Give your body the opportunity to recover and repair with appropriate rest. Immediately following hospital discharge it is usual to continue the in-hospital routine for the first 1-2 weeks unless you are advised otherwise. Thereafter try to ensure a balance between daily rest and appropriate exercise particularly over the first 6 weeks. Choose comfortable resting positions with your spine well supported. You may find it comfortable to rest lying on your back with a pillow under your knees. Alternatively you may prefer to lie on your side with a pillow supporting your abdomen and between your legs. Prioritize rest as an essential part of your hysterectomy recovery.
Exercise after hysterectomy
Appropriate post hysterectomy exercise is very important to prevent some potential complications associated with hysterectomy surgery and moving less after your operation.
The right kind of exercise after a hysterectomy will help you to:
- Minimise your loss of muscle strength and tone
- Manage your weight better
- Improve your confidence and self esteem
- Decrease your stress levels
- Improve your ability to return to your regular work and activities
- Maintain and even improve your bladder control
- Improve your core muscle control and your pelvic support for your surgery long-term.
Immediate in-hospital exercises
These may vary according to your hysterectomy procedure, your specialist's guidelines, pre-existing conditions and how your body has coped with the surgery. You can usually expect your physiotherapist or nursing staff to guide you safely through your immediate post hysterectomy exercises.
Exercises during your hospital stay may include:
- Circulation exercises for your lower limbs
- Deep breathing exercises for your lungs
- In bed mobility exercises for your hips and low back
- Walking according to your specialist's instructions.
Exercise after hysterectomy discharge from hospital
There are a variety of exercises that you may benefit from whilst recovering from hysterectomy surgery. The specific exercises you perform must be approved by your gynaecologist and may include one or more of the following:
- Walking exercise
- Muscle strength exercises
- Pelvic floor exercises
- Deep abdominal muscle control exercises
- Specific low back, hip and pelvic mobility exercises
Walking exercise after a hysterectomy
Post hysterectomy walking exercise has many potential benefits for your physical and emotional wellbeing. Walking can assist you to breath well, improve your circulation and prevent or minimise joint stiffness and spinal discomfort. Walking usually progresses gradually over the first six weeks after a hysterectomy, commencing with short daily walks and slowly progressing the daily distance walked on a weekly basis. Women who are having an uncomplicated recovery and who are generally fit and well may expect to perform a single walk of up to thirty minutes by the end of week six. Once again check with your gynaecologist regarding his/her post operative walking expectations and guidelines.
Some women are concerned with the potential for weight gain after hysterectomy surgery. This is a time when you will be moving less and out of your regular routine. You can avoid post hysterectomy weight gain by eating sensibly and gradually increasing your walking exercise. Eating well balanced meals with good dietary fibre will help your bowel function so that you avoid straining and constipation post-operatively. 'Improve your fitness and lose your fat' (Chapter 5 Inside Out) teaches you how to exercise safely and effectively for weight loss whilst supporting your insides following your initial six week recovery. Remember that your pelvic floor is vulnerable post hysterectomy and you should avoid exercises such as high impact exercises which have the potential to injure your pelvic floor long-term.
Muscle strength exercises after a hysterectomy
Strength exercises in the first six weeks after a hysterectomy are designed to help you maintain strength and minimise further loss of strength during your recovery. Avoiding loss of strength may be particularly important to you, especially if you are planning to return to work and physical activity. You need to be particularly careful performing strength exercises during your hysterectomy recovery, and seek your gynaecologist's approval prior to performing them. With your specialist's permission, speak with your physiotherapist for some suitable basic strength exercises to assist in your rehabilitation. Your gynaecologist will have specific guidelines regarding how much you are permitted to lift post hysterectomy and this is usually a maximum of 1-2 kg total for the first six weeks.
Many women are confused about safe strength exercises long-term after a hysterectomy. Inside Out - The essential women's guide to pelvic support includes an illustrated strength exercise program specifically designed for women who are at increased risk of pelvic floor dysfunction, which includes women who have undergone a hysterectomy procedure in the past ( Refer to 'Get your body strong-active workouts' Chapter 6 Inside Out). These are the types of exercises you may perform after your hysterectomy with your specialist's approval to return to strength exercises.
A word of caution regarding strength exercises after a hysterectomy. There has been some suggestion in some studies of an association between an increased likelihood of vaginal prolapse after a hysterectomy however this association is not clear. Heavy lifting is an identified risk factor for prolapse in women. Based upon this information, it makes good sense to perform the right kind of strength exercise to protect your insides post hysterectomy. Inside Out details potentially unsafe gym exercises to avoid for long-term pelvic floor protection (Chapter 7 Gym and equipment exercises exposed).
Pelvic floor exercises after a hysterectomy
Your pelvic floor muscles should work to support your insides post hysterectomy. These muscles also assist your bladder and bowel storage and emptying. A weak floppy pelvic floor will not work well to support your internal organs and stitches after your hysterectomy. It makes good sense to train your pelvic floor muscles into their best possible condition to prepare for hysterectomy surgery. After a hysterectomy, check with your gynaecologist regarding his/her preference for when you are able to commence gentle pelvic floor exercises.
Since your pelvic floor muscles are hidden from view inside your body, performing correct pelvic floor exercises can seem mysterious and confusing. If you are at all uncertain about how to perform your pelvic floor exercises using the correct technique after a hysterectomy, contact a physiotherapist or continence advisor to help you to find and train these important muscles. Tone up your pelvic floor (Chapter 2 Inside Out) guides you through finding your pelvic floor muscles and training them into their best possible condition, and a range of exercise devices are also available to assist you. Regular pelvic floor exercises should be part of your weekly routine to keep your pelvic floor healthy and working as it should.
Deep abdominal muscle exercises after a hysterectomy
Your deep abdominal muscles should work with your pelvic floor muscles to protect and support your insides. Deep abdominal muscles form part of your cylinder of support and many women have learnt about these particular core muscles in Pilates exercises. You will benefit from learning how to use your pelvic floor and deep abdominal muscles together correctly for your long term pelvic support after a hysterectomy. 'Take control of your abdominals' (Chapter 3 Inside Out) guides you through the correct technique for activating and then training your deep abdominal core muscles.
Avoid the sit-ups! Don't be confused by sit-up exercises which should be avoided for the first three months at least after a hysterectomy. Sit-up exercises and abdominal exercise machines will train the muscles that increase downward pressure upon your pelvic floor AND your internal hysterectomy wound. For a comprehensive list of safe and unsafe abdominal muscle exercises and equipment for when you have your gynaecologist's permission to return to exercise, refer to 'Gym and equipment exercises exposed' (Chapter 7 Inside Out).
Specific low back, hip and pelvic mobility exercises after a hysterectomy
Some women experience low back, hip and/or pelvic pain or stiffness after hysterectomy surgery. You may be more likely to experience spinal pain and stiffness post-operatively if you have a pre-existing back or hip condition. Resting in a different bed, the position of your body during your surgery and moving less freely can all increase your likelihood of back pain and/or stiffness. When you are in hospital, your physiotherapist may prescribe exercises for you to perform during your recovery and he/she may also discuss the importance of protecting your back with supported resting positions and paying attention to good posture during your recovery.
In summary. You can promote your physical recovery after a hysterectomy through simple daily exercises and prioritizing daily rest. Appropriate exercise is a MUST for women who wish to return to general exercise routines and for long-term pelvic floor support after a hysterectomy.
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