sessions, Preet has always been so encouraging and patient with me. Exercises are customised based on my body condition and ability. Always feel welcome for every single follow up. Highly recommended! 🥰

Ong Mei Ping Avatar Ong Mei Ping
June 12, 2023

Embrace life. Embrace Physiotherapy.

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