Ask-A-Salty: Returning to Running After a C-Section

Got questions? Just ask!
Got questions? Just ask!

Ask-A-Salty is the feature where YOU ask the questions and WE give you the answers! (If you have a question, you can ask us here.) Today’s question comes to us via Basil:

So my friend and running coach had a c-section (her first baby) 11 weeks ago and has been returning to running/training over the past 6 weeks. She’s been good about building back slowly, but is still having some pain near the incision when she does any tempo work or longer stuff (like 8 miles). Have any of you (or anyone you know) returned to running and training after a c-section and experienced this? She’s trying to figure out whether it’s not a big deal and she can keep pushing through it, or whether she should back off a little to give it more time to heal.

We were really excited to field this question, since c-sections are one of the few pregnancy-related topics Salty Running hasn’t covered.  And as it turns out, several of the Salty bloggers have been there and shared a great discussion about their recoveries.  Peppadew takes the helm after the jump!

Just a quick disclaimer here, None of the bloggers on Salty Running are obstetricians, surgeons or medical experts, so our advice should not be taken in replacement of a proper medical check up; in fact, it should encourage you to seek medical advice for yourself.  And spoiler alert: a caesarian section is MAJOR ABDOMINAL SURGERY. You get a cool prize at the end of it and that prize may not have any respect for an easy recovery period (or your sleep schedule) but essentially you have had your abdomen sliced open and everything has been pushed around and rearranged… Don’t mess with that. My advice is purely anecdotal.

Eyes on the prize, pregnant Salties! Any amount of recovery time is worth the payoff! img via kb_vaidya on flickr

Its no secret that many of us runners like to be in control:  we control our breathing, our speed, our schedules, our training plans…it’s just what we do. The greatest reality check to that I have ever experienced was the process of having children. Pregnancy symptoms are completely unpredictable, reactions to exercise during those 40 weeks are varying, yet I was still determined to control the outcome of the process in any way I possibly could.  As we all know, though, that’s not really how it works.

After an easy “textbook” natural birth and speedy recovery with my first child, I expected to have the same experience with my second.  Obviously life does not always go according to plan… I had an emergency c-section with my son and was horrified at how much pain I experienced around the incision.

My doctor (who was always very supportive of exercise and running during my pregnancy) explained that, although I was not doing any damage to the scar, the pain was an indication that I was overdoing it and pain was a normal reaction to overworking the damaged tissue. I was NOT engaging in tempo workouts!  I was told that if there is any pain at the incision then back off that activity.

Looking at my training log for that year, I see that I did three short runs 5 weeks postpartum (hence the pain!). These runs were short, only about 1.5 miles but my incision BURNED. I did not run again for two weeks until after my 6 week check up.  I confessed to my doctor that I had tried running and he laughed and said that it explained the pain but assured me that although I was slightly crazy and somewhat stupid I had not done any damage.

Other Salties chimed in:

MintI had 2 c-sections and was surprised at how long it took to fully recover.  They say you can run after 4-6 weeks, but I felt pain and/or pressure in that area for upwards of a year, although it of course got better over time.  Even though it’s considered a routine surgery, it is a pretty major surgery.  Recovery will be different for everyone, but I recommend she take it seriously and listen to her body.  If it hurts, I’d say stick under 8 miles and go easier until it is more comfortable.  Hard for us type A runners, but her time will come.
Also tell her that even though it sucks she will have a longer recovery time, at least she shouldn’t have the incontinence issue many face after vaginal births. 😉

SaltyI don’t have experience with [c-sections] but 11 weeks is a very short time post delivery to be doing hard workouts and longer runs if she doesn’t feel good. It won’t hurt to ease back in more slowly even though it feels like it’s been an eternity since last being in shape!

Catnip:  I would say stop and heal. I didn’t have a c but had a million intimate stitches and it was the limiting factor in my initial return to running (and walking. And sitting. ) With the depth of a c incision and going through layers of skin, fat and MUSCLE, it’s possible that something deep has not quite healed. Pain 11 weeks out from any surgery regardless seems like a red flag. I might be projecting my own experience onto your brief snippet because I wish I’d put less running pressure on myself immediately postpartum but it seems like she knows something is a bit off.

And as for me, Peppadew, I only started to do any tempo running or hard workouts when William was 6 months old, and my incision did not bother me again.

So the short answer to the question above is that your friend is doing too much too soon! If she’s working out hard already I’ll bet she has very strong abdominal muscles and the incision would have had to go through all of that. I guess having a six pack can have major disadvantages!

Have you had a c-section or other pregnancy complications?  How soon did you start running after baby was born?

An ultrarunning gal from sunny South Africa... I'm a mummy of two kiddos under 5, wife, runner (and attorney) from the balmy shores of South Africa. Although I am definitely a mid-packer I have the soul and aspirations of an elite athlete, sadly without the pedigreed legs! But every day I dream and work towards loftier goals... maybe a sub 20 5k to start?

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  1. Hey, that’s me who posed the question about return to running after a c-section! Thankfully I’ve been feeling really good for the past 3 weeks (now 16 weeks postpartum). For me, it was just a matter of massaging my incision to break up the scar tissue. Once I did that periodically throughout the day, I haven’t had any discomfort since. I also talked to my doctor to make sure I wouldn’t slow the healing process down or cause any more damage; she said everything looked good.

  2. Hi Michelle
    Thanks so much for the feedback and the great tip… if i ever have another baby (or a c-section) I will definitely remember that – it makes sense. the scar tissue is what is pulling and causing the discomfort so that is good to know. Well done on your fantastic comeback from MAJOR ABDOMINAL SURGERY 😉
    Keep us posted on your progress.

  3. I had a C 17 months ago. It definitely took a year+ to really feel like myself running again. I had a lot if ups and downs with incision pain, pelvic/back pain, etc. Keeping on the scar massage, Not slacking on the abs, and keeping glutes/adductor and Hammies both strong and loose seem to have been the 3 major ones. Remember, 6 weeks to healing doesn’t mean 6 weeks to your previously strong awesome self (yes, that was hard to swallow at the 6 month set back).