The Importance of Physical Therapy after a C-Section

About 1/3 of women deliver via c-section in America and the majority of them don’t receive the support they need postpartum to recover well. A c-section is major abdominal surgery that requires a surgeon to cut through 7 layers of tissue to take the baby out before stitching them back up together again. A c-section is also the only surgery that requires you to take care of a brand new human (that also just went through a traumatic event of their own – being taken out of the nice cozy uterus) immediately after surgery. While most orthopedic surgeries (knee, shoulder, ankle, etc) are followed by rest, multiple follow-up appointments by the surgeon, and months of rehab, most c-sections are followed by discharge after a 3 day hospital stay followed up by one 6-week visit where an OB clears the mother for all activities in a visit that typically lasts around 15 minutes.

Two of the 7 layers that are cut through during a c-section are fascia and muscle. Any time either muscle or fascia is cut through, both that muscle and surrounding structures are often affected by the trauma (yes, even a controlled incision is trauma) to the tissue.

Fascia is a sheath of connective tissue that covers all of the muscles in your body and connects your muscles together via slings. The anterior oblique sling connects the oblique muscles of the abdomen to the adductors and helps provide stability to the front of the pelvis and aids in rotational movements (think rocking a baby or throwing a ball). When this fascia is disrupted our body naturally heals itself by producing scar tissue. Often times, this scar tissue adheres to the muscles it is covering and then the fascia can no longer glide the way it ought to. This can cause both pain and decreased muscle performance. One way that physical therapy can help c-section recovery is with scar mobility, restoring the fascia’s natural glide over the muscles to normalize, allowing for anterior oblique sling to work more efficiently.

Research shows that women who deliver via cesarean have a higher prevalence of diastasis (compared to pelvic organ prolapse being more prevalent following a vaginal delivery). Diastasis recti is typically considered an abdominal separation that doesn’t resolve postpartum. When evaluating for a diastasis, both the width and depth of the separation should be accounted for. Just as there are fascial connections between the obliques and adductors, there are also fascial connections between the transverse abdominus (deepest core muscle) and pelvic floor. A deep diastasis is indicative that the transverse abdominus is not able to accept and transfer load well, and because of the fascial connections, can affect your pelvic floor as well leading to pain, heaviness, or leaking down the road.

As you can see, a lot of structures are involved in a cesarean delivery that require adequate time to rest, recover, and reconnect with your both your core and pelvic floor well beyond 6 weeks postpartum.

If you had a c-section and want to take charge of your recovery, our Raise with Strength – Early Postpartum Program is the perfect way to start from the comfort of your own home. Get you 7-day free trial when you SUBSCRIBE today.