My client has 2 kids, the youngest is 4 and both delivered through caesarians. She has lost most of her baby weight, and we include lots of core training in her routines. Any suggestions on what else we can do and how realistic is it for her to expect her abs to return to pre-pregnancy firness/strength? How much more difficult is it to lose this baby fat than with vaginal deliveries?
Your client need to be extrememly disciplined in order to regain her core strength and pre-pregnancy abs but it can be done nowadays!
A C-section is a surgical procedure so there will always be some scarring, but there is no cutting through muscle with the exception of the uterus. When a C-section is done, two sets of abdominal muscles are ‘separated’ not ‘cut’ from one another. A transverse (horizontal) cut,the so-called bikini cut C-sec, actually has fewer complications. and less noticeable than the (vertical) incision.
The fascia is one of the layers cut during a c-sec. Fascia covers the muscles and acts as a sheathe much like a girdle. Of course if your muscles are not tightened and strong there is a lot more compacting for the fascia to do! After giving birth the fascia will be back to 90% of its original strength within in 6 weeks, the other 10% will come back within a year. You cannot strengthen or tighten your fascia without surgeryso it is so important to stay within the dr’s recommended weight gain.
Exercises to train the pelvic floor and transverse abdominis are important to focus on. Vaginal deliveries in which an episiotomy is made also creates a dysfunction to the pelvic floor and causes weakness in the core as well. Whether it’s a vaginal delivery or a c-section, the pelvic floor and the TA act as a sling for the baby and this is why you need to train these specific muscles to regain core strength http://youtu.be/aqLPJ4R0KiI
If your client notices her belly protruding over her incision, this is usually referred to as the “shelf” and it’s mainly fatty tissue damage which eventually turns into scar tissue. Since this is your client’s 2nd c-sec, her scar tissue will obviously be larger than a single c-section.