C-Section Recovery Weeks 2-4

So I was doing great at 2.5 weeks and then a nasty bout of mastitis flared up. The fever came on FAST and by the time I was suspicious of it I was already pretty much laid out. I was able to treat it at home for a few days, until the other side flared up even faster and then I was truly out of commission. My fever was the highest I’ve ever had and my whole body ached. We had a doctors appointment for Rose and thank goodness the doctor looked at me too and prescribed antibiotics right away. After a few more days I started to feel a lot more normal and I’m back on track now! This serves as a healthy reminder that postpartum period is freaking insane and all bets are off for what’s going to come next haha. 

So around 3 weeks post op c section, overall things felt really good. I continued to work on my “treatment exercises”, as well as increased difficulty and variability of my bridging exercises with the goal of squatting full depth for normal reps by about 5 weeks. Some signs I keep an eye out for to see if I’ve pushed it a bit to far are:

-Heaviness in pelvic floor 

-Increased pain along incision 

-The need to rest or be in bed the rest of the day

General rule of rehab I use in clinic is that I’m totally fine with discomfort being in the 0-4/10 range; as long as after a few hours after it has settled back down to baseline and the next day there is no lingering discomfort or a decrease in physical ability. 

My goal is to push the envelope of what I can do everyday, but not blow up the envelope. My main exercise still looks like a 30-45 minute walk each day... It’s the easiest form of exercise to progress by increasing duration/distance. Around week 6 I will focus on increasing intensity (speed walking) and will decrease my duration back down to about 25 minutes and build again from there. That will continue til about 10ish weeks when I will hopefully (fingers crossed) slowly transition into jogging in place/30 second intervals. 

The lower body strength routine I have started to work on through 2.5 weeks til now is a lead up to lunges, deadlifts and squats. I perform heavily modified versions of all of these but it makes me feel a bit more normal. I plan on slowly transitioning back to running and the most important muscle group to keep happy is going to be my calves. Therefore my usual circuit is*:

Kneeling squat 

Kneeling hip hinge 

Mini split squat/lunge

Calf raises 

Clamshell**

*progressions I sometimes use if I had a shorter walk or things feel good:

-Adding a theraband 

-Using Rosie as weight 

**I will be the first to admit I make fun of clamshells and they are not my exercise of choice usually, but the key here is progressive loading. I’m performing all my accessory stuff still either on my back, kneeling, or side laying. This is to take pressure off pelvic floor but also my incision so I can get a decent workout volume in still. Again, push the envelope, don’t blow it up. This cracks me up because in the physio world this last week there was an attack on the clamshell exercise as being pointless, but again, it’s appropriate for where I am at. The glutes perform hip extension and external rotation, so if I’m not using a theraband for my circuit it’s a helpful way to work on another function of the muscle group. 

I think it’s also important to note that when I look at the toll on my body (mental, emotional, physical) for this rehab blog, I’m mostly talking in this space about the physical toll. It’s worth mentioning that there are some days where I have Rosie all day, or I’m cooking and starting to clean etc and as a physiotherapist I know that this is a significant physical load as well. I can’t just count my exercises and walking and then do whatever I like on the side… this is where a lot of patients go wrong, because they overload their body without realizing. Cooking, vacuuming, laundry etc are also loading exercises for me at this point in my recovery. If I know I’m going to be doing a “heavy task day”, I’m barely doing anything beyond an easy 30 minute walk with Willow, and that’s only if I feel up to it. 

If I know I have Caleb’s help, I’m more inclined to push my rehab and walking a little bit more, just in case. This is what I’m very cautious of with this blog- I’ve been exceptionally lucky overall with how I’ve been feeling and having my husbands help. For someone else postpartum, if they have kids they are already looking after, or their husband has gone to work, their rehab and recovery would look exceptionally different to mine. This is why rehab at our clinic is always tailored to the individual and based on milestones that they achieve. 

It’s also really important to me that I touch on the emotional and mental toll of recovery. Again, this applies to any rehab or injury scenario and doesn’t only apply to postpartum. Our bodies can’t always perceive stress or load as strictly physical, mental or emotional. Similar to the scenario I described with daily tasks contributing to overall physical toll on my body, mental and emotional strain count the same. If I have a day where Rosie is more fussy than normal and I’m feeling down, that’s not a day I like to push rehab either. I will do the bare minimum of movement that checks off the “movement and activity” box, but not enough to start to add more strain to my system. If I have a day where I’m writing a blog (like today), reading for a course, or doing a lot of clinic work on the business side of things, that’s enough effort and strain mentally that I won’t push the physical side. 

I hope that makes sense- it really is a huge component of recovery that I see patients struggle with all the time. The day that you remodel your garage, renovate a room, landscape your yard… this is not the best day to try and strengthen or train through your injury, and it can lead to a flare up of symptoms. Daily task loading is still loading. In addition, if I know my patients either: aren’t sleeping, are crazy stressed at work, have had a breakup, or are a single mom responsible for 3 kids, etc… My rehab plan immediately changes. This will look like the physical domain not being pushed as much, and we work on reducing overall strain to their system. Our bodies can’t differentiate between types of stress… being aware of that and the impact of what we are dealing with can make a huge difference for our recovery timeline.