From C-Section to the Ab Wheel: Rebuilding my core strength
I realize this blog post is a little bit niche, but next week I’ll be writing about core strength in a way that will relate to all runners. Stay tuned.
After going through pregnancy and a cesarean delivery my whole abdominal and pelvic area was traumatized (as would be expected right?) Here’s a little background of my process of re-building my core strength.
6 weeks postpartum:
I started PT with a pelvic floor physical therapist. The main focuses at this point were:
prevent scar tissue forming at my incision
reduce muscle tension in the pelvic floor
address urinary incontinence
introduce some light stability exercises (single leg deadlift and “sharkies”).
Toward the end of this 6-week program (3 months postpartum) I had started doing walk/jogs and had resumed weekly pilates sessions. Everything was modified in pilates. I kept taking little steps forward as I felt able to, and completed a half-marathon when my son was 11 months old.
~1 year postpartum:
I was still unable to do a lot of moves in pilates. There was no real rush, but it was concerning that I wasn’t making progress anymore. I couldn’t connect to my lower abs, I would try to engage them but it was like there was nothing there. I was at a standstill, so I went back to PT. A different one this time. This is when I was taught Diaphragmatic breathing (belly breathing). Surprisingly, it was brand new to me and hadn’t been mentioned in my first round of PT.
This is a video… watch carefully
Belly Breathing How-To:
1. Lay down and relax (legs can be flat or knees bent)
2. INHALE: (through nose ideally) and let the air expand your belly from all sides, like a balloon.
I find it helpful to put my hands on my waist and feel the movement. It may be hard to notice in the video, but my thumb is also moving out as I inhale.
3. EXHALE: let your belly sink down. Imagine you’re shrinking the circumference all around your waist.
I was instructed to practice the belly breathing technique and then use it in coordination with Pilates and other exercise too, whenever needed. The hardest part of an exercise should coincide with an exhale. The breathing technique allowed me to turn a corner. Almost right away, I could do a single leg lower and lift which is something I hadn’t been able to do yet. (I would exhale on the lowering AND the lift, inhale in between reps.)
Over the next 2 years I’ve used belly breathing in all my strength training and pilates sessions. I’ve also done belly breathing while running (to manage side cramps) but since I have gotten stronger this is no longer a common occurrence for me.
3 years postpartum:
I can legitimately do the ab wheel again!! (Exhale on the roll out.)
Until recently, there were exercises I didn’t even attempt to do. Challenging core exercises like the ab wheel or TRX body saw had been unthinkable for years. But little by little, with the right instruction and continued effort I’ve gotten stronger and more confident. I can do everything I used to do. It took 2 rounds of PT, weekly pilates, strength work at home, and 3 years of consistency to get here.
What is Possible vs. What is Probable
There are many stories highlighted on social media about women who have children and quickly get back to training and racing at a high level. These stories are impressive and they show what is possible for some people.
But possible doesn’t mean likely, realistic, or appropriate for the majority of recovering new mothers. The comparison trap can be damaging and discouraging, so whenever I see another new mom crushing races with a tiny baby at the finish line, I hope that we can see it as amazing but NOT as the norm.
Get a Second Opinion & Don’t Settle
As with any injury, treatment and recovery requires professional help, and not all providers are equal! I got some help from my first PT, but I eventually hit a plateau and was unwilling to accept my limitations. I actually got an MRI to rule out an abdominal hernia at this point. I didn’t know what was wrong but was determined to figure out my situation. Once that was cleared I tried a new PT who taught me something new that I really needed. It took a long time but was worth it.
Nicole Sifuentes is a full-time Running Coach for adults of all ages and abilities. She is a former professional runner and 2-time Olympian, and Certified Strength and Conditioning Specialist. Read more about her services, and schedule your free coaching consultation.
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