C-Section, Muscle Function, and Fitness Expectations After Childbirth

Ever wondered if C-sections could lead to muscle dysfunction? Do they cut muscles during a C-section or do they not?

This week I answer those questions; I'll talk through the intricasies of C-section procedures, explaining clearly that stomach muscles are not cut but some fascia is sliced to access the uterus. And that the uterus itself is a muscle and that's where some of the confusion tends to come from.

Then I'm talking about muscle dysfunction after C-section childbirth. Take a deep breath, and rest assured, it's not as common as you might think.

The recovery process, much like natural births, is pretty straightforward, barring any labor complications. We'll touch upon the topic of scar tissue possibly affecting muscle function and suggest solutions such as scar tissue massage.

I'm talking about the challenge of juggling motherhood and training while managing expectations of achieving an athlete-like body.
We'll navigate through the dedication, consistency, and rigorous training required to reach the apex of any sport. Comparing oneself to athletes at their physical peak can lead to unrealistic expectations.

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Though I'm not terribly active on  Instagram and Facebook you can follow us there. I am however active on Threads so find me there!

And, of course, you can always find us on our YouTube channel if you like your podcast in video form :)

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Email peter@healthypostnatalbody.com if you have any questions, comments or want to suggest a guest/topic

Playing us out this week "Brand new day" by Ivy Bakes

Transcript

Peter Lap: 0:00

Hey, welcome to the Healthy post natal body podcast o your postnatal expert, Peter Lap. That, as always, would be me. Today I am talking about C-section recovery, specifically in relation to a question I had on via direct message on Instagram, as in have you heard of muscle dysfunction postpartum due to C-section? So we'll go into that a little bit and I am talking about why you will most likely never be able to achieve that full-on professional athlete body. This is coming off the back of someone send me a picture of Katie Taylor and Cameron something or other the boxers a picture of their way, and I posted this on threads the other day. So we'll go into that a little bit as well. So you know it'll be fun, I promise. Here we go. Welcome to the Healthy postnatal body podcast. This is the podcast for the 26th of 2023.

Peter Lap: 1:28

And I hope you're very, very well. You know it's a month till Christmas or something like that I am surrounded by. I've got Lola, I've got Kitty, I've got Bob here. Buddy decided to go snore in another room, which I am grateful for, because it means I'll have less sound suppression to do. I hope you're all tremendously well. I hope you're absolutely crushing it.

Peter Lap: 1:52

What am I doing today I'll make this another quick one because, again, no guest. So you know, I have to fill the time myself and, as always, I do that with questions that have been asked. Now, what about this for a question? So someone sent me an email, a direct message. I suppose you call them on Instagram. Now I don't check Instagram often. This is not the best way to get in touch with me, right, Pe? At healthy postnatalbodycom is much better. So when this lady got in touch with me, it was on the 17th of November, after I did the interview with Ed Paget on his your Life style is your Medicine podcast. She sent me a question "Peter, does the C-section create muscle dysfunction? What I mean is that's not something you can work on after and the damage is done, right? So that's an awesome question, because there is a lot of, there are a lot of misconceptions about C-sections, and so I'll go into that a little bit, because we tend to write two things.

Peter Lap: 3:07

People tend to fall into two camps one, c-sections are horrible and two, c-sections are amazing, and quite often postpartum professionals, postpartum personal trainers and all that sort of stuff tend to say and I do the same C-section is fundamentally, the recovery is fundamentally the same as a natural birth, except that you'll have to give it an extra couple of weeks, two or three weeks. So instead of usual six to eight, where six weeks that you get started up again, you start after eight weeks and technically that is all true and that is all correct and all that sort of thing. From a diet status directly and going back, getting back into exercise perspective. Now obviously you know there are and that's when I say that I mean that for on for birth, without any complications. So other than having had a C-section, that's then the only difference. That's only difference from a natural birth, is what I mean by that. So no complications during the C-section, no complications during a natural birth. Then it's just a case of, yeah, you take a bit of extra time to recover and you should be fine.

