How much walking after a hysterectomy, bladder or pelvic prolapse surgery…
walking is usually one of the best forms of general exercise for most women. It is low impact so it will place minimal pressure on your wound as it helps you to recover.
This article by pelvic floor physiotherapist Michelle Kenway teaches you:
- how walking helps you after pelvic surgery
- how walking decrease side effects of pelvic surgery
- 7 great tips to help you walk after surgery
- week-by-week walking guidelines after surgery
- specific advice for walking safely after surgery.
After pelvic surgery walking helps you:
- maintain some physical condition
- improve your energy levels and feelings of well being
- improve your your posture
- ease back pain and joint stiffness.
Walking helps you decrease side effects of pelvic surgery such as:
- decreased fitness, strength and tone
- post-operative complications such as lung problems and blood clots in the deep veins in your lower legs
- back pain and stiffness
- constipation
- feelings of sadness, stress and sometimes anxiety.
Tips to help you walk after pelvic surgery
- wear firm support briefs (underwear)
- keep your walking to flat surfaces and avoid hills
- wear supportive and cushioned footwear
- level grass surface is ideal to cushion impact
- don’t walk with pets on leads
- remember that you have to walk home so don’t walk too far
- short regular walks are preferable to long walks especially within the first 6 weeks after surgery.
Week-by-week general walking guidelines after a hysterectomy or prolapse surgery
Your walking program depends upon factors such as your level of fitness before your surgery, the type of surgery you’ve had and any post-operative complications you may have experienced. This means that all women are different in how they progress with walking when recovering from hysterectomy or prolapse surgery.
After discharge from hospital weeks 1-2
Most women are able to comfortably continue their in-hospital walking routine when discharged from hospital. This usually involves short walks of approximately five minutes at a time at intervals throughout the day. By the end of the second week it is usually appropriate to aim for ten minutes continuous walking but this varies from woman to woman.
Weeks 2-4
Most women can comfortably increase their continuous walking by approximately five minutes per week after their surgery. By the end of week four you may be able to perform twenty minutes of continuous walking. Listen to your body and only progress the time you spend walking as you feel comfortable to do so. Discomfort during or after walking can be an indication that you have overdone things a little and that you need to ease off on your speed and time spent walking.
Weeks 4-6
By six weeks after surgery many women can perform up to thirty minutes of continuous walking. Once again remember that everyone progresses at different rates so take things at your own pace. If you are unable to manage one long walk then you may find it better to break your walks down to a couple of shorter walks during the day.
Week 7 onwards
By this time you have usually had your check up with your gynaecologist. When you have the all clear to exercise you may wish to start gradually increasing the speed of your walking and the distance you walk. Remember that for most women, full healing requires three months so you need to continue to progress your walking program gradually.
For information regarding safe strength and fitness workouts after hysterectomy, bladder surgery or pelvic prolapse surgery; refer to Inside Out – the essential women’s guide to pelvic support
Specific advice for commencing your walking program
Seek your gynaecologist’s approval - before commencing walking exercise after a hysterectomy, bladder surgery or surgery for pelvic prolapse.
Listen to your body – when you are very tired or experiencing discomfort, then you should rest. During the first weeks following your hysterectomy, plan your exercise to be well timed with adequate pain relief. If any exercise causes you discomfort then cease it immediately. If you find that you have discomfort during or after exercise you may have probably done too much. In this case stop, rest and next time take things easier.
Exercise at your own pace – women progress at different rates after a hysterectomy or prolapse surgery. Avoid comparing how quickly you progress after your surgery with anyone else. Everyone is different and surgical procedures may also differ from woman to woman.
Progress exercise gradually – make sure that you feel comfortable during exercise. Gradually increase your walking exercise as your body heals.
Combine exercises with rest – rest will promote your physical recovery. You may find that it helps to walk for short regular intervals during the day, rather than one long session of exercise.
Contact your gynaecologist – if you have any particular concerns when exercising after surgery, contact your specialist immediately.
For expert exercise guidelines and safe strength and fitness workouts for women after hysterectomy, bladder surgery or pelvic prolapse surgery; refer to Inside Out – the essential women’s guide to pelvic support by Physiotherapist Michelle Kenway and Professor Judith Goh Urogynaecologist
Please read our disclaimer regarding this information
This information is provided for general information only and should in no way be considered as a substitute for medical advice and information about your particular condition.
While every effort has been made to ensure that the information is accurate, the author accepts no responsibility and cannot guarantee the consequences if individuals choose to rely upon these contents as their sole source of information about a condition and its rehabilitation.
Copyright © Pelvic Exercises.com.au
I had cystocil/rectocil/bladder repair on the 10th of January 2011. This is repeat surgery from 10 years ago. On day 7 I began having terrible pain in right leg. Was sent to ER where they confirmed it is not a blood clot. The pain is now through out the entire leg making even walking to the restroom excrusiating. I will be following up with my doctor but everyone seems stumped.. Have you heard of this with anyone else. What it might be.. Thank you..
Hi Jennifer
You need to see you doctor about this problem following prolapse surgery. Unfortunately I cannot advise you about this problem, my apologies. Michelle
Iwould like to start exercising again. Can I use the elliptical for cardiovascular exercise?
What weight training can you do and are there limits to the amount of weight you can lift?
