Core Training Following a C-SectionFebruary 19, 2019
Core training postnatally can be confusing as it is, but adding a C-section delivery into the mix can leave women with even more questions about what core exercises are safe and effective. Here are my ABCs of core training to keep in mind once you’ve been cleared to workout following a C-section (and we also have a safe, OB-approved early postpartum program to ease into the healing process ahead of embracing full activity!).
(A)bdominal separation (also known as diastasis recti). Have your abs separated? The likelihood is high. Most pregnancies result in some degree of separation between the two halves of the rectus abdominis (the 6-pack muscles). And even if you avoided it during pregnancy, a C-section delivery can induce the condition. I’ve worked with many clients who managed to avoid or minimize abdominal separation throughout pregnancy, only to discover that the surgeon literally pulled their abs apart while performing the Caesarean. How do you know if you have it? Watch this self-check video to find out. Some surgeons routinely stitch the lower abs back together after delivering the baby, so be sure to check all three measurement sites. While this might sound desirable, that’s not necessarily the case. I’ve seen women suffer more severe abdominal separation in the upper abs during subsequent pregnancies due to the stitching together of the lower abs… And that surgical “favor” does nothing to eliminate the muffin top. Don’t despair – there is a solution! If you do have abdominal separation in the upper, middle, and/or lower abs, seek out a medically proven exercise program to resolve diastasis recti and restore core strength before you dive into other workouts that could potentially exacerbate it. The last thing you need is weaker abs and a more compromised back. Because what takes the brunt of every core challenge when your abs are separated in the front? That’s right. Your back. And even if your abs have not separated, the targeted and progressive deep core exercises that help resolve diastasis recti are also shown to restore abdominal strength, form, tone, and core function.
(B)eware of barre. “What? But I thought barre was great with all those Pilates-inspired core exercises!” Unfortunately, a majority of the abdominal exercises in barre classes are detrimental to the core post-pregnancy, especially following a C-section. Any moves that lift either your shoulders or both of your legs off the floor from a back-lying position will widen your waistline and hinder core recovery. It’s also important to avoid or modify any exercises that involve tucking the pelvis and maintaining a C-curve. This is very unhealthy for back health and core function. Instead, maintain neutral spine (neither pelvis tucked under, nor butt sticking out) while performing those exercises. And finally, any moves that forcefully bulge the abs forward will cause more harm than good.This could include a variety of different moves and body positions. Be vigilant during class. Keep one hand on the abs when possible, or watch yourself closely in the mirror. Modify or swap in different exercises as needed. At the end of the day, you will likely be safer and more relaxed simply skipping the final 15-20 minutes of class, when they typically slate the abdominal work, and devoting those precious “me time” minutes to safe and progressive core stability exercises that build strength and restore muscle tone without inflicting collateral damage.
(C)urb the crunches, especially the cross-over type. Traditional core exercises such as crunches, reverse crunches and cross-over or bicycle crunches can actually induce abdominal separation in a healthy core (!) — yes, you read that correctly — , and these exercises will worsen diastasis recti if your abs have already separated. Eliminate crunches from your repertoire. Every forward flexion bulges the abs and stresses the spine. You do not need to to crunches or sit-ups of any variety for a healthy, strong or toned core. There are better, safer ways to train all layers of your abdominal muscles, including the transverse abdominis, the rectus abdominis and the obliques. Crunches inflict more harm than good, so you’re officially off the hook on doing crunches from now on.
What can you do to strengthen your abs and improve core function (that means a healthier back, better sex, no more leaking when you sneeze or cough)? Begin by building stability and muscle endurance with deep core exercises that healthfully engage the transverse abdominis, your natural corset, and your pelvic floor. As you get stronger, you can begin to incorporate progressively challenging planks, paying special attention to your breath and correct form. And adding twists to some of these exercises- the deep core activation and twisting or side planks, can ramp up tone and strength in your obliques. As long as you avoid combining twisting with forward flexion, twisting is safe postnatally and when DR is present. You can fully restore your core after a C-section, and even achieve greater strength and confidence than you might have enjoyed before you became a mother.