Exercise After C-Section: Everything You Want to Know
March 18, 2020
You welcome your child into the world and spend your first few weeks together bonding around the clock. But once you slowly start to get back to your routine (or a revised version of your routine, #helloparenthood!) one of the things you may be wondering about—perhaps even craving—is exercise. But when is it safe to start exercising again?
Perhaps unsurprisingly, that question is a lot more complicated if you underwent a cesarean section during childbirth. While c-sections may happen every day, they count as a major surgery. And surgical wounds need time to heal.
Still, that doesn’t mean you have to give up exercise after c-section. It just means that you have to be a little patient with how long you should wait and what you can do. Read on for the best types of exercise after c-section, exercises to avoid after c-section and, most importantly, how to know when you’re body is ready for it all.
If you’re wondering, “when can I exercise after c-section?,” take heart: You won’t have to wait too long. “A c-section is an abdominal surgery, so six weeks is the minimum you should wait,” says Nazneen Vasi, PT, a physical therapist and owner of Body Harmony Physical Therapy in New York City.
But just because you’ve hit the six-week mark doesn’t necessarily mean you’re ready to resume exercise after c-section. “It’s imperative to go to the OB and get an okay prior to commencing physical therapy or exercise," she says, "because there can be complications, including slow healing at the incision site or an infection.”
After six weeks, if you get your doctor’s approval and you’re feeling good, Marianne Ryan, a New York City-based physical therapist and author of the book Baby Bod: Turn Flab to Fab in 12 Weeks Flat, suggests assessing your strength with the Straight Leg Raise Test.
To do this, you must be lying down with both legs straight out. Gradually lift one leg, making sure to keep your back flat on the floor. If you feel pain while raising the leg—specifically in the region of the incision—it’s too soon to start exercising. You can repeat the test weekly until you feel no pain, at which point, you can start gentle exercises (see more on that below).
Both Ryan and Vasi suggest seeing a physical therapist who can help guide your way. “A PT can assess the abdominal and pelvic muscle tone and strength, and offer guidance about proper techniques,” Vasi tells The Bump.
Walking after c-section? Running after c-section? Planks after c-section? No sweat—just give it a minute.
Vasi says that in her opinion, a healthy woman with no complications can generally start running, swimming and doing yoga six weeks after surgery. Ryan, however, believes that to ensure the health of one’s pelvic floor, it’s better to wait a full three months.
The fact of the matter is, every woman heals at a different rate, so it’s best to assess how much pain you’re feeling at the site of the c-section incision. One way to tell if you’re fully healed, according to Ryan: The Jumping Test. Standing with a full bladder and feet shoulder-width apart, jump up and down 20 times, then cough five times. If you don’t leak any urine or feel any pain, then you should be ready to gradually return to more vigorous sports.
But before any of that happens, you should start with low-pressure fitness, specifically for the muscles of the abdominal wall. (That’s where the tightening up comes in!) Vasi also recommends Gyrotonics, a series of gentle exercises using dials, pulleys and weights that’s said to promote a quicker recovery after childbirth.
The moral of the story: You’ll be able to return to your favorite exercises soon. You just need to give yourself the time to heal properly—your body will thank you in the long run!
And if you simply aren’t sure, ask for professional help. “I would advise consulting with a PT trained in women’s health to assess the muscles and plan an exercise protocol for the patient tailored to her needs and physical status,” says Vasi.
As for what exercises to avoid after a c-section? Crunches and curl-ups top the list, Vasi says. She explains that while they’re not unsafe per se, she would avoid them all the same, especially if a woman has diastasis recti (when the large abdominal muscles separate). Women with abdominal separation should absolutely consult a physical therapist before post-op exercising.
Vasi also notes that you should avoid running if you have incontinence or organ prolapse. If you’re dealing with either, a physical therapist can advise when and how you can get back into running.
Avoid doing full planks (with the legs straight) right after delivery. Instead, try starting with half planks, with the knees bent first. Why? “It’s rare that I see people doing them correctly—including athletes!” she says. And done incorrectly, they can do more harm than good.
And now for the question on all of your minds: What’s the quickest way to flatten a tummy after having a c-section? Ryan recommends the following four exercises:
• The Bridge. Lay on your back with your knees bent and your heels up (toes aimed toward the ceiling). Then raise your pelvis so your shoulders, hips and knees are aligned. Pulse your pelvis five times before returning to the mat.
• The Tabletop. Begin on all fours and turn your hands in toward each other. Keep your hips over your knees and your shoulders over your hands. Bend your elbows slightly, tuck your chin in a bit and move your body forward so your breasts are over your hands. Then take a deep breath in so your ribcage expands laterally. Exhale. Hold this position for 15 seconds. You want to work your way up until you can do 30-second intervals, twice in a row.
• Slide-Leg Glides. Start by lying on your side with a pillow under your head for support. You want your entire spine, from your head down to your buttocks, in a straight line. Make a fist with your upper hand and press it into the floor in front of your tummy. Roll your hips forward a bit so they are stacked on top of each other. Bend your bottom leg so your knee is at a 90-degree angle. Lift your top leg up to hip height, and glide your leg forward and then back into a straight line with your body. Repeat this 15 times with each leg for one set.
• Knee Touchdowns. Start this move in the same position as the side-leg glides; on your side with your knees at a 90-degree angle. Then lift the foot of your upper leg so it’s facing toward the ceiling. Keeping your knee bent, bring your knee down and slightly forward so you can touch the floor with your knee, then extend that leg back up until it’s aligned with your body and above your hip. Repeat this 10 times with each leg.
Of course, Ryan points out that all of these are useless if your form is off. You need to be properly aligned, breathing correctly and engaging your core, which should feel as if your lower tummy is gently stiffening (without forcing it!). That’s what will flatten your tummy and strengthen your body postpartum.
To see Ryan in action and working with a patient on these exercises, you can watch this video.
Updated March 2020
Nazneen Vasi, PT, DPT, PRPC, is a physical therapist and owner of Body Harmony Physical Therapy in New York City, with a focus on prenatal and postpartum care for women. She received her PT degree with a concentration in neurology from the Krannert School of Physical Therapy, Indianapolis in 2005.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.