Peter Lap: 4:30

Now the question is interesting from a perspective of there are quite a few misconceptions about C-sections. So what we find? So a couple of things here. The debate about whether muscles are cut during a C-section is, for instance, is one so no muscles. Usually we say no muscles are cut during a C-section. What we mean by that is no stomach muscles are cut during a C-section. They cut the fascia sheet because they have to get food up, but that's pretty much it. To get to the uterus, the other muscles are kind of kept apart. Your abdominal muscles are kept apart to provide access for the surgeon. Then there is an incision made into the uterus. Obviously you have to get the baby out right So usually the cut through the muscle tends to be just above your pelvic bone, below the bikini line, horizontally. Sometimes it can be vertical, but you know that, and again it seems to be a bit of a we don't know what the best way for it is yet, but the horizontal just because the bikini line and below the bikini line is the one that doesn't show up whenever you're wearing a tank top and all other stuff. And again, surgeons will feel free to correct me on any of this sort of stuff. Peter et al Palsnatalbodycom Peter@healthypostnatalbody.

Peter Lap: 6:04

Now, the uterus is a muscle, right, it's a muscular organ and therefore, yeah, it's a muscle and that is obviously cut. So when we're saying that no muscles are cut during the C-section which is what I think they say on the NHS website, technically that is not correct, but you know it is sorry. That's American Pregnancy Association will say the muscles in your stomach will not be cut, right, which is true, right. So there's a definition. I know, for instance, the one of these H, get Fit for Birth sort of programs have a thing saying "yeah, they're all liars and all that sort of stuff.

Peter Lap: 6:58

Now, when people say stomach muscles aren't cut, that is what they mean. They don't cut through the abdominal muscles. The connective tissue will be cut around the muscles and that's a fascia sheet and all that sort of stuff. And the uterus an incision will be made in the uterus. So there is some cutting into muscle, yeah, but that doesn't mean that your stomach muscles are cut and therefore, you know that is one of those will my stomach muscles be cut? No, but that doesn't mean there are no muscles being cut at all. That is mainly a semantics point, though from a postpartum recovery point of view, right, because usually when people come to your postpartum and they say the muscles I need to work on tend not to be the muscles of the uterus, it tends not to be the uterus they want to work on. You know they cut that, they sit you back together and the uterus tends to be fine after a few weeks, a few weeks. Well, postpartum women are potentially confused about because you know, is whether their stomach muscles are within. In this case, this lady who emailed I'm saying can you have muscle dysfunction because the muscles are gone? And the answer to that is no.

Peter Lap: 8:19

Now they do cut the fascia sheets of the obliques and the transverse muscles, so you know that could potentially cause issues. I've never come across that being an issue, though, and causing muscle dysfunction. We know, for instance, you know, along the linear album, that fascia sheet, that which is involved with disassoractive and all that sort of stuff, right, everybody listening will notice your muscles pull apart a little bit Again, they don't tear, and that fascia sheet gets a bit weaker and that can take a little while to recover. And I'm fairly sure that that could also be the case when you're recovering from a C-section. But those fascia sheets take a little while longer to heal than the standards. Just get back into exercise, because after eight weeks you're all fine, right, some people's recovery is a bit quicker, some people's recovery is a bit slower.

Peter Lap: 9:24

However, you know, surgeons tend to be pretty good at putting stuff back together, right, they're not just good at taking things apart. They sound really stupid, Because it is. They tend to be really good at opening up, but they also tend to be pretty good at closing it down, because I'm fairly sure that surgery 101 will be the opening people up, surgery 102, maybe even at the end of class one is putting people back together, Right. That tends to be where they're pretty much on the ball and there is no reason that I can think of why that wouldn't all work fine postpartum, unless there are some complications during the surgery.

Peter Lap: 10:09

Now, from a postpartum recovery point of view because most of the LL air quote is damaged is done during the pregnancy rather than during the birth the postpartum recovery process is pretty similar for C-section recovery and natural birth. There is not really any difference between it, because you know your separation, your disasus has already happened right, because otherwise there would be no room for the baby. Your shift in alignment has already happened because you've been walking around for three or four months where the center of gravity of your body shifted a little bit because the baby is there and you know. But your core works slightly differently, your glute works slightly differently and all that sort of stuff, so that part of it is completely the same.

Peter Lap: 11:10

I have never had anybody train with me after C-section that had any sort of muscle dysfunction because of the C-section and you know, muscle dysfunction this is. You know it's one of those scary phrases, but muscle dysfunction, as far as I know, it's just as far as I use it. Let me put it that way Muscle dysfunction, as far as I use it, it's just muscles not working when they're supposed to work right. It's not a big scary term, it's just, you know, muscles aren't quite doing the right thing at the right time. That's, that's they're not functioning properly. That doesn't mean your muscles don't work, just means they're not functioning when you need them to.

