Friday 6 September 2019

C-Section Recovery – An Holistic Viewpoint

C-Section Recovery – An Holistic Viewpoint

Post by Jenny Burrell from Burrell Education.

As the title suggests, this blog isn’t about what happens during a C-Section but about the road back to wellness with an inside/out perspective.  It’s based on my own personal healing journey and my professional standpoint as a massage/remedial therapist and my background in nutrition, so without further ado, C-Section recovery for the Post Birth and Post Gynae Surgery woman, a road less-reported......

Photo used with kind permission of Clear Passage Physical Therapy
First up, C-Section Scar Tissue and Adhesions.  Not many people talk about these two areas of recovery but nearly everyone experiences them as a normal part of healing.  Pelvic organ dysfunction, incontinence, scar pain, poor sensation and a sense of restriction after the C-Section procedure are often due to the build-up of post-surgical adhesions.  I never cease to be amazed by the lack of emphasis on soft tissue work after such as large and deep trauma to the muscles, fascia, blood vessels, nerves and tendinous structures at such a pivotal position in the body.  Without doubt, EVERY SINGLE WOMAN WHO HAS EXPERIENCED A TRAUMA OF THIS NATURE DESERVES AND NEEDS SOFT TISSUE THERAPY as part of her return to health, wellbeing, functionality and
As the healing process commences collagen fibres are laid down at the site of injury to create powerful healing bonds that aid recovery.  This leads to the formation of ADHESIONS.  These adhesions which initially have a hugely positive role to play in wound healing can then create the foundation for dysfunction as their structures can bind to nearby organs and tissues within the pelvic cavity and around the site of the wound.  For a lot of women post C-Section, this can result in a pulling or trapped sensation when they eventually return to full-range movements as part of their daily lives and exercise programmes.  Adhesions can also be a source of digestive/bowel problems and be part of the story of post-birth urinary incontinence and at their extreme, infertility.  Take a look at the video below.  I think it really helps one to understand that the C-Section scar and the work that needs to be done runs WAY deeper than only massaging the superficial scar.
Once the C-Section scar is fully healed on a superficial level, massage and other soft-tissue strategies such as deeper visceral work are an often overlooked form of self-care that a woman can administer to herself to minimise at least the more superficial scar tissue that may have built up due to surgery.  The aim is to start gently as soon as the wound is fully healed before the adhesions increase in density and need deeper work in order to get positive results.  Starting sooner rather than later is always best but I'm a firm believer that one should 'NEVER GIVE UP ON SOFT TISSUE' and that our bodies are always open to a little TLC regardless of how long it's offered after trauma.   Massage also has the benefit of being soothing, and encourages blood flow (bringing oxygen and nutrients) to and lymph drainage away from the site of healing so a powerful 'assist' in the recovery process!
 C-Section Scar, Water Retention + Constipation Massage Video....ENJOY + Feel Free To Share!

C-Section Scar Massage, Water Retention + Constipation Strategies from Jenny Burrell on Vimeo.

Next up, and slightly left-field if you’re not into Eastern practices, but I absolutely adore Acupressure.  You can apply it to yourself so easily or administer it to others.  Undressing isn’t required and so can be performed almost anywhere.  I use it on myself and clients post training and during traditional massage sessions and as part of remedial therapy.  Here’s a simple Acupressure point for water retention.  Great for reducing any oedema that has built up in the pelvic region due to the natural healing process.  Ensure the C-Section wound is fully healed before administering Acupressure.  DO NOT WORK NEAR OR ON OPEN WOUNDS.
P6 = ‘Sea of Energy’
Location: Two finger widths directly below the belly button. Benefits: Relieves water retention, constipation, and gas – all might be an issue for the client in the post birth period.
Find a quiet place to lie comfortably and apply comfortable pressure to Point A for 2-3 mins at a time, it varies, but usually, after the second application of pressure, you’ll get a great urge to have a pee!  Remember to also hydrate well after applying Acupressure to aid the flushing of toxins out of the system. (There is a voiced over explanation of this in the video above).

