After my C section, I lost all strength in my body and I found it particularly difficult to get up from lying down and had to perform the 'log roll' technique to get up out of bed for quite a few months. This makes it particularly challenging when baby wakes crying and you need to feed, it just adds to your body aches and pains.

One of my main aims is to empower women to know more about their post natal recovering bodies so that you know how to heal from the inside out. The scar may look fine on the outside but there are many layers they have had to cut through to get the baby out. So, why not know what its all about and you might find it helps you understand how and why you need to heal properly before starting to run again or doing whatever other form of exercise you love.

So..How do Scars Form?

When we have a wound that needs to heal, our body does something amazing … it lays down new protein fibres to knit the wound together. This protein is called collagen. While these new fibers are regenerating, the uneven distribution of collagen cells is often chaotic and forms itself in a messy fashion. If left untreated, a thicker, more dense and fibrous tissue can form a scar tissue or so called adhesions. Unfortunately these can sometimes bind to nearby tissues and it can result in a pulling sensation or sometimes even a ‘trapped', restrictive feeling. Adhesions can also be a source of digestive / bowel problems, incontinence, lower back pain and sometimes even infertility. It is estimated that 93% of people develop adhesions in response to the trauma of abdominal surgery.

Once we are ‘healed’ there is a visual reminder in the form of a scar. There are four stages of wound healing: hemostasis, inflammation, proliferation and maturation. In brief:

• Hemostatis phase
  This is when the wound begins to close by clotting (think scab forming).

• Inflammatory phase
  This is when the blood vessels leak something called transudate which is made of water, salt and protein) and causes localised swelling, which both controls bleeding and prevents further infection. I’m pretty sure this is what we refer to as the wound ‘weeping’ or pus.
• Proliferative phase
  This is when the wound is rebuilt with new tissue made up of collagen and extracellular matrix, it’s also when things start to feel a bit tight and pucker up a little because the wound contracts as the new tissues are built and pulls things together. Perhaps the most important aspect of this phase is the laying down of new blood vessels so that the new tissue can be healthy and receive the oxygen and nutrients required.
• Maturation phase (aka remodeling stage)
  This is when the wound fully closes, and the ‘repair’ cells are no longer needed.

The primary aim of scar massage is to promote the alignment of collagen fibres (‘break’ the adhesions and help them to form in a ‘less messy’ way) which are laid down as part of the healing process and also the development of more supple scar tissue which will allow for movement. This benefit will not be as visibly obvious as the texture and the appearance of the actual scar, but will certainly be a ‘felt’ benefit as these adhesions are ‘tidied up’.

A C-Section results in major abdominal surgery. Whether it was an elective or emergency C-Section, the recovery is much tougher than of a vaginal delivery. Its really important you do start moving as soon as you feel comfortable and starting with a gentle walk for 10mins around your room or corridor.

In those first few weeks its important to rest and focus on your little one and your recovery.

1. Move as much as you can to help improve blood flow which can help speed up your recovery
2. Avoid lifting or carrying anything heavy
3. Drink plenty of fluid
4. Once the scar and stitches have healed you can start gentle abdominal massage
5. If you need to cough or laugh, place a pillow on your tummy and press firmly whilst coughing or laughing to ease any discomfort

During your 0-10 weeks recovery, some of you may want to start your healing journey and here are a few things you can start to focus on until you are given the all clear from your GP or midwife to start exercising.

1. Breathing
2. C-section and DR Abdominal Massage
3. Integration on breathe, PF and TVA activation during functional day to day demanding exercises
4. Nutrition - hydration, increased protein intake and anti-inflammatory foods will be a must for supporting your recovery.

Please join me for my Post Natal Self Care Class on Saturdays 10.15-10.45am. (please email me Angela.jameson@physically-fit.co.uk, as dates change) Its free and the focus is to improve your knowledge about your post natal recovery and a chance to ask any questions you might have about getting started into an exercise programme. It will also be a chance to meet other mums who are recovering so you don't feel alone in the process.

We take over 20,000 breaths a day and the breath is one of the primary restorative influencers in post-natal core recovery. For many post-natal ladies we need to re-learn how to breathe the right way as the rigours of pregnancy and delivery can cause a mis-firing of these muscles in the right order. Faulty breathing can totally hinder your healing of the pelvic floor and diastasis. This is where stretching and massage can really help to release tight areas/muscles so that you can be re-aligned for function and ready to ‘exercise’ again.

How to breathe correctly

1. Lying supine on your back with one hand on belly and the other hand on the side of your ribcage

2. Breathe into your belly and into the side of the ribcage

3. Feel belly lift and feel ribcage expand wide

4. As you breathe out, feel belly soften down and ribcage draw in and down

5. Breathe out through your lips to deepen this connection and to help aid the pelvic floor engagement during this breathing

6. Once you have mastered this you can move onto movement based exercises

What to stretch?

Hip flexors, chest, neck, Lower back to start with a few.

Get into good alignment!

Have a tall upper body, growing through
the crown of your head

Weight even through your fee

Stack your ribcage over your pelvis

Feel that your shoulder blades are softening down towards your back pockets

Feel your collar bones are wide like they are smiling at you

Think of ears, middle of shoulders, middle of hips and middle of knees and ankles are in a vertical line

So now with a more functional breathe pattern, released muscles that were tight from carrying baby, and from the rigours of delivery you can then align your pelvis and body correctly ready for the next phase of your post-natal rehabilitation, body weight loading…..