Exercise after Pelvic Surgery
There are many different surgeries women may have in the pelvic region. These include: hysterectomies (removal of uterus), oophorectomy (removal of ovaries), prolapse surgery (perhaps a sling, tape, or a repair) and laparoscopies (these may be to see if there is endometriosis present, and sometimes includes the excision of endometrial tissue). Surgeries can have different approaches, usually vaginally, laparoscopically or via laparotomy. Depending on what surgery you had, why you had the surgery, and what approach your surgeon used, will depict how long your recovery will be and the time frames in which you can return to normal activity including walking, housework, lifting, exercise and returning to work.
This blog will discuss how you can return to some of the above activities in the safest way possible.
1. Immediately after surgery
In the first hours and days after you have surgery, no matter what surgery it was or the approach used, there will be an element of rest you need to have. It is important to rest and let your stitches heal, and to utilise the medication suggested by your doctor as required. There will be some discomfort and if you feel your pain levels are abnormal, you must voice this. Probable the two most important things you can do after surgery include
- Use a log roll to get out of bed – this is when you roll onto your side, and push through your arms as your legs lower towards the floor. This is the easiest way to get out of bed without putting pressure on your wounds or pelvic floor. Your nurses or physiotherapist will be able to show you how to do this. It can be handy to practice the log roll prior to surgery so you are prepared post surgery.
- Do not get constipated – passing a bowel motion after surgery can be difficult, and it is painful to need to strain. So the goal is for your bowel motion to be soft and easy to pass. Your surgeon or nurse may suggest that you take something (eg Movicol) to help make passing a bowel motion easier. Pain medication can make you constipated so having a little extra help above diet and fluid can really help some people.
2. Gradual return to physical activity
Vaginal or Laparoscopic surgery
- For these types of surgery, for about the first 2 – 4 weeks post surgery you want to focus on getting back into some walking. Things that will depict how easily you get back into exercise include: your pain levels, how active you were prior to surgery, if you had any blood loss during your surgery, how you responded to general anaesthetic etc.
Laparotomy
- This surgical approach involves a larger wound, which take a little bit longer to heal compared to laparoscopic surgery. After this surgery you will be gradually building up your walking for 4-6 weeks.
After the 6 weeks mark
- Usually women have had a review with their surgeon 6 weeks post surgery
- If things are travelling well, you can start increasing your activity.
- Women ask what exercise is best for them – and the answer is the exercise you enjoy! If what you enjoy is a bit more high level eg weight lifting or lots of jumping and landing – consider seeing a physiotherapist so they can check that your body is ready for these activities
3. Lifting
There are no definite guidelines around lifting for women post-surgery. Some surgeons like to give their patients a strict lifting maximum, whereas other surgeons will ask you to just be careful. It is most likely best to err on the side of caution, and try not to do too much lifting in the first 6 weeks post surgery. In saying this – lifting means different things to different women. For some women lifting means their baby, for others it means the 20kg boxes at work. You should take into consideration what your “normal” is – and discuss this with your surgeon or physiotherapist to make an action plan around it.
4. Return to work
Similar to lifting, different occupations have varying requirements. Eg some jobs you get to sit for most of the day, others you may be lifting for most of the day. You want to ensure you give your body the best chance to heal, so have a real conversation with your surgeon around this and get a medical certificate as required.
5. Swimming
Wait until your 2 week check up with your GP or surgeon before swimming due to infection risk
Emily Georgopolous (APAM)
Physiotherapist
Featured in the Top 50 Physical Therapy Blog
Click here to book an appointment with Emily or view our Clinical Pilates timetable here.
