Hi Mary-
I’m having trouble feeling my lower abs after my C-section 11 weeks ago. Are there any exercises you can teach me to help me feel my lower abs?
Let me reassure you: it’s really common to lose sensation or connection to your lower abs after a C-section.
A C-section is a major abdominal surgery. Major abdominal surgery can decrease the strength and function of your abdominal muscles. In other words, it’s likely your lower abs are weak. Additionally, the procedure can disrupt your brain/body connection, which can result in numbness or lack of sensation in the abdominal muscles.
You CAN restore the strength of your lower abdominal muscles. You CAN restore sensation and your brain-body connection to this area. Here’s how:
1. Massage your scar
Scars don’t just affect the outside of your body, they also affect the inside. Scar tissue forms on the inside of your body, and this scar tissue can create adhesions in the layers of surrounding tissue. In other words, two tissues that were once separate are glued to one another. These sticky spots can prevent the tissue and surrounding muscles from moving well.
Once you are cleared by your healthcare provider (around 6 weeks), you can start to work on restoring the gliding motion of these tissues by massaging your incision site. Here are two great videos to help you get started:
This might be difficult. It can be uncomfortable. You might not feel anything- numbness is normal. You might have negative feelings associated with your scar. You can start by looking at it, or gently placing your hands on the incision site and sending your body gratitude. When you are ready, you can progress. Be consistent- it takes a long time for tissue to remodel.
2. Work on 360 degree breathing
Pregnancy disrupts normal breathing patterns. The more your baby grows, the more your baby pushes up on your diaphragm, which disrupts your ability to get a good inhale. When you don’t get a good inhale down into the bottom of your pelvis, it limits the ability of your abdominal muscles to contract, especially the lower abs. Muscles have to fully lengthen in order to fully contract. A shallow inhale doesn’t allow your lower abs or pelvic floor to lengthen, which means you won’t get a good contraction.
The key to getting your lower abs firing again is reestablishing your breathing. Your breath doesn’t go back to normal just because you delivered your baby. You have to work on it.
To get a good inhale, visualize sending your breath all the way down to the bottom of your pelvis. As your breath moves down, allow the entire circumference of your ribs to expand. Most of us are good at expanding the front ribs, but most of us get very little side and/or back rib expansion. If you can’t tell if your breath is moving your ribs, put a hand on them and feel it.
As you exhale, your belly, ribs and chest should soften- in that order.
One of my favorite ways to work on this is side-lying breath.
It takes time and consistency to reestablish good breathing patterns. Pick something you do multiple times a day, like feeding your baby or rocking your baby to sleep, and use that as a time to practice your breathing. I suggest 5-10 breaths.
3. Learn to contract from the bottom up
Most of us don’t contract our abs correctly. We push from the top down, or, we suck our belly in. Both are poor strategies for recruiting your lower abs, and can create abdominal dysfunction.
A good abdominal contraction starts with a good inhale- which is why you need to work on your breathing first. On your exhale, lift your pelvic floor and gather your abdominal muscles toward your midline. It’s like zipping up a pair of pants.
When you contract from the bottom up, you get your lower transverse, internal obliques and lower rectus firing- hello, low abs! Nice to meet you! It can be helpful to add a sound to your exhale, like “ha” or blowing the air out of your lips like you were blowing through a straw.
Then, you can add this to your strengthening exercises, like when you are tilting your pelvis back in a pelvic tilt, lifting your hips into Bridge Pose, or Dead Bug regressions.
Please don’t lift your pelvic floor and contract your abs with every exhale. That’s not healthy for your abs or pelvic floor, either. Use it during hard movements, like picking up your baby, or when you need to stabilize your trunk in a movement like Bird/Dog.
It’s NEVER too late to work on this. Even if your C-section was ten, fifteen or twenty years ago, following these steps will help you find your strength again. If you’re struggling with any of these steps, call a pelvic floor therapist and make an appointment.
If you have had a baby in the last five years, and are struggling to connect to your abdominal muscles, Yoga for Moms with New Babies is the program for you. The next series is all about your core. We start June 15th, and spots are filling up quickly. Click here to sign up.
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