Thank you!
Hi Sally
We cannot answer you specifically on this. Once a woman has approval to recommence general fitness exercise after pelvic surgery low impact options ar best: walking, stationary cycle. Elliptical machine would also fall into the category of low impact exercise, I always suggest to use the arm handles gently to minimise abdominal muscle involvement which can cause pelvic floor strain.
The limits for weight training are set by the specialist. In Australia these limits vary from specialist to specialist and woman to woman depending onm many factors such as level of fitness, age, type of surgery etc. We have an extensive library series of free vidoes and articles on exercises after pelvic surgery and exercises after a hysterectomy. Our book Inside Out – the essential women’s guide to pelvic support is designed to give you this specific information and pelvic floor safe workouts if you are interested in further reading on exercises after pelvic surgery Good luck Mchelle
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I am recovering from rectal prolapse surgery (laparoscopic&sling) which I had 10 days ago and was really pleased to find your website. I had a hysterectomy 2 years ago and it looks like I may need surgery for bladder prolapse later this year. I am 48 years of age and have two kids 15yrs and 10yrs. EMG of my lower left side showed only 40% nerve response and am due to have neuro stimulators inserted in the coming months. I enjoy walking and was doing at least 40mins per day before surgery and also pilates (but I am not sure that pilates is a good idea). I have osteopenia in my hips and I suffer from constipation.
Your videos and website are the best I have come across and I have found them REALLY helpful. You are doing a super job and helping lots of women with problems that can be difficult to talk about and find help with.
I am wondering how to proceed with starting to exercise as I still feel quite exhausted and a bit guilty to be sitting around and not doing much.
Hi Mary
Getting back into exercise is a slow business after prolapse surgery. First and foremost follow your specialist’s guidelines. The first 6 weeks post op are a maximum protection stage, the next 6 weeks moderate protection. Full healing for most women takes place at around 3 months after prolapse surgery and many women do not realise that this is the case so you need to take things easy during this time. Exercise during the first 6 weeks should really be directed at simply minimising de conditioning and maintaining mobility. This means that walking is usually the primary form of exercise during this time. Many specialists will have specific requirements for how much walking post operatively. A general rule of thumb is to commence with a manageable 5 minute walk in the first week, and gradually increase walking duration by approximately 5 minutes weekly, so that by the time of the 6 week check up, most women can manage a 30 minute continuous walk. This will however vary from woman to woman and case to case. Some tips are to wear good supportive underwear when you walk, keep the walking surface flat, don’t walk when you are tired and prepare to have a short rest preferably lying down with a pillow under your knees when you return from your walk, particularly in the first 6 weeks. Some women find that it is helpful to do a couple of small walks rather than a longer one, particularly during this time. Hope this helps your exercise regime at present, please keep us posted as to how you progress, Michelle
Hi Michelle,
This guidance is really helpful. I got very little direction from my consultant. The staged recovery programme makes sense and gives me a good timeframe to allow my recovery. I think there are a lot of women like me that feel we should be up and doing things. I find it hard to allow myself to rest but now I am reassured that I am doing the right thing for my healing.
Hi Michelle,
I am so happy I found your site, it’s so informative.
I am 62yrs old. I had 3 vaginal births and tubes done at 28yrs old a few days after my third child. I weight 55 kgs, 165cm height.
I had my prolapse bladder mesh repair along with incontinence strip three weeks ago. I am still having slight incontinence along with spotting. My surgeon advised me this would happen. However, he never mentioned anything about when to resume pelvic floor exercises. Said to not lift anything heavy until I see him for 6-week check up. Of course I am unable to lift my two youngest grandchildren and they are finding it very hard to understand.
I have exercised all my life using the gym, weights, pilates and yoga along with enjoying walking, swimming, boogie board riding, dragon boat racing, bush walking and playing competition tennis.
I am finding it so frustrating not being able to do any form of exercise apart from walking. I feel like I am losing my tone already, scary!
Questions:
1. When do I resume specific pelvic floor exercises?
2. How long do I use little stool to double void?
3. Do you have a suggested week by week exercise immediately after surgery programme for the pelvic floor area?
I understanding the walking part of exercise, I am relating to pelvic floor area, do I squeeze, draw up, stop the flow ??????
4. When can I resume playing social tennis and other outdoor sports?
I look forward to your response in due course, thank you.
Also I would like to purchase your DVDs and additional copies of your book to share with my girlfriends.
Kind regards
Caza
Pelvic floor exercises after bladder repair
Hi Caza
Yes I agree it is really difficult when you can’t do anything but walk. You will regain your tone when you can commence strength exercises so you can relax about this.
In answer to your questions:
1. Different specialists often have different protocols regarding when to recommence pelvic floor exercises after prolapse repair surgery. This usually varies from 6-8 weeks but this is up to the discretion of your specialist so this would be a good question to ask when you return for your post op review.
2. Use your double void technique as long as necessary to ensure complete emptying. Swelling can remain for 6 weeks and it is particularly important to empty completely without straining to do so.
3. Once again different specialists and physiotherapists have different protocols regarding how to perform pelvic floor exercises after gynaecological surgery, so again this needs to be discussed with your specialist and/or physiotherapist. Usually pelvic floor exercises commence gