Today’s question comes from a c-section mom:  How do I get my tummy muscles back after having a c-section over 4 years ago?

C-sections are so commonplace now, that as a society, we almost forget that it’s major abdominal surgery! While most often the stomach muscles aren’t actually cut during a c-section, they are pulled apart for entry into the uterus. Whenever a muscle is injured, it needs to time to heal. Unfortunately, that healing doesn’t always mean that things go back to the way they were before the injury. This can lead to numbness, a build up a scar tissue, and even herniation at the incision site. All of this on top of the fact that your muscles and ligaments were just stretched to capacity during pregnancy.

This leads many to believe that it’s impossible to regain your core strength after a c-section. Not true! It may take a little more time and a little more effort, but it is certainly possible. First things first, whether you had your c-section two months ago or two years ago, you need to regain connection to the deep core muscles. If you’re still experiencing numbness, it will be a little more difficult, but still possible. Two exercises to begin with are:

  1. Focus on drawing the lower abdomen in and up. This is a transverse abdominal contraction and is great for reconnecting with your core. If you can’t feel the lower abdomen, visualize drawing the lower abdomen in and up while placing a hand on your stomach. Feel your lower abs contract beneath your hand (even if you can’t feel them drawing in on the stomach). The more you’re able to visualize, the more your brain will begin to reconnect with these muscles.
  1. Begin to reconnect with your pelvic floor muscles. The transverse abdominal (deep abdominal muscles) and pelvic floor muscles work together for optimal core functioning. Similar to a kegel, draw the pelvic floor muscles up and hold for 2 seconds before releasing. If you can’t feel this muscle contract, again, visualize it.

Once you’ve begun to regain a connection with your core muscles, you can slowly progress to more intense core exercises. But take it very slow before progressing to exercises such as planks, sit-ups, yoga backbends, or anything that places intense pressure on the abdomen. This intense pressure before your core is functioning properly can cause more harm than good!

So what core exercises are there besides sit-ups, planks, and those that place pressure on the abdomen? There are many available to you! Think back-lying or semi-upright exercises with lower back support.   You could research them or I’d be happy to help you. Also, keep in mind; the core is a group of muscles that work synergistically. It’s not all about the belly. A complete program may also need to include the glutes and back muscles for optimal functioning.

A c-section incision is a very deep incision. As the layers of tissue heal from the inside out, the scar tissue may fuse together causing the area to be extremely tight and hard. This can slow blood supply and oxygen to the area resulting in numbness. Something that I’ve also found really helpful with regaining some sensation in the lower abdomen after a c-section is scar massage therapy. This doesn’t always bring sensation back to the area, but it has worked for many women. You can do this yourself or find a physical therapist/chiropractor (or someone else) that is trained in the Graston Technique.

How do I do scar self-massage or what is the Graston TechniqueScar self-massage involves placing pressure on the incision site and gently massaging in a circular pattern from the edges towards the middle (warning: don’t do this until after the incision site has completely healed!). You have to place a fair amount of pressure on the area because you’re trying to break up the scar tissue. The Graston Technique is very similar where the practitioner uses the assistance of specialized tools to massage the area and break up the scar tissue.   Keep in mind this should not be painful, perhaps a little uncomfortable, but never painful.

One final note on regaining your core after a c-section is nutrition. Usually a poor diet will catch up with you in your mid-section, if not anywhere else. You’ll be able to improve muscle tone through exercise, but a poor diet will keep you from obtaining that totally flat stomach (if that’s what you’re hoping for).

P.S.  If you had your c-section more recently, check out the C-Panty.  It was a lifesaver for me during the healing process.