C-Section Recovery - What They Haven’t Told You
Did you know that c-section birth rates are on the rise, accounting for 1 in 5 of all childbirths? Per the World Health Organization (WHO), this is likely to continue to increase, projecting nearly ⅓ of all births to take place via c-section by 2030. There is currently support for a patient in the hospital setting to manage initial recovery from a c-section, but what happens after you are discharged? Most women only have one follow up at 6 weeks postpartum and we would argue that this is not enough support following a major surgery! In this blog, you will learn how a pelvic floor physical therapist can further assist you in your recovery!
Improving Core Connection
Your abdominal wall stretches as your baby grows in the uterus during pregnancy, even greater changes can occur to your abdominal wall if your baby is brought into the world via a c-section. With this surgery, there are 7 layers of tissues that are either stretched or cut through that will need time to recover and heal. These stressors to your abdominal muscles reduce their ability to turn on in the post-partum stage which affects their ability to manage pressure, stabilize the trunk and assist with movement.
Tip: working with a pelvic health physical therapist post c-section is helpful to reduce any restrictions in the tissues affecting the ability of the abdominal muscles to engage. We can also guide you through an individualized program to prepare your body for the demands of newborn/toddler care, return to higher level exercise and complete daily living tasks that involve carrying or lifting.
Are Your Nerves Affected?
Following a c-section we expect a certain amount of discomfort in the initial healing stages, but if the pain continues after 6 weeks following your delivery, it is time to seek medical attention. One reason you could have lingering pain, burning, itching or numbness around the incision is nerve damage. The most common incision type for a c-section is the low transverse incision, in simple terms - along your “bikini line”. There are 4 main nerves that could be affected by this incision leading to the symptoms described above.
Tip: in pelvic floor physical therapy we would usually recommend a technique called desensitization. This is when we slowly integrate touch, pressure and movement to the surgical site to reduce nerve sensitivity. Connecting with a local pelvic health physical therapist would be encouraged to assess and teach you these strategies!
Below is a picture of our c-section scar skit where we would progress through different textures to improve the sensation around your scar!
What about Inflammation?
Inflammation is when the body sends out certain cells to fight infection or injury. This is an important part of the healing process to close the incision at your c-section site. Post c-section, you may also notice more swelling if you required IV fluids during your delivery. To help reduce swelling, improve blood flow and support postpartum pain, we recommend wearing a postpartum compression support that has shorts and abdominal coverage to provide equal pressure throughout the pelvic region!
Tip: a pelvic health physical therapist can also complete gentle lymph drainage techniques to encourage drainage of excess fluid and bring oxygen and nutrients to tissues that will assist in the healing process!
Scar Tissue Creates a Sticky Environment
There is a really great benefit to scar tissue as it is the body’s natural response to heal injured tissues. However, the problem with scar tissue is that it lacks flexibility and circulation and can create a band of tissues which we call an adhesion. This band of thick, inflexible tissues attaches from one surface inside the body to another surface.
Think of when you made a craft project with glue and applied too much, the end result usually leads to the glue spilling over - sometimes attaching to the table or other craft items, leaving everything stuck together. This is what scar tissue does in the body, it will not only close the incision but also binds onto muscles, fascia, organs and nerves.
Get Rid of the “Shelf”
If you have a lingering lower abdominal “shelf” from your c-section it is likely related to scar tissue and adhesions mentioned above. These restricted tissues are never too late to work on! In pelvic floor physical therapy we have many strategies to help improve mobility of the restricted tissues to reduce the appearance of a shelf. This includes hands on manual techniques, dry needling, cupping, targeted exercises and breath patterns.
Tip: Not only can a pelvic floor dysfunction physical therapist change the appearance of the abdominal wall, but If you are struggling with other symptoms such as leakage, bladder urgency/frequency, back pain, or difficulty turning on your core muscles, you will likely see an improvement in these symptoms after hands-on treatment!
There are so many strategies to help support healing and full recovery from a c-section. A pelvic floor physical therapist is a great health practitioner to add into your recovery plan. We have specific training for the post-partum healing process to address any lingering symptoms, improve mobility and strength and help you meet your overall goals! Contact us today to book a consultation to see how we can help you recover after your c-section!
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