By Shirley Srubiski, R.Kin, CSEP-CPT.

New moms often wonder when they can expect to get back to the gym or start a new high-intensity fitness program after having a baby. Unfortunately, this is a tough question to answer as there is no one size fits all when it comes to postnatal recovery and readiness to exercise. This is especially true when healing from a caesarian section, or C-Section, because you are recovering from the pregnancy AND a major surgery.

Before engaging in a fitness program postpartum it essential to rest, restore, and re-train the body to to be able to handle the essential activities of daily living, as well as any high-intensity physical activity. This process will likely take longer after a C-section compared to a vaginal delivery so it’s important to be patient. Skipping steps and signing up for a bootcamp before you are ready can lead to, or worsen, any number of issues including Diastasis Rectus Abdominis (DRA), aka “mummy tummy”; incontinence; pelvic organ prolapse; and hip, pelvic, and back pain; just to name a few.

In the first few days following the C-Section the most important thing is to rest. Don’t do too much too soon; ask for help moving around and holding the baby. By over exerting yourself you increase the risk for tearing stitches or infection. This is definitely not the time to sign up for a fitness challenge.

Stay well hydrated and, most importantly, start your pelvic floor exercises within the first couple of days of delivery. If you haven’t been seeing a pelvic floor physiotherapist yet then it’s a good idea to make yourself an appointment with one. A pelvic floor physiotherapist can teach you how to massage your scar to help prevent adhesion, assess you for a diastasis, and see how your pelvic floor is functioning. Keep in mind that just because you had a C-Section doesn’t mean your pelvic floor hasn’t been affected. The 9 months of pregnancy included added weight on your pelvic floor and hormonal changes which make your tissues more lax and put you at risk for dysfunction. Not to mention that the abdominals and connective tissue have been cut and sewn back together, a muscle group that works synergistically with the pelvic floor. Remember, just because you are not noticing any overt symptoms of pelvic floor or core dysfunction doesn’t mean it doesn’t exist. Very often pelvic floor issues and DRA can be asymptomatic or may seem unrelated to other aches and pains. By doing too much too soon you are stressing already weakened tissues beyond what they can handle. Eventually symptoms will start appearing, at which point it will likely take even more time and work to correct the dysfunction. You can help correct or prevent many of these issues.

So you have followed all of the advice above and you’ve been given the ok to start some physical exercise after your 6-week check-up, is it time to sign up for a bootcamp? Realistically, your body isn’t ready for that yet. The 6-week mark has been treated as a magical line in the sand that once you cross, you are completely healed. In truth, this is still very early on in your healing process and usually is the time to start restoring and retraining. It’s all about strengthening your core and correcting muscle imbalances that were present before pregnancy or emerged in the process. A big part of this is postural correction; without proper alignment in the body you are perpetuating muscle imbalances and preventing abdominal and pelvic floor healing. The Bellies Inc. 8 week restorative program is a great place to start.

Once you have rested, restored, and retrained and finally feel up to a fitness program here are some tips to keep in mind:

-       Start slowly. You need to build up your endurance and capacity for exercise. For example, never underestimate the value of walking as an excellent source of physical activity.

-       Don’t run to the weights just yet. Your body is a great source of resistance for exercises. If you are not able to do a perfect squat with just your own body weight then adding in weights is a big no-no. You can accomplish a full and challenging exercise routine just using your own body weight.    

-       If you have a Diastasis avoid positions that can exacerbate it such as prone positions (e.g. planks) or any activities that increase intra-abdominal pressure (e.g., V-Sits and 100s). Also, a belly binding system like the Bellies Inc. AB Tank and wrap would be a great investment and something that can be worn daily to help treat the DRA and provide support during exercise.  

-       If you are Incontinent (even if it’s just a drop or two when you laugh sneeze or cough) follow all of the rules above for a Diastasis and avoid high-impact activities (e.g., anything involving running or jumping). You should NEVER pee when you exercise as it’s a sign that your are overloading your tissues and pushing them past failure.

-       Say goodbye to crunches….forever! They create too much intra-abdominal pressure that has nowhere to go but down against your pelvic floor and forward against your abdominal and overload your spine. Not only can this exercise exacerbate a pre-existing condition, but it can create a whole new one.

-       Ask for help. This is the most important piece of advice that I can give. If you don’t know what to do or where to start then seek out a qualified fitness professional that can guide you. It is impossible know everything and to be objective when it comes to our own bodies. By having an assessment done and working with a qualified professional you are exponentially increasing your odds of safely and successfully maintaining a fitness program that will help you reach your goals.

To summarize, getting back to fitness after a C-Section can take time and work but it is not about training hard, its about training smart.

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