Post Natal Exercises after Caesarean Section.

1. Physiotherapy management in Post natal
care
Mayuri Zanwar

2. Potential Structural and Functional Impairments
 Risk of pulmonary ,GIT , or vascular complications.
 Post surgical pain and discomfort.
 Development of adhesions at incision site.
 Faulty posture after childbirth.
 Pelvic floor dysfunction
 Incontinence.
 Prolapse.
 Diastasis recti.

3. Importance of Post-Natal Exercises
 Improve circulation
 Strengthen pelvic floor muscle
 Prevent backache
 Strengthen the tummy muscles

4.  Goal: To improve pulmonary function and decrease the risk of
pneumonia
 Breathing exercises.
 Coughing and huffing technique.
 Goal: To decrease incisional pain with movement or during breast
feeding.
 TENS.
 Support incision site.

5.  Goal: To prevent post surgical vascular or GIT complications
 Active leg exercise.
 Early ambulation& abdominal massage to peristalsis can be thought.
 Goal: To enhance incisional circulation and healing prevent adhesion
formation.
 Scar mobilization.
 Friction massage.

6.  Goal: To correct posture& To prevent injury and reduce LBP
 Postural education during child care and feeding
 Ergonomic advice.
 Goal :To prevent pelvic floor dysfunction
 Pelvic floor exercises.
 Goal : To develop abdominal muscle strength.
 Corrective exercise for diastasis recti.

7. Post Natal Exercises
 Deep breathing exercise
 Lie on bed with knees bent, with a
pillow behind
 Breathe in deeply through nose.
Sigh out.
 Repeat 5 times
Breathing exercises
help to
improve your
circulation

8. Foot and ankle exercise
 Keep knees relaxed for both
exercises.
 Bend and stretch ankles
vigorously up and down for 30
seconds.
 Circle both feet 10 times in each
direction.
 Repeat these exercises
frequently

9. Pelvic floor exercise
1. Contract the pelvic floor muscles every time the intra-abdominal pressure
increases.
2. Support the sutures.
3. Start with static abdominal exercises to dynamic.
4. Rhythmic gluteal contractions.
5. Pelvic tilt

14. Goal: To decrease incisional pain with movement or
during breast feeding.
 de Sousa L et al. transcutaneous electrical nerve stimulation for the relief
of post-partum uterine contraction pain during breast-feeding : a
randomized clinical trial. J Obstet Gynaecol Res 2014.
 Electrode placement between T10-L1 and S2-S4, frequency 100Hz pulse
duration 75 us and amplitude adjusted to produce a strong tolerable sensation
for 40 min.

15. Goal : To develop abdominal muscle strength.
 Agata michalska et al. Diastasis recti abdominis- a review of treatment
methods . Ginekologia Polska 2018, vol 89,no 2
 Strengthening of transversus abdominis muscles or rectus abdominis muscles.-
Pilates
 Postural training ,education and training on appropriate mobility techniques and
lifting techniques.
 Abdominal bracing and taping or a corset.

18. References
 Physiotherapy in obstetrics and gynaecology By- Margaret Polden, & Jill Mantle
2nd edition.
 Therapeutic exercise By- CAROLYN KISNER,LYNN ALLEN COLBY 5th edition.