What Is Acupressure?
Acupressure balances the body's energy by applying pressure to specific points along energy channels (Meridians). In Chinese medicine, energy and blood are closely related. The energy channels are pathways for both chi and blood. When a finger touches an Acupressure point, the energy flowing in the channel is attracted to the surface. An Acupressure practitioner will hold a point until she feels a pulsation under her finger. When energy is attracted to the surface, the flow of blood increases at that location and the pulse is felt. The pulse is a confirmation that the energy is now flowing.  To relax an area or relieve pain, apply pressure gradually and hold without any movement for several minutes at a time.  Gradual, steady, penetrating pressure for approximately 2-3 minutes is ideal.  Do not continue to press a point that is excruciatingly painful.
 Core Reconnection To The 'Core' Through a Simple Breathing Meditation
This is so simple!  Basically, all of the components of the core work in synergy.  The Diaphragm, the Pelvic Floor, the Abdominal Wall and the Lumbar muscles and fascia.
To experience this phenomenon, exhale through pursed lips for a count of 8, you’ll find that TVA is activated and you will feel your belly moving inwards, your pelvic floor tensioning and lifting and the muscles and tissues of your low/mid back tensioning.  All of these activities create ‘core stiffness’ and increase in 'tensegrity' which is our natural protective mechanism offering pelvic stability and supporting potentially vulnerable structures of the low back and pelvis.  It's a simple and effective re-connection strategy for clients that helps them to truly understand the inter-connectedness of the components of their core.  Perform for 5-10 mins a day – especially during the early post birth days and feel a) much more connected to your core and help to re-establish that 'dulled' motor control pathway and b) to down-train the nervous system and stimulate the Parasympathetic System - your rest and digest system.  I should think that there's not a mom in the world who couldn't do with a little deep breathing 🙂
This next area is almost ALWAYS OVERLOOKED.  Nutrition has a huge role to play in healing and consuming a diet that’s high in anti-inflammatory ingredients will benefit post birth fat loss and healing.  The inflammatory response is a natural part of healing/fighting disease so a diet high in anti-inflammatory foods will truly help to support the healing process.  There's lots more on this here and some suggestions of a 'Day's Healing Nutrition and Why?'
Top Anti-Inflammatory Food Sources
Wild Alaskan Salmon
Extra Virgin Oil
Cruciferous Vegetables
Green Tea
Sweet Potato
Eat-to-Heal-HCR2 (1)
Mind How You Sit!
Your soft tissue will 100% respond to the load applied to it and that includes the negative load of sitting for such extended periods so that the abdominal wall and that your healing scar and the rest of your abdomen simply isn't elongated to its optimal position.  This is a bit of an occupational hazard for a mom who is breastfeeding and will need to spend nearly half her day in the sitting position but...I think if we're mindful that the abdominal wall, hips and the pelvis at the very least all need to be gently lengthened and mobilized throughout the day, we'll avoid those tissues getting stuck and the scar possibly becoming painful when the woman starts to return to more dynamic movement/exercise. This is a simple but HIGHLY effective movement to add to your day if you're feeling a little stuck....
See 'Stress Management' as a NECESSARY not a LUXURY
The short version......chronically elevated Cortisol has been shown to retard wound healing!  Less stress = lower Cortisol = better wound healing.
Improve Your Gut Health
If you've birthed via C-Section or had a dose of antibiotics in the last 4 years, the chances are that your good/bad gut bacteria ratio is probably a little off.  It will take time to fix but it's totally doable and alongside improvements in your bowel function, a happier gut could also reap benefits for your mental health and your ability to lose any post-baby weight that seems a little resistant too! Read more here!  Adding 'resistant' starches to your diet is a simple strategy that can help you improve your gut health with relatively little extra effort.  I wrote about this here.
Increase Glutamine Content of Diet
Glutamine has powerful effects on the immune system, muscles, digestive tract, liver and brain. In fact, it is the single most abundant amino acid (building blocks of protein) in your body.  Your body stores Glutamine in muscle, lung, liver, brain and stomach tissues. Glutamine can be depleted if you experience severe wounds or infectious diseases. C- Section can be considered a serious wound!  Glutamine acts to fuel to the immune system, heals soft tissues and maintains the body's antioxidant supply.  Taking Glutamine increases the activity of disease-fighting white blood cells called macrophages.  Another beneficial effect of Glutamine is that it boosts metabolism and fat burning. Glutamine can also help fight the negative effects of the stress hormone Cortisol – Cortisol is naturally high during pregnancy, very high during birthing and into the post birth period!  It is possible to supplement with L-Glutamine in a powder form but natural sources are abundant.  Natural Sources of Glutamine: eggs, pork and chicken, yoghurt, milk, cottage cheese, ricotta cheese, spinach, cabbage, parsley.
You can read more about Glutamine Supplementation and Optimal Nutrition Post Birth in Patrick Holford’s great book – CLICK HERE

Patience, Faith and Compassion!
Basically, you’ve just got to believe that you will heal, regain your strength and not be uncomfortable forever!  It will take time, but normal service WILL be resumed at some point!  Your journey is unique, don’t compare your recovery or your abilities to anyone else's, we’re often stuck in the trap of comparing what’s going on for us ‘inside’ with what is presented by others ‘outside’!  The above diagram is universal for all tissue recovery....from injury to remodelling and return to previous function/strength can truly take 1 year and some fascia experts consider 500 days to be the timeframe for fascia recovery!
We all need to have more patience, faith in the healing process and a good dose of self-compassion.  I think these terms are rarely used in association with C-Section recovery!  Ultimately the body will heal in its own sweet time.  Our job is to support Mother Nature through our commitment to nurturing behaviour.

I am certified by Burrell Education Holistic Core Restore® coach and provide C-Section Recovery programme at Highgate Holistic Clinic, 253 Archway Road, London N6 5BS
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