Physiotherapy Exercises After C Section to get back to Fitness

Physiotherapy after a C-section is intended for females who have undergone a cesarian section so that they may get back to fitness without endangering their health and the C-section wound.

Pregnancy, Vaginal birth, and C Section are associated with physical changes in the body. A C-Section is a major surgery where an incision is made through the abdominal and uterus under General, Spinal or Epidural anesthesia. So, it is essential to consult your doctor before initiating any exercise schedule.

It is better to avoid lifting objects, straining, and squatting immediately after a C-section because the C-section scar may not heal properly.

When can you start exercises after a C-section surgery?

Some physiotherapists usually allow pelvic floor and gentle core stability exercises just a few weeks after a C-section, while others will suggest waiting for at least 6-8 weeks before getting back into a gentle exercise routine.

It may take 9 – 12 months before getting back to regular intense workouts and abdominal exercises like crunches & planks etc. Generally, one must wait for at least 6 – 8 weeks before resuming strenuous muscle activities.

The first step of the workout should always begin with gentle pelvic floor and core strengthening exercises gradually progressing into some gentle standing exercises.

So, as per your doctor’s advice, do what’s safe for you and don’t perform any exercise or activity that causes pain. Preventive exercises may be started as soon as possible after recovery from surgery.

If you want to perform work out at your home, you just have to follow these steps carefully, you don’t need any expensive equipment to perform exercises.

Indeed, with slight modifications, you can easily and safely perform all exercises at home, without having the need to visit the hospital daily to seek a physiotherapist consult.

It’s not compulsory to wear shoes while performing these exercises however if you’re more comfortable wearing shoes you can absolutely wear them.

Mandatory Exercises and Physiotherapy after C-Section:

Diaphragmatic Breathing Exercises:

• Come into a relaxed, erect seated position to get started. Place both hands on your ribcage to practice diaphragmatic breathing.
• You’ll be able to keep your core engaged while letting your lower belly draw in & breathe into your ribs.
• As you’re going to do exercises to keep your core safe, just take three deep inhales and exhales.
• While exhaling, when you blow out as if you’re blowing out a candle you can get extra involvement that’s great for healing the core.
• When you’re doing the difficult part of the exercise, you’re going to exhale & contract, and then as you change the specific exercise posture you’re going to inhale.

Benefits of Diaphragmatic Breathing Exercises:

This practice is actually safe in protecting your core while you’re healing after surgery. Perform Deep breathing, coughing, or huffing to improve pulmonary ventilation and reduce pulmonary complications.

Try to relax your abdomen during inspiration, feeling that the abdominal cavity is filling up and ribs are expanding.

While expiration, abdominal muscle contraction is not complementary to relaxed breathing. However, it’s important to avoid hyperventilation for which slow breathing is advised.

Important Note:

While performing deep breathing exercises, if you feel any dizziness or tingling in your lips or fingers, decrease the rate and intensity of breathing.

Ankle Pumps:

• Perform Ankle pumps to prevent deep venous thrombosis.
• Lie straight on the floor, keeping both legs straight knees extended, keeping in full contact with the ground.
• Point your toes away from your head, then pull them back towards your head.
• Perform 10 repetitions hourly while you’re in your bed.

Benefits of Ankle Pumps:

After C-Section, a woman is on prolonged bedrest therefore this exercise is helpful in preventing edema and Deep Venous thrombosis.

Pelvic Floor Strengthening Exercises after C Section:

Pelvic floor strengthening exercises are performed to regain control and tone of the pelvic muscles.

Pelvic Tilt Exercises:

• Begin in quadruped position i.e. bend on both hands and knees.
• Try to perform posterior pelvic tilt while keeping the back straight with the intention to keep the lower abdominals tight. Hold this position, release, and perform anterior pelvic tilt in the same way.

