Can a C-Section Cause Diastasis Recti? Plus-Timeline of Healthy Recovery Part 2 of 2

 Hello Intelligent Instructors!

In part 1, we talked about how to prepare for a

Click here to read Part 1

Here is Part 2 of 2

C-Section Preparation and Recovery 

Can a C-Section cause diastasis recti?

A C-section is performed by:
 – Cutting through the fascia-or aponeurosis-of the abdominal wall, and
  – Pulling apart the muscles, including the rectus abdominus.
So, in theory, a C-section delivery could cause a DR.
BUT, the protocol of most doctors is to stitch the fascia back together, taking care of any parting of the rectus abs.

So, it would be beneficial to treat a mom who has had a C-section, the same as a mom who has DR, as the connective tissues need to heal after they have been manually pulled apart.

Medical Complications That Require A Cesarean

  • Prolonged labor/ failure to progress in labor (Delphine and Alison experienced this)
  • Multiple Births
  • Breech position of the baby
  • Changes in the fetal heartbeat
  • Mother’s age
  • Mother is overweight or obese
  • Prior abdominal surgery

In addition, women can elect to have a Cesarean delivery.

Possible reasons for an elected C-section:

  • Profound fear of “natural childbirth”
  • Convenience/Time constraints for the mother and/or physician

Understanding what your clients go through during birth is helpful in designing a postnatal program.

Timeline of a healthy C-Section recovery: 

12 Hours Post-Surgery mom is bed-ridden.

12-24 hours – mom can sit up with assistance. The incision is incredibly painful.

o The abs must stay dormant for the next 2 weeks to allow the internal and external incisions to heal properly.

o For Pilates minded women, this is completely against our nature.

o To compensate for lack of abdominal assistance, you must engage the pelvic floor and lattisimus dorsi muscles, and use your arms when getting up off of the bed and laying down onto the bed.

What mom can start doing:

  • Lateral Thoracic Breathing
  • Pelvic Floor contracting and releasing

    24-32 hours – mom can stand and walk, and is encouraged to do so.

o Risk for blood clots in the legs is high, so walking helps to reduce this risk.

o Laughing hurts! Bending over hurts from the incisions. Put a pillow against the belly to reduce this discomfort.

o Sitting in a chair tends to be most comfortable, because it is easy to get up from and down to.

What mom can start doing:

  • In addition to the above, Walking the hallways, slowly.
  • Use the legs and gluteals to control sitting and standing.

32-48 hours – the pain from the incision is tolerable.

o Mom can shower, and prepare to leave the hospital, with her doctor’s release.

o The uterus is swollen, and it looks as if mom is 7 months pregnant.

o The doctor will recommend no abdominal exercises for 2 weeks to allow the incision to heal. The concern is the internal incision which, if it opens up, can cause infection, and prolong recovery time.

What mom can start doing:

  • In addition to the above, begin raising the arms above the head and while keeping the ribs closing down.
  • Alternate one arm and the other while sitting, and then one arm and the other.
  • It is important to practice this to prepare the core to stretch without disrupting the incision – more of a reason to keep the ribs closed

48 hours – 2 weeks – CRUCIAL recovery time.

Recruit help from husband, friends, or family.

o If mom can get through these 2 weeks taking the doctor’s instruction: to not use the abs, no ab exercises, no lifting anything heavier than the baby, she should heal quickly. It’s when a woman does not follow docs instructions that she causes herself a prolonged recovery.

  • Make sure mom has help with baby, either from husband, friends, or family!

What mom can start doing:

  • In addition to the above, mom can go on longer walks.

From 2 Weeks –  6 weeks, recovery continues at a rapid pace.

The body’s ability to make a human being and then be able to recover quickly is supernatural!

What mom can start doing:

  • In addition to the above, mom can start passively activating the TVAs during exhale breathing, and begin supporting her everyday activities again using the tvas.
  • Still keep the lats and arms and pelvic floor doing most of the support.

6 Weeks to 6 Months

  • It is a misconception that women can go back to their regular workouts pre pregnancy at only 6 weeks postpartum.

    Client Rachel at 3 months postpartum after a C-section.
  • It took the body about 10 months to make this child. It will take the body at leastthis long to completely recover. 

What mom can start doing:

  • With doctor’s clearance, mom can start modified Pilates sessions
  • Brisk Walking

6 Months to 2 Years

  • According to Tom Meyer’s of Anatomy Trains, and the expert on fascia, it takes connective tissue 6 -24 month to regenerate itself. 

What mom can start doing:

  • Pilates training should be focused around conditioning the facia through stretching and dynamic sessions, in addition to muscular strength and endurance.

Thank you for taking the time to learn more about this special population!

Please leave questions or comments! And Share if you found this helpful!


Tom Meyers’ Fascial Fitness tips:

C-Section Procedure

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