For new mothers who delivered via cesarean section (C-section), core strength takes on a whole new meaning. Instead of planks and crunches, abdominal work involves being able to sit, stand, and move without pain or discomfort. This type of surgery is not only hard on your pelvic floor and abs, but also requires a bit more recovery time in order to heal properly and avoid complications, such as diastasis recti. Our experts explain how long to wait before working out, what core workouts should be avoided entirely, and ways to safely strengthen your core after a C-section.
When can I exercise after a C-section?
“In the majority of cases, women need a minimum of eight weeks before they are cleared by their medical professional to start an exercise program after a C-section,” states Laura Arndt, certified pre- and post-natal exercise specialist, and CEO of Matriarc, a health and wellness company for post-delivery mind and body. “However, every pregnancy and delivery is unique and should be treated as such. Once you are cleared, you can begin low impact pelvic floor and core work. Pay attention to your body and listen to cues. Just because you are cleared to exercise does not mean [that] you are necessarily ready.”
In the same way that you’d take plenty of time to recover, rehab, and heal after any other major surgery (such as getting your ACL repaired), it’s critical to use a similar approach toward a C-section, advises Personal Trainer Chris Cooper. Patience is key, adds Aaptiv trainer Rochelle Moncourtois. Don’t rush into performing core exercises within the first six to eight weeks. If you’re feeling antsy during the postpartum period, Aaptiv trainer Candice Cunningham recommends light activity, such as walking. Or, work with a specialist for specific pelvic floor exercises starting around six weeks postpartum, adds Lyndsay Hirst, a physiotherapist who teaches clinical pilates.
“While many moms get cleared by their doctor for exercise after six weeks, in my own body, I found that I needed eight weeks to get back into an actual workout—and I do this for a living!” says Amy Jordan, CEO of WundaBar Pilates and a mother of two. “Because the abdominal muscles are cut, the healing and scar tissue can cause numbness and general loss of feeling in your lower abdomen. But, stay the course. In about a year, it’s back to a relatively normal state of being, except on the scar line.”
Are there any core exercises that I should avoid completely?
“Avoid sit-ups, twisting movements, and push-ups on flat ground in the first six weeks after starting to work out again,” says Cunningham. “You have to wait until your core is healed. I never advise crunches or planks until I can see no clear sign of diastasis recti or any pressure on the abdomen when doing core work. This can be anywhere from eight to 12 weeks after being cleared to work out from your doctor. Everything except twisting movements can be done elevated, and then progress to the ground as your core strengthens. But in the beginning, it’s advised not to so that nothing is damaged long term.”
Other core exercises to avoid during the first six months of your postpartum recovery:
- Twisting or crunching movements that put strain on abdominal tissues
- Lifting heavy objects, such as overhead presses
- Leg raises
- Sit-ups, especially from a supine position
Instead, says Moncourtois, let your body get its strength back and completely heal first. It’s understandably tempting to want to strengthen your core after a C-section and “get your abs back,” notes Jordan. However, he adds that curling the front of your body only encourages further separation of the abs and won’t help you fully recover.
“You need to build your core stability and control up before progressing to more challenging exercises,” says Hirst. “Strength needs to be developed from the inside out.”
What are some safe core exercises that I can do after a C-section?
“Start with static activation of the transverse abdominus, the deepest tummy muscle,” says Jordan. “The best way to practice this is to lay on your back with your knees bent, spine in a neutral position, and draw the area between your tummy button and pubic bone towards your spine without moving your back. Then, challenge your core stability with control-based exercises, such as a hip twist. In the same position as described above, keep your pelvis level and slowly drop one knee away from the other and back. Repeat on both sides. This will start to activate other areas of the abdominals without putting too much pressure on the scar.”
Cunningham recommends two specific core exercises, called “dead bugs” and alternate toe taps. For the first one, lay on your back and bend your knees over your hips. Shoulders stay off the ground with hands pressing into your thighs and arms locked out. Hold and plant your lower back into the ground, then breathe deeply to engage your deep inner core muscles. With the second one, lay on your back with knees bent and stacked over hips. Alternate taking one toe to the ground while focusing on keeping your back flat and pulling in from the lower part of your core to bring your leg back up.
Additional suggestions from Moncourtois, Arndt, and Jordan include:
- Modified side planks or planks from knees
- Inverted rows
- Bodyweight squats and/or lunges
- Resistance band movements
- Pelvic tilts
“Bridges are a great way to get started. Even though it looks like a leg exercise, the length on all sides of your waistline during the lift and lower engages your deep abdominals and encourages the abs to knit back up,” says Jordan.
Positional Breathing Exercises
Cooper also suggests positional breathing exercises to practice regaining proper movement of your diaphragm. Aaptiv trainer Jaime McFaden echoes this as a great exercise to rehab your core and strengthen your abdominal wall. McFaden explains how to do it: Start on your back and relax your body on the floor. Take a big breath in through the nose and expand all sides of the body. Hold the breath for three seconds, and then slowly release as you draw your belly towards the floor and contract your abdominal muscles. Perform this exercise for one to two minutes daily to strengthen your deep core muscles.
Two more ways to strengthen your core after a C-section: Wall sits and heel slides. These are both ideal body toning exercises that can be done every day.
“Stand one to two feet away from the wall. Bend your knees and press back against the wall to come to a position as if you are sitting in a chair. Knees are at a 90-degree angle. Inhale, and as you exhale, draw your tummy towards the wall. Repeat this for 30-60 seconds,” says McFaden.
“Lay on your back and bend your knees, pressing your feet into the floor (using socks or a towel under feet will help to slide your heels). Inhale and slightly elevate your hips off the ground (to modify, keep your hips on the ground). Exhale and push one heel away from your body. Inhale and slowly drag your heel back to starting position. Do ten on each side. Focus on your breath and pulling your belly button towards your spine without changing the shape of your spine as you breathe.”
What is the most important thing for postpartum moms to keep in mind about core strength?
Let your body completely heal, and then prioritize rebuilding your pelvic floor with low-impact exercises, says Moncourtois. And, be patient, because if you want your core to heal correctly, it is going to take time. Even though a slow approach may not be what you’re looking for, says Cooper, it’s the approach that you’ll need for long-term health.
“Jumping into workouts like you did before pregnancy or HIIT-style stuff will only make things worse because you could potentially make a diastasis worse if you have it or impair your pelvis,” says Cunningham.
Similar to pregnancy, listen to your body, encourages McFaden. “Remember, it takes almost a year to grow your baby, so give your body time to recover. Even if your scar has healed on top of your skin, you still have lots [of] healing [to go] under the skin. So be kind to yourself and don’t rush into any exercise routine too fast. Show your body love and embrace the changes that your body has gone through to have your precious baby.”