Peter Lap: 11:50

And I personally have found that there are the same issues with C-section recovery, with people recovering from a C-section after a C-section birth as they have been from from a natural birth, like I said, assuming everything went right during the labor process, right, because that is obviously the big thing, so I wouldn't worry about it. It is a sort of thing, though, that what we tend to find and this is why, why some people might find that the muscles aren't functioning quite right postpartum when they've had a C-section, compared to, say, when they've had a natural birth is that because you've had, you have that scar, and in a lot of cases that scar can pull a little bit and I can feel a little bit weird and all that sort of stuff. And you can do scar tissue massage and all that sort of stuff on it. There's videos for for how to do that on the interwebs. That keeps it all a bit more loosey-goosey and all that sort of stuff. Just be very careful when you do that so it can feel a bit odd.

Peter Lap: 13:07

I've heard that complaint a lot of her, that comment about where women just say everything just feels like it's, I don't know, sticking and pulling a little bit. That's not a muscular thing, that's a scar tissue, a skin thing, and, like I said, you can massage that and that seems to help a little bit. I don't know again, the reports I get from people do some scar tissue massage. Is that it helps? There isn't a study that says that it does and there isn't a study that says that it doesn't that as far as I can tell. So you know that's one of those things that I recommend. It's not going to hurt as long as you're careful with it. Will it make the scar go away? No, because that's not how scars work. But you know it might help a little bit. So I hope that helps Because, to be honest, I have completely forgotten where I started with this.

Peter Lap: 14:10

Other than you know, it answers the question of muscle dysfunction because of the C-section. I've genuinely never come across that, you know. And, like I said, everything else with regards to muscle cuts, it depends on which muscles you're talking about. They cut through your muscles, yeah, through your uterus, right, and they cut through some fascia, but that is not the same as what most people think is in cutting through a stomach muscle, and I think some people tend to scare you into that, thinking a little bit than to be people that have, you know, fear cells, they have something to sell and all that sort of stuff. Obviously, everybody knows that I'm completely agnostic when it comes to the type of birth, what's better, and all that sort of stuff. I hope, because you know it's all about this. I'm concerned, it's all just about keeping baby alive and all that sort of stuff.

Peter Lap: 15:15

Now I had another question yesterday which actually came to me. I think it was yesterday, it was a, yes, it is Sunday. I was sent a thing about boxing Katie Taylor, so let me look up to see who she was fighting, because it was Cameron, cameron, cameron, chantel Cameron and I was. I'll send the picture of them out the way. These are two boxers, just in case you don't know. And obviously at the way end they both looked phenomenal, right, they looked at the peak of their condition and the question was can you make me look like you know, cameron? I think Chantel, chantel, cameron.

Peter Lap: 16:05

And the answer that this came? The answer was no, and the answer is no for most of you. Listen to this. The answer is no for almost everybody. Right?

Peter Lap: 16:16

These are two women, I believe in their 20s or 30s or however old they are, doesn't really matter. These are top athletes. And this is the same problem as I have with when people talk about Jessica and his hill and all that sort of stuff. When you say, how do I get abs like Jessica and his hill? And I've said this before you can't. You're not a professional athlete and unless you train to the level of a boxer I mean, these were women at their physical not even a physical peak, to be honest, because you know this was at the way in that that picture was taken and therefore they're not actually at the physical peak, they're just the leanest they've ever been because they're trying to make a weight they have trained so ridiculously hard to get to that point and their diet has been so ridiculously restrictive in a couple of weeks before the fight simply to make a fighting weight.

Peter Lap: 17:22

Fighting weight for boxers tends to be below their usual weight. So when you see Katie Taylor or Chantelle Cameron walking around somewhere, they won't actually look like they do when they're fighting or during the weigh in. Right, that goes for all boxers, goes for all bodybuilders and all that sort of stuff. If you compare yourself to athletes at competition stage, especially, especially martial arts people at competition stage, or bodybuilders at competition stage, you're going to end up really, really disappointed. And because they don't look like that most of the year, right, I used to train out of a bodybuilding gym and those guys just and girls walk around like normal human beings.