Pelvic Clock:

• Maintain hook-lying position, and try to visualize the clock on your lower abdomen. Imagine as if the umbilicus is 12 0’ clock and the pubic symphysis is 6 0’ clock. Your legs can move slightly while performing this lie
• Now you have to do gentle movements back and forth between 12 0’ clock and 6 0’ clock, progressing to move the same between 3 0’ clock (shifting weight to left hip) and 9 0’ clock (shifting weight to right hip)
• In the end, move in a clockwise manner from 12-3, 3-6, 6-9, and then back to 12 0’ clock, then reverse.

Abdominal Exercises and Physiotherapy after C Section:

• Lie on your back with the knees bent to 90 degrees and feet placed flat on the ground while keeping both hands on the anterior surface of your thighs.
• Now gently lift your shoulder and upper back off the ground just trying to touch your knees with the fingers of both hands.
• Try to keep the head in midline while looking forward.
• Hold this position for 5secs.
• Go back to the initial position.
• Do 10 repetitions daily.

Benefits of Abdominal Exercises:

Abdominal exercises play an important role in providing core strengthening and improving posture, balance, and coordination.

Posture Correction exercises after C Section:

• Activities involving holding & caring for the baby, breastfeeding, etc. usually stress the postural muscles, therefore it is highly recommended to breastfeed in an erect sitting posture while keeping the back & shoulders supported to prevent muscle weakness and fatigue.
• Develop control of shoulder girdle muscles, focusing on posture realignment or postural correction
• Place the pillows between the knees and under the abdominal area in side-lying.

For breast enhancement, pro-breast-plus is one kit containing natural supplements and a cream that is used to augment breast size.

Stress-Relieving Exercises after C Section:

• Perform relaxed breathing techniques to reduce stress and promote relaxation.

Bridging Exercises:

• The patient can perform bridging while twisting her hips to the right or left.
• Lie supine on the floor with knees bent and feet flat on the ground.
• Keep your arms on the body’s sides.
• Raise your whole back and pelvic floor off the ground so that only shoulders, arms, and feet remain on the ground
• Lower your trunk back on the ground after 10-20 seconds,
• Take a rest for 10 secs and repeat again at least 10 times.

Benefits of Bridging:

Bridging is the most beneficial exercise targeting the major muscle groups.

Helps to strengthen back muscles, and abdominals, thus providing good posture and core stability.

This exercise is highly effective in improving balance and relieving stress and muscle fatigue.

Abdominal Massage:

• Abdominal massage is very effective after C-section, for regulating intestinal mobility and relieving constipation.
• Support incision with pillows while coughing or breastfeeding to reduce the risk of injury.
• Cross-friction massage should be done at the incision site immediately after the healing process is completed. It is highly effective to prevent lumbago and postural problems.

Contract-Relax:

• Women can perform contract-relax techniques to strengthen pelvic girdles. pretend to hold urine flow for at least 3-5 seconds, and relax for the same period of time. perform a minimum of 10 repetitions.

Elevator Exercises:

• Elevator exercises are quite helpful in strengthening pelvic floor muscles. the patient needs to imagine as if the elevator is going up, she contracts her pelvic floor muscles, in this way strength will improve, adding more floors to the sequence of contractions.
• Then she’ll be asked to relax her muscles gradually as if the elevator were going down.

Standing Push-ups:

• Keep standing position, facing a wall, feet pointing straight forward.
• Stand at the distance of an arm’s length away from the wall.
• The palms of both hands are placed firmly on the wall at the level of your shoulders.
• Try to slowly bend the elbows, bringing your upper trunk close to the wall, and maintain a stable trunk and hip position.
• Then, slowly push the wall with your arms, taking the body back to the starting position.

Benefits of Standing Push-ups:

These exercises actually provide strength and flexibility to the upper trunk region and shoulder girdle including back and core muscles.

Walking:

Walking to improve circulation & strengthen your leg muscles.

