Management Guidelines-Postcesarean Section

By Carolyn Kisner PT, MS and Lynn Allen Colby PT, MS on February 24th 2009

Potential Impairments and Functional Limitations:

Risk of pulmonary or vascular complications

Postsurgical pain and discomfort

Development of adhesions at incisional site

Faulty posture

Pelvic floor dysfunction
• urinary or fecal incontinence

• organ prolapse

• hypertonus

• poor proprioceptive awareness and disuse atrophy

Abdominal weakness, diastasis recti

Coughing or Huffing
Coughing is difficult because of incisional pain. An alternative is huffing. A huff is an outward breath caused by the upper abdominals contracting up and in against the diaphragm to push air out of the lungs. The abdominals are pulled up and in, rather than pushed out, causing decreased pressure in the abdominal cavity and less strain on the incision. Huffing must be done quickly to generate sufficient force to expel mucus. Instruct the patient to support the incision with a pillow or the hands and say “ha” forcefully and repetitively while contracting the abdominal muscles.

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