Post C-section recovery

[DeriHughes]

Rip,

I've searched for this but couldn't find much, and asked downstairs but didn't get any detailed advice, so wanted to ask you.

My wife had a c-section to deliver twins on 2nd Sep, 12 days ago. She is already pain free, has walked for 60-90 minutes a day for the last week, and can do a sit up. Her diastasis recti is 1 finger currently, about the same as pre-pregnancy.

She can also do bodyweight squats with no pain, so we don't see much reason for her not to put a bar on her back and start loading (within the limits of pain, and using a belt to manage hernia risk). That said, the standard advice is to wait six weeks before doing anything, so she would be training again very quickly vs that.

I suspect you will say the standard advice is bullshit and she should just crack on if she's not in pain, but wondered if we might be ignoring something important re the internal repairs and risk of rupturing?

She is 35, normally 72kg (currently 89kg, was 102kg at peak pregnancy), and was squatting & pulling c200x5 before she got pregnant. This was her third pregnancy.

Thanks,
Deri.

[Mark Rippetoe]

I'd say that considering her training history, her pregnancy history, and the competence of the BPHS, she's in a much better position to decide when to add a barbell to her pain-free squats than anybody else on the planet.

[Dr.T]

The six week thing comes from pretty good basic science about new collagen formation and its strengthening process and organization. Whether this applies to training, who knows? I can tell you that I can easily pull apart sutured skin with two fingers at 12 days. The collagen is just not there. Pain is not a good indicator of wound strength.

A belt will not manage hernia risk. Hernias in C-sections fascial incisions are fairly common without training. That is your main risk here.

When my wife had surgery recently we started with the bar at 2 (day 14) weeks post op and quickly worked up to about 80% of 5RM over two weeks. More detailed: we divided 80% of her 5RM by six and those six workouts got us to week 4 (day 28), then she built back up to her 5RM by week 6 and was hitting new PR's around day 40-42 postop.

Plastic surgeon here BTW

Take care

[DeriHughes]

The six week thing comes from pretty good basic science about new collagen formation and its strengthening process and organization. Whether this applies to training, who knows? I can tell you that I can easily pull apart sutured skin with two fingers at 12 days. The collagen is just not there. Pain is not a good indicator of wound strength.

This is very helpful, thank you. So basically she could start training but needs to be very careful about re-opening her wound.

A belt will not manage hernia risk. Hernias in C-sections fascial incisions are fairly common without training. That is your main risk here.

Can she do anything to manage this, or is it just a fact of life for her now?

When my wife had surgery recently we started with the bar at 2 (day 14) weeks post op and quickly worked up to about 80% of 5RM over two weeks. More detailed: we divided 80% of her 5RM by six and those six workouts got us to week 4 (day 28), then she built back up to her 5RM by week 6 and was hitting new PR's around day 40-42 postop.

Plastic surgeon here BTW

Take care

This is impressive and gives us some confidence to push on. Was her surgery something that carried the same hernia risk?

Thanks for the input