Self Stretching:

• It is quite helpful to relieve muscle spasms and increase muscle flexibility.
• Lie straight on the floor.
• Try to abduct the hips i.e. hips moving apart, & gently pull the knees towards the side of your chest.
• Hold this position for as long as you can.

Modified Squatting:

• This exercise improves core stability, strengthens back muscles & tightens the loose abdominals or burns belly fat.
  Stand with your back against the wall and feet apart at the width of your shoulder.
• Now try to slide your back down the wall bending your knees and hips as comfortably as possible.
• Hold this half-sitting position for at least 10 secs.
• Get back to the starting position.
• Do 5 repetitions minimum.

Warnings and Precautions to Physio and Exercise after a C Section:

The woman having the following co-morbidities should participate in an exercise program under the close supervision of their physician to avoid any future complications.

• Anemia

Exercise during anemia can cause exertion & muscle fatigue because involved muscles are not able to get enough quantity of Oxygen.

• Fatigue

During exercise a large amount of energy is utilized, making you feel weaker sometimes, but fatigue may be due to other health conditions so proper assessment is necessary if you’re fatigued earlier during exercise.

• Musculoskeletal problems

if you feel pain in the joint while exercising, or if there exists any joint inflammation. Don’t do vigorous exercise as it can exaggerate the existing clinical condition. Don’t force your body to exercise behind your threshold.

• Fever and heat intolerance:

When you’re doing exercise, your body’s normal temperature rises from the optimal range, and the body’s cooling system has to work harder and faster to compensate for this heating effect.

However, if you don’t stop exercising in overheating conditions, it can result in heatstroke. Symptoms of heatstroke or heat exhaustion include nausea, vomiting, and dizziness. In severe cases, hyperpyrexia can be fatal and lead to multiorgan failure and death.

Immediately stop exercising in case your body temperature is high and you are not comfortable with it. Drink plenty of fluids. Proper warm-up and cool-down periods should be taken during exercise to avoid any harmful conditions.

• Existing Infection

If you’re having some infection anywhere in your body, avoid doing any strenuous activity or exercise as harsh activities can temporarily slow down your immune system putting you at risk of having a more severe infection.

To Summarize:

The following physiotherapy exercises after the C-section help you get back to fitness and your pre-pregnancy physical appearance:

• Ankle pumps prevent deep venous thrombosis.
• Walking to improve circulation
• Lower extremity active range of motion exercises ROM
• Pelvic floor strengthening exercises to regain control and tone of muscles.
• Deep breathing, coughing, or huffing to improve pulmonary ventilation and to reduce pulmonary complications.
• Abdominals exercises
• Develop control of shoulder girdle muscles, focusing on posture realignment or postural correction
• Perform relaxed breathing techniques to reduce stress and promote relaxation.
• The patient must wait for at least 6-8 weeks before resuming strenuous muscle activities.
• A stability ball can be used in labor to reduce back pain and to induce rhythmical and relaxed contractions.
• Pelvic tilting and bridging
• The patient can perform bridging while twisting her hips to the right or left.
• Place the pillows between the knees and under the abdominal area in side-lying.
• Abdominal massage is very effective after C-section, for regulating intestinal mobility and relieving constipation.
• Support incision with pillows while coughing or breastfeeding to reduce the risk of injury.
• Cross-friction massage should be done at the incision site immediately after the healing process is completed. It is highly effective to prevent lumbago and postural problems.
• Emotional support is compulsory for a woman to deal with conflicting emotions she experienced.
• Women can perform contract-relax techniques to strengthen the pelvic girdle. Pretend to hold urine flow for at least 3-5 seconds, and relax for the same period of time. perform a minimum of 10 repetitions.
• Elevator exercises are quite helpful in strengthening pelvic floor muscles. the patient needs to imagine an elevator going up, she contracts her pelvic floor muscles, in this way strength will improve, adding more floors to the sequence of contractions. Then the shell is asked to relax muscles gradually as if the elevator were going down.