C-section Rehabilitation - Pelvic floor physical therapy
I always tell my patients; you have ONE chance to heal correctly. The biggest mistake I see C-section mamas make is not giving their body the time to heal properly. A lot of women are just told to “take it easy” for 6 to 8 weeks post c-section— but we find that advice to be entirely too general to be useful. C-section mamas often leave the hospital with little to no information on recovery and are left to fend for themselves. At Empower Movement Physical Therapy, we strongly believe that ALL women should be equipped with the knowledge to heal SAFELY and CORRECTLY.
You have ONE chance to heal correctly.
We believe that ALL women should be equipped with
the knowledge to heal SAFELY and CORRECTLY.
C-section is a MAJOR surgery. Your incision, scar tissue, and adhesions can impact your entire core musculature and surrounding organs. Scar tissue and adhesions can affect issues like low back pain, urinary urgency, bladder leakage, impaired digestion, lymphatic issues, infertility, painful sex, and the tummy pooch, your movement patterns - ladies this can affect the way you walk and run…and so much more! This is not intended to be scary, but rather as an explanation as to WHY this work on yourself is necessary. While we hope this information makes it into your hands prior to your c-section, this information is still useful to women with ANY history of abdominal surgery.
Even if you’ve had surgeries years ago, it is NEVER too late to heal.
general timeline for recovery
Acute stage of inflammation after a c-section lasting 3-4 days is 2-6 weeks
It takes about three months for the nerves around the surgical site to heal
Six months for the incision to deeply heal.
Scar continues most of its remodeling by about 2 years.
Empowering Your Physical Recovery 4+ weeks
What many of our patients want to know after a c-section is how to get the core back! The main tenants of this are:
Improve Breathing
Shallow breathing pattern can create neck pain, pelvic pressure and slow down healing
Release work/ Soft-tissue work
You can't connect to anything you don't have control over. You don't have control over your scar until you do your release work
Untangle the scar- Some women will feel tightness and a tugging sensation around the scar for years. We’ll get in there and work on it as well as show you how to do the same
Release all other elements of the core to promote their function → Back, obliques, rectus
Thoracic mobility
Need to be able to rotate, flex and extend. It takes thoracic mobility to be in a stacked posture without the head jutting forward ahead of the body
Without thoracic mobility, there is an insane amount of pressure downward into the pelvis and upward into the neck
Posture
Your rib cage needs to be stacked over your pelvis in order to actually work!
Strength - after any abdominal surgery, we need to restore balanced strength. The muscles of the body work together in predictable patterns. After a c-section, we work very specifically to get the following muscles working efficiently together once again:
Pelvic floor
Transverse abdominals
Obliques
Rectus abdominis i.e. your “6-pack” muscle
Motherhood Mechanics
To optimize your daily experience with the very PHYSICAL tasks of young motherhood
Wolff's Law - the body remodels in response to the stresses we place upon it. We therefore want to make sure we are creating and sustaining balance. A simple example is illustrated here: Holding a baby on one side when we do this we ONLY load the opposite abdominal wall… So we have to make sure we are switching sides with where we hold the baby.
Returning to sex
It may seem strange, but one of the most common complaints of moms after a c-section is incredibly painful sex. It is a little known fact that your pelvic floor and core can get incredibly grumpy after not only pregnancy but also major abdominal surgery.
Your pelvic floor needs to relax and you or your pelvic floor physical therapist may have to do some release work to get it to a point where penetration is doable
Might have to try different positions - if your partner is on top and putting their weight down onto you that may be uncomfortable.
Nearly every postpartum mama benefits from use of lubrication, even if you never needed it previously
Foreplay is important! Now more than ever! Pain or difficulty with sex is one of THE most common complaints we hear from postpartum moms– and we can ALWAYS fix it!
FURTHER OUT RECOVERY FROM C-SECTION
Abdominal scarring can affect your movement patterns years down the line. A lot of the same principles apply as we discussed above but after physiological healing takes place we can apply but it is NEVER too late to make a change! Working on our scar is a life time process. We can get to a really SOLID baseline in 8-12 weeks, but continual scar care should become a part of your routine - just as others should work on mobility. We can’t stress enough how it is NEVER too late to make improvements! We treat surgical scars no matter how old because it is almost always relevant to somebody’s physical health.