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Cesarean Section and Your Core

April is C-section Awareness Month.

  • Do you have discomfort at your c-section scar?

  • Do you feel disconnected to your core since your c-section?

  • Have you noticed a change in bowel or bladder habits since your c-section?

  • Have you had difficulty exercising after your c-section?

  • Have you noticed hip, back or pelvic floor pain since your c-section?

  • Have you wondered why you have pelvic floor problems without a vaginal delivery?

Postpartum pelvic floor rehabilitation is a big part of what we do at Healthy Core and healing from a c-section is often overlooked. At Healthy Core, we ask these questions during our evaluation, regardless of how many years have passed. Many times we see women with pain and dysfunction related to a former pregnancy or surgery. After visiting our clinic, women become empowered in their healing potential and learn lifelong strategies and exercises to prevent future problems.

C-section is short for cesarean section, and is the delivery of a baby through an incision in the mother’s abdomen and uterus. According to the most recent Obstetric Care Consensus from the American College of Obstetrics and Gynecology (ACOG), roughly 1 out of 3 women give birth by c-section. For many women, c-section isn’t a choice; it is the only safe way to deliver their baby but often requires a longer healing period and has more potential risks. During a c-section, the lower abdominal wall fascia is separated and stretched at the midline to allow access to the uterus. After the baby is birthed, the endopelvic fascia is repaired. Unfortunately, most postpartum women are not given much information regarding the healing of their incision beyond general wound care. Since fascia is under neurological control, the brain sends messages to contract and protect the organs and underlying tissues, thus contributing to adhesions.

Whenever an incision is made, a scar forms as part of the natural healing process. The healing time for wound closure takes 6-8 weeks. The body creates scar tissue from collagen, a fibrous protein. Scar tissue is not only what you see at the surface, but it can extend into the deeper layers below the skin and fascia, down to muscle, organs and sometimes bones. When the scar extends to these deeper layers, adhesions may form. Adhesions may cause:

  • Pain and sensitivity at and around the scar or remote areas caused by nerve irritation and decreased blood flow

  • Reduced mobility and difficulty standing up straight due to fascial restrictions (adhesions)

  • Constipation or irritable bowel due to decrease organ mobility, causing a swollen or bloated abdomen

  • Myofascial pain/muscle guarding in the abdominals, diaphragm, pelvic floor and even the jaw

  • Nausea, sometimes persisting for years

  • Disruption of the pelvic core piston function, causing core weakness and hip weakness and/or stiffness

  • Urinary urgency, increased frequency (including nighttime voiding) and/or urinary incontinence

  • Pain with sexual intercourse or altered sensation with intimacy

At Healthy Core, we are specialists in Pelvic Floor PT. Our assessment of a mom post c-section includes scar mobility (once the incision is closed), muscle and fascial restrictions, diastasis recti, rib and pelvic alignment, posture, strength and body mobility. Our treatment includes education in scar massage and manual therapy to change the sensory input to the brain in order to improve the motor output. Manual therapy at our clinic can includes visceral mobilization (myofascial release of deep abdominal fascia), cupping therapy, dry needling and mobilization of joints and muscles. Individualized exercise prescription is necessary to address mobility and strength/coordination deficits and to achieve your specific mobility goals, whether it be standing without pain, taking care of your family and home or returning to high intensity exercise.

If you have questions, we are here to help you restore your core, no matter how much time has passed! Click here for more information on exercising your core after baby.

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