Peter Lap: 18:20

Right, they have some muscle, but quite a bit of muscle, and they have some fat not too much, but some fat. And then in a few weeks before competition they start to drop the body fat and that highlights all the muscle. Now they walk around relatively lean, don't get me wrong. I'm not saying they walk around at 25, 30 percent body fat the whole time, but they're not walking around completely ripped. And the same goes for boxers and martial artists, kickboxers and all that type of stuff. They don't walk around in that. For them at that fighting weight Right, it's called a fighting weight for a reason you cut extra amount of fat off that weight that you usually walk around with. That makes you train a bit harder, makes you lift a bit heavier, and all that sort of stuff makes you just basically be a bit more comfortable.

Peter Lap: 19:26

And if fighting or training is what your job is, then you can do that. You can train for three or four or five hours a day. You can go into training camp and then you have your crappy lunch that somebody else makes for you and then you go back training and all that sort of stuff. So you're constantly moving, but all you have to do nine out of ten times they're not mothers, they don't have a school run, they don't have toddlers walking around that they can't take care of. They have time to recover. So when they train and when they recover, they really recover. They don't then have a ton of other stuff to do, a ton of choice to do, because that interferes with your recovery and that means that you're going to end. And they do this consistently and have done this consistently for years, for absolute ages.

Peter Lap: 20:31

You don't get to the top of your sport without an insane amount of dedication. I always think I had this child with somebody on threads the other day. I'm on threads healthy postnatal body right. And you know it doesn't take nearly as much effort as people think it does to get into reasonable shape. That is fairly straightforward. That really is not a hard diet and hard training and type sort of thing. Just, you know, eat relatively well 80% of the time you eat completely fine with your. You know you get your vegetables, you get your lean meat and all that sort of stuff and whatever, and eat your fruit and all that sort of thing.

Peter Lap: 21:20

And you do I don't know three hours exercise a week, some resistance training, a little bit of cardio, a little bit of stretching and all that a range of motion stuff and all that sort of thing. That will get you in great shape. That will get you in better shape than 70, 80% of people. If you just do that for long enough, you look phenomenal, you feel phenomenal, you be stronger, you be fitter, you'll be fine and you'll be healthy. But to get to that professional, that elite athlete level, needs so much more work that it basically becomes ridiculous. And unless you have nothing else to do and you have a ridiculous amount of motivation, you're not going to reach that level of fitness. So it would really help if you don't, if you manage. When you see Instagram fitness models or people whose job depends on their aesthetics, right. So a lot of personal trainers tend to fall into that camp as well. Online coaches tend to fall into that camp as well, and professional athletes.

Peter Lap: 22:34

You can't compare yourself to those people If you just do the best you can. You're nice and steady, you do a few hours exercise a week and, like I said, three hours is an ideal right. If you can do less, then that is, of course, okay. As I always say as part of the Healthy Pulse Natal Body Program, you're kind of already doing two, two and a half If you do your 10 minutes a day, five days a week, so that's 15 minutes. And then you have to half hour to 45 minutes session, so they say that's another hour and a half. You're already at two hours and 15 minutes a week. That's enough. You're done well after that, right.

Peter Lap: 23:19

And if you then eat well on top of that and by eating well I don't mean starve yourself to death, but just highly nutritious diet Then you look and feel better, you'll be stronger, you'll be more flexible and then most people right and you'll probably. If you're overweight, you'll probably lose weight and if you're on the weight, you'll probably gain a bit of weight, but you can't look. It's monstrously difficult to look like a professional athlete without being a professional athlete. Sitting aside the fact that the person who asked me this was 45 and had already had two kids, and it wasn't that active before she had baby number two, so for her it was a case of you know, can I still reach that level of fitness now? Well, realistically, the answer is just no, because you're not willing or able to put the amount of work in, and that's completely fine. My point is mainly don't compare yourself to people like that.

Peter Lap: 24:21

Anyways, that's me done for another week because I got nothing and I need to be social with people. Now I'm being forced to go out, if if you have any if. if, any comments. I have guests lined up. Some of them keep falling through and keep rescheduling and all that sort of stuff, and that's a bit of a pickle. Obviously, next week it's December, so I'm going to be running some episodes from the vaults again in December because I want Christmas off. So just so you know that that's coming up. But you know I've done 240 episodes of this, so chances are you won't have heard them anyways, and I've done some phenomenal nutritional ones, so they will be making an appearance again. That's it for me. Have a tremendous week. You take care of yourself right Bye now. It's a brand new day. It's a brand new day. It's a brand new day. It's a brand new day.