Pelvic floor exercises after c section

When and how to exercise after a c-section

Tommy's PregnancyHub

Gentle activity will help you recover from your caesarean section (c-section). Pelvic floor and abdominal exercise can also help. After your 6-8 week postnatal check, you should be able to gradually increase the amount of exercise you do.

While you’re in hospital, your midwife should give you information on exercises that will help you recover from your c-section. They will encourage you to start moving around as soon as you’re able to get out of bed. Gentle walking will help you recover from your surgery.

If you had any complications during pregnancy or birth, or you have any medical problems, get advice from your GP or a physiotherapist before starting any type of exercise.

Find out more about what happens after a c-section.

Pelvic floor exercises

These exercises help to strengthen the muscles that support your womb, bowels and bladder. This may help you manage any problems with leaking urine.

You may have been doing these exercises during your pregnancy. After your c-section, you can start to exercise your pelvic floor once your catheter has been removed and as soon as you feel ready.

Speak to your GP if you’re worried about your pelvic floor after your 6–8 week postnatal check. They may refer you to a specialist in women’s health or gynaecology.

Read more about how to find and exercise your pelvic floor muscles.

Abdominal exercises

These exercises will help to strengthen the muscles in your abdomen (tummy area). This will help you to protect your spine and have good posture.

Lie on your side and slightly bend your knees.
Relax your abdominal muscles and breathe in gently.
As you breathe out, gently pull in your abdominal muscles.
At the same time, squeeze your pelvic floor muscles.
Hold in your abdominal muscles and squeeze your pelvic floor for 10 seconds, then gently release.
Repeat this exercise 10 times.

Returning to exercise

It’s best to wait until you’ve had your 6-8 week postnatal check with your GP before returning to your pre-pregnancy levels of exercise. If you weren’t very active before your pregnancy, this is a good time to start exercising. Try to build up gradually and stop if you have any pain.

Once you have recovered from your c-section and no longer have any pain, it’s usually safe to start low-impact exercises, such as swimming, pilates, yoga, gentle jogging and low resistance gym work.

Your GP may recommend you wait for at least 12 weeks before starting any high-impact exercises, such as aerobics, running and resistance or weight training. Hormones can affect your joints for about 6 months after the birth so start off gently.

Read more about recovering at home after a c-section.

Review dates

Reviewed: 16 July 2021 | Next review: 16 July 2024

5 Exercises to Help with Your C-Section Recovery

Medically reviewed by Deborah Weatherspoon, Ph. D., MSN — By Natasha Freutel on October 5, 2018

After your cesarean delivery

A cesarean delivery is a surgery where an incision is made through the abdominal wall to deliver a baby quickly and safely. Cesarean deliveries are sometimes medically necessary, but the recovery time is slightly longer than a vaginal birth. For this reason, caution should be taken. Moms should get their doctor’s OK before returning to regular exercise. Some key muscles that require retraining after pregnancy include the transverse abdominis. These are the corset-like muscles that wrap around the midline to the spine, the pelvic floor muscles, and the abdominal and lower back muscles. After a cesarean delivery, it’s important to activate and strengthen these areas so that they can provide support, decrease your risk of injury, and help you make a full recovery postpartum. Try these gentle exercises after a cesarean delivery. They require no equipment and can be performed from anywhere.

1. Belly breathing

This exercise is a great relaxation technique. It also helps retrain the core muscles to work together during daily activities. Muscles worked: transverse abdominis

Lie on your back on a comfortable bed or couch.
Place your hands on your belly and relax your body.
Take a deep breath in through your nose, feeling your abdomen expand into your hands.
Breathe out through your mouth. As you exhale, pull your bellybutton in toward your spine, contracting your abdominal muscles. Hold for 3 seconds.
Repeat 5 to 10 times, 3 times a day.

2. Seated kegels

A layer of connective tissue called the fascia connects the muscles of the abdominals to the pelvic floor and helps them work together for optimal performance. Kegels are an excellent exercise to strengthen and activate the pelvic floor. They have been shown to decrease stress incontinence following childbirth. After a C-section you may have a urinary catheter and these exercises will help after the catheter is removed. Muscles worked: pelvic floor

Sit on the edge of a chair with your feet on the floor.
Contract the muscles of the pelvic floor. It should feel like you’re trying to hold back the flow of urine.
Imagine you’re closing all the openings of the vagina, anus, and urethra. Imagine lifting them up away from the chair.
Hold this contraction as long as possible. Start with 5 seconds and work up to a longer duration.
Take a deep breath in and then breathe out fully, relaxing the contraction.
Try Kegels in different positions like standing or lying on your side.
Perform 8 to 12 times with a 2-minute rest between contractions. Repeat 2 times per day.

3. Wall sit

This full-body isometric exercise is an excellent way to get all the muscle groups to work together in unison. Muscles worked: quadriceps, hamstrings, pelvic floor muscles, core, and lower back

Stand with your feet 1 to 2 feet away from the wall.
Slowly lean back toward the wall, lowering yourself into a sitting position. Your hips and knees should be at 90-degrees to one another.
Engage your core. Take a deep breath in and while you exhale, feel as if you’re pulling your belly button into the wall.
For an added bonus, contract your pelvic floor by doing a Kegel while holding this position.
Hold for as long as possible. Rest 1 minute, then repeat 5 times.

4. Cesarean delivery scar massage

As a cesarean delivery scar heals, the different layers of skin and fascia can become adhered to each other, limiting your range of motion. These adhesions may lead to future problems like urinary frequency, or hip or back pain. A scar tissue massage, also referred to as scar tissue release, helps break up the adhesions and assists with proper tissue healing. Only begin scar massage after your scar is healed and your doctor gives you the green light. Areas worked: fascia, connective tissue

Lie on your back with your fingers positioned above your scar. Pull the skin with your fingertips around the scar and observe its movement. Try sliding it up and down and side to side. Notice if it moves more easily in 1 direction than another.
Working in 1 direction, slowly move the scar back and forth. You will want to start off gently and gradually move up to a more aggressive massage.
Move the scar up and down, side to side, and even around in circles. Small movements are better, but tissue mobilization can be done in all areas of the abdomen.
If the scar is painful, stop and try again at a later date. Once you feel comfortable, you can perform this massage once a day.

Note: Be sure to consult your doctor before engaging in exercise postpartum. Always start small, working up to more challenging movements. Avoid activities that place a lot of stress on the abdominal muscles and hip joints. If possible, consult a physical therapist or postpartum exercise specialist. If you notice an increase in bleeding, fatigue, or inflammation of the scar area, stop and seek medical help.

5. Leg slides

Generally, exercise should not start until six to eight weeks after the surgery and you should always check with your doctor before beginning. Low impact exercise such as yoga, Pilates, or swimming is the best way to begin. This beginner core exercise helps engage the core muscles in a gentle but effective way. The transverse abdominis muscle is an important area to strengthen as it supports the body core. Also, it supports the linea alba, a fibrous structure that extends from the xiphoid process down to the pubic bone and also supports core stability. Muscles worked: transverse abdominis

Lie on your back on the floor with your knees bent and feet flat on the ground. Wear socks or put a towel under your feet to allow your feet to slide easily on the floor.
Take a deep breath. As you exhale, contract your abdominal muscles by pulling your belly button to your spine without changing the curve of your lower back.
While maintaining this contraction, slowly extend your foot away from your body until the leg is fully extended.
Slowly bring it back to the starting position.
Repeat 10 times on each side. Perform once per day.

The takeaway

Abdomen and pelvic floor exercises are beneficial following a cesarean delivery. To increase strength and stability in the core muscles, try breathing exercises, isometric contractions, and exercises that target the transverse abdominis. Regaining strength gradually will help you return to doing the activities you love with ease.

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Last medically reviewed on October 5, 2018

Parenthood
Postpartum Care
Post Delivery

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Current Version

Oct 5, 2018

Written By

Natasha Freutel

Edited By

Cody Cowan (admin)

Medically Reviewed By

Deborah Weatherspoon, Ph.D., MSN

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Medically reviewed by Deborah Weatherspoon, Ph.D., MSN — By Natasha Freutel on October 5, 2018

Recovery after caesarean section. Part 2 .. YogaMammy Blog

In the first part of the article we discussed the first days after caesarean - how to change positions, relieve pain with breathing practices, how to "wake up" the intestines and prevent postpartum discharge from stagnating.
Let's move on.

Pelvic floor training.

It would be a misconception that since the birth was operative, the pelvic floor does not need to be trained.
Intra-abdominal pressure increases in all pregnant women, regardless of delivery. And hormones had approximately the same softening effect on ligaments and muscles. nine0004

After a caesarean section, you may experience urinary incontinence when coughing, sneezing and even laughing. And the lack of experience in vaginal delivery is not a guarantee that pelvic floor problems will bypass you.

Functionally, the muscles of this zone are closely related to the deep abdominal muscles and the respiratory diaphragm. These connections have long been studied in sufficient depth. And that is why we can confidently state that by training the pelvic floor, we indirectly activate and restore neuromuscular connections to the transverse and internal oblique muscles of the abdomen. And restoring the mobility and amplitude of movements of the respiratory diaphragm during the practice of full yogic or diaphragmatic breathing, we also influence the restoration of the functions of the pelvic diaphragm. nine0004

In the first week after the operation, you can easily train your perineum muscles, linking their contractions to a calm natural exhalation. Inhale - relaxation, exhale - contraction. You can start literally with 5 times, and if comfortable, increase the number of repetitions to 10-15.

It is important to make contractions light, without excessive effort and without fixing the pelvic floor in tone after exhalation. Our task is to “wake up” the stretched muscles and at the same time not interfere with the exit of lochia from the uterine cavity. nine0004

Make sure that the abdomen remains relaxed, as well as all other parts of the body (face, fingers, shoulders, hips, etc.).

It is convenient to train while feeding your baby - lying or half-sitting.
Relax completely for a few minutes after the approach.

Yoga therapy for stress.

Sometimes the operation leaves a mark not only on the body. A caesarean section can be a serious psychological test, and sometimes even a cause of depression. The state of anemia also contributes due to the loss of a large volume of blood - after a cesarean it is more than after a vaginal birth. Increased fatigue, weakness, loss of strength are expected companions of the postoperative period. The help of loved ones in caring for the baby, the assignment of everyday household chores will be very helpful. Rest, sleep and eat quality whole foods, and as they say, "let the whole world wait." nine0004

Prevention of adhesions.

Any abdominal surgery is a risk factor and the cause of the formation of adhesions - adhesions of organs to each other or to aponeuroses. The good news about caesarean section is that adhesions after it are less common compared to other non-obstetric operations. However, with each subsequent operative birth, the risk of adhesions increases.

What can be recommended as a prophylaxis in the early period (until the sutures are removed or until the wound edges are well tightened):

Diaphragmatic breathing lying on the back.
Regular bowel movements.
Tie or brace when sitting, standing or walking.

After removing the stitches up to 1.5 months after childbirth, it can be recommended:

Activation of the transverse abdominal muscle lying and sitting - with a smooth exhalation and then at the moment of a natural comfortable pause after it.
Self-massage of the abdomen - with gentle stroking movements in a clockwise direction. nine0045
Crocodile crunches or variations with knees bent. and feet on the floor - shallow, with a comfortable speed in dynamic mode.
Diaphragmatic breathing lying and sitting.
Ujjayi pranayama.
Prana Vyayama.

1.5 months after completion of lochia and complete healing of the suture on the uterus:

Simultaneous activation of the pelvic floor muscles, deep abdominal muscles.
Transverse muscle training in comfortable starting positions. nine0045
Body movements in the cat.
Viparita-karani-mudra with ujjayi on inhalation and gentle uddiyana on exhalation.
More active self-massage/massage of the abdomen - with pinches, ribs of the palms, fingers.
Uddiyana-bandha in therapeutic variations of inverted postures
In the absence of contraindications, gradually and accurately introduce into practice active abdominal manipulations - agnisara-dhauti, nauli-kriya.

Restrictions on yoga practice after cesarean. nine0007

For 1.5-3 months after the operation, the following abdominal exercises are contraindicated:

sit-ups, legs, and both in various combinations

sit-ups with twists

horizontal plank, side plank

push-ups
navasana and variants in statics and dynamics

power balances on the arms

throwing

postures with excessive pressure on the abdomen and excessive stretching of the anterior abdominal wall (for example, deep backbends and deep side bends). nine0045

Until complete completion of lochia and tissue healing, also exclude from practice: retraction training with muscle contraction.
After 1.5-2 months, do a control ultrasound of the pelvic organs and go for an examination to your treating gynecologist. If he confirms that the suture on the uterus has healed, and everything else goes on as usual, then you can safely proceed to soft recovery training. nine0004
Choose programs that take into account the characteristics of the female physiology after childbirth and that do not have potentially harmful exercises.

I wish you a full recovery and great health!

Yours
Maria Khavkina.

Kegel exercises after childbirth: rules for performing

Daria Tikhonova Practicing obstetrician-gynecologist and reproductologist, ultrasound doctor 11/23/2020

3 Reading time

Mom after childbirth

Contents

Postnatal Kegel exercises

Kegel muscles - where are they?

What problems can Kegel exercises help with after childbirth?

Kegel exercises after childbirth: when is it possible and who is not allowed?

Kegel exercises after childbirth: how to do it right?

A set of Kegel exercises for women after childbirth

Not by Kegel alone

As the heroine of the famous film said about her birth: “Try to push something the size of a pumpkin through a hole the size of a lemon!” Naturally, after such a process, the organs directly involved in it cannot remain in their former form. Any woman wants them to return to her as soon as possible, or at least get closer to the desired parameters and sensations. The gynecologist Kegel will come to the rescue, who developed the legendary method of strengthening the muscles of the pelvic floor. Kegel exercises after childbirth - something that every girl needs. nine0004

Kegel muscles - where are they?

This is a complex of muscles designed by nature for intimate processes, therefore, in ordinary everyday events of life, they are little involved and practically not felt. But their loss of elasticity will immediately affect the quality of life. After childbirth, this is felt especially acutely. This group includes muscles that support the organs of the small pelvis:

internal genital organs;

bladder;

rectum. nine0045

Their location is between the pubic bone and the coccygeal bone, and not only labor activity, but also sexual relations, as well as such a vital process as getting rid of waste products of the body, depend on their tone. Important reasons to pay attention to them, right?

What problems can Kegel exercises help with after childbirth?

Gymnastics, which strengthens the muscles of the perineum, is useful not only for those who have recently given birth, but also for all healthy women and even men. Its role in the postpartum period is especially relevant. Correct and regular use of Kegel exercises for women after childbirth contributes to:

prevention of blood stasis, the fastest cleansing of the uterus;

contractions of the uterus, its return to its original state;

restoration of elasticity of tissues stretched during pregnancy and childbirth;

pelvic prolapse, incontinence problems;

speedy return and maintenance of libido at a bright level;

improve the quality of sexual intercourse;

reduce the risk of inflammation.

Postpartum Kegel exercises are easy to do at home and take no more than 10-15 minutes to complete. nine0004
Kegel exercises after childbirth: when is it possible and who is not allowed?

New mothers concerned about when to start Kegel exercises after childbirth? Almost immediately, as such a desire appears, if there were no gaps and everything went naturally. Good health and the absence of pain and discomfort is an excellent criterion for starting classes.

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And in 3 months or less, you will return not only physical shape, but also mental balance. Happy mom, happy family! nine0004

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It is believed that Kegel exercises are absolutely harmless. But where it comes to a woman in labor, one must act very carefully and prudently, because the effect on the pelvic floor muscles as a result of Kegel exercises after childbirth is quite active. Doctors warn of a number of contraindications for postpartum uterine contraction exercises. nine0004

If the inflammatory process has aggravated in any pelvic organ, these muscles cannot be trained. Cystitis, urethritis, vaginitis, etc. - not an exception.

After a caesarean section, suturing or other surgical procedure, the surgical incisions must first be allowed to heal completely. The concept of "completely" should be defined only by a doctor.

If you have a miscarriage or a premature delivery, it is too early to load the perineum with additional exercises.

For women with oncology and cardiovascular problems, the Kegel method is contraindicated. nine0045

But breastfeeding is not a contraindication at all, only it is better to choose the time of exercise after the baby has eaten.

Kegel exercises after childbirth: how to do it right?

Before you start recovery, you need to feel these muscles. A description and even a picture will not help much here: physical sensations take precedence. Kegel muscles are easiest to spot when… sitting on the toilet. If you interrupt the stream during urination, they are activated. Obviously, they are also felt during orgasm, but immediately after childbirth, this will have to wait a bit. There is another way to look for the “lower push-up”: in the prone position, you should bend your legs, keeping your feet on the floor, and then insert two fingers into the vagina and try to squeeze them. The right muscles will work. And now let's make them "pump up" a little. nine0004

Breathing should be calm and should not be delayed or forced. The bladder should not bother - empty it before starting classes.

Beginners should start in a prone position, then move on to more advanced levels - sitting or standing. Do not strain the abdominal muscles.

You need to eat at least. Than 1.5 hours before class starts.

A set of Kegel exercises for women after childbirth

"Interrupted stream" - a pause in urination during daily trips to the toilet, you can interrupt the stream up to 5 times in one act. nine0045
"Fix" - squeeze and fix the vaginal muscles for 3-5 seconds, gradually lengthen the moment of fixation. Do 10 repetitions.

"Pulsation" - tension and relaxation of the muscles of the vagina, 1 per second. For starters, 30 repetitions, then you can bring it up to 100.

"Lift". Lying on your back, you need to focus on your feelings, it is better to close your eyes. The vagina is an "elevator" of several floors, and the woman imagines how she "rises" (strains her muscles), "stopping" on each floor for 3-5 seconds, and then increasing pressure - "rising" higher. Then comes the “elevator descent” - a gradual relaxation of the muscles. nine0045
"In the rhythm of SOS". Lying on your back with bent legs, the muscles of the perineum contract according to the principle of "three dots - three dashes - three dots", that is, three times strongly and quickly, then three times slowly and lingeringly. Start with 10 repetitions.

2-3 months after childbirth, elements of Kegel exercises can be included in other sports and even household activities.
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