Exercising After a C-Section

Some of my clients have suffered through significant anxiety in anticipation of needing an emergency c section come delivery day.  Most of the anxiety seems to build around the thought of “losing their body”.  It’s true, a caeserian is a serious procedure.  Medicine has it down to an art, minimizing trauma, pain and risks but nevertheless, tissue must be cut and muscle must be repaired.  Barring any rare mishaps during the procedure or any post-surgery tearing,simply resting should do the job. But there are a few things you can do to help rebuild muscle, elasticity and strength once the initial healing is done.

when to start

Everyone heals at a different pace, but 6 weeks of rest and careful, low impact movement (everyday tasks – not exercise) is a fair average time to allot to recovery. Your body needs the proper building blocks to promote immune function, rebuild tissues and provide food for the baby. Your recovery period should be paired with good food, a slight increase in protein, healthy fats and a variety of vegetables is a good start. As mentioned above, about 6 weeks post delivery, and preferably with your doctors go ahead, you can begin low impact exercise.  Some women may need a little less or a little more time to recover prior to beginning an exercise program. Listen to your doctor and listen to your body.  If you begin a fitness plan and you feel any kind of pain or discomfort more than the normal soreness from exercise, than it may be best to take a few more weeks to rest and heal.

how to start

You may want to try and do as many sit ups as you can in order to get your abdomen back to form, but resist, it doesn’t work and if premature, it may do more damage than good.  Two motions you want to avoid at the beginning are crunching and twisting.

I usually take the same approach to a post c-section training program as I do for planning a recovery program for women who have significant abdominal tearing during pregnancy and/or delivery.   For the first three to four weeks a fair portion of the training is focused on core rehabilitation through controlled calisthenic type movements, with specific breathing patterns and guidance with core activation. I also like to add a number of  isometric exercises that target all of the back muscles as well as abdominal and deep core tissue.  Your lower back may have had to, and may continue to compensate for weakened abdominal muscles.  keeping them working functionally is paramount in avoiding a prolonged healing period, pain and postural problems.

Examples of core-centric exercises –

Plank – facing the floor, rest on your forearms bringing your body off the floor.  You can do these on your toes or on your knees depending on your fitness or recovery level. keep your head straight and your butt down so that your body is perfectly aligned. 30 seconds is a good place to start. work up to a minute 3x.

Draw-in (on knees) – use a mat, rest on your knees, place a ball or cushion between your knees, stretch your body tall extending your hands above your head, palms together. squeeze the ball with your thighs and draw your navel inwards toward your spine. Hold this for a count of 10. Increase time as you become stronger. 8-10x

strengthening the rest of your body

Post natal training tends to be overly ab centric.  Its no surprise. You’ve spent nine months watching your abdomen grow, its the focus of yours and everyone else’s attention throughout your whole pregnancy, so its natural to keep it as your focus in regaining your pre pregnancy body.  In addition, all the top ten “get great abs” exercise lists ten to be full of, well, ab exercises.  But if you keep tabs on the training habits and programs from some of the best (but not most popular) trainers in the world, you quickly begin to realize that only fitness models spend hours doing sit ups.  An intelligent, functional exercise program should promote longevity by reducing body fat, increasing lean muscle, strengthening your cardiovascular system and supporting stability and mobility. It will also give you an incredibly strong and esthetically pleasing core.

Crunches don’t flatten your belly.  Sure, they will strengthen them (for one very specific movement) but it is far from building functional strength and support, which should be a priority for any new mom. You will be carrying your new baby for quite some time, as well as supporting them during feeding and maneuvering strollers, car seats, and other baby gadgets for the next little while. Post c section, your focus should be on rebuilding your abdominal strength in a safe and useful way, and the rest of your body needs attention too.  The best way to do this is by including isometrics (as mentioned above) to a program full of compound movements that increase the strength of multiple muscle groups using proper body mechanics.  Your legs, core, arms, chest and back will all benefit from it.  Add in some low impact interval training, and/or low to mid intensity cardio and you will have a great post c section routine.

Examples of compound movement exercises –

Split squats – step out into a lunge position, dip so that both knees bend to about a 90 degree angle, keeping your shoulders back and chin up, hands on hips or behind ears. push back upwards but don’t step back just dip and rise in the step-out position – 10-15x each leg. Add weight or more reps once ready.

lying leg curl (slightly advanced – only perform this exercise once completely healed and have gained some abdominal strength) – lay on your back with a small stability ball under yourfeet, knees bent Lift your torso off the floor and extend your legs, just keeping your shoulders on the ground. Curl your heels back in towards your butt, keeping your body of the floor still. Repeat 10x.

what kind of cardio is best, and how much?

Normally I recommend swimming as a great cardiovascular workout, its low impact,  uses every major muscle group and can be just as intense as running. But the stretching and twisting involved in swimming is slightly too intense for post C section exercise. I usually suggest biking, uphill walking or using an elliptical machine.  Once you have healed completely, swimming would be one of the best exercise you could do to get fit.  The amount of cardiovascular exercise you do depends on your intentions.  Unless you are training to get back to high level competitive sports I would stick to about 45-60 minutes of mid intensity cardio. This will help you burn calories and increase your endurance and over all health.  If your fitness program includes resistance training then you can probably stick with 20 minutes of cardio.

* A NOTE ON CARDIO – There are some trainers that say that cardio exercise is a waste of time, that you can get enough cardio from doing interval training or a mix of plyometrics and strength training.  This is only partially true. You can burn enough calories to lose weight or stay fit by doing interval training, and strength training will give you the after effect equal to that of medium intensity cardio – but only as far as calories burned is concerned.  To actually improve cardiovascular health, i.e. strengthen your heart, increase your oxygen capacity, blood flow and blood quantity, long term cardio training is the best way.  Strength training is a tool to improve your capacity for powerful movement in sport as well as to build your body for general strength and for esthetic purposes. It is a key component in rehabilitation exercise for the pelvic floor, lower lumbar and deep core muscles post C section or post delivery.  Cardiovascular exercise is a tool to increase stamina, life span, as well as to lose weight.

So, you can look at your priorities and preferences and judge how much cardio you would like to do.  Keep it low impact for the first few weeks and once your recover is complete, you can up the ante.

If you are able to find a specialized personal trainer or yoga instructor who can guide you through the first few weeks, It is totally worth it.  Once you have regained a reasonable level of complete functional strength you can return to your usual routine or sport, but take this time to carefully adjust and prepare for life with a new born.  Good Luck!


5 Comments on “Exercising After a C-Section

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  2. Hello. How many weeks should I start before doing plyometric exercises again? Thanks!

    • Hi Angela, No set time frame before you can do ballistic work. If their was no diastasis, I would say 10-12 weeks would be a safe bet. But if you did have some separation of the abdominal wall then I would focus on rehabbing that first. The impact / twisting / strong pulsing activation of the core with plyometrics can slow down recovery. Hope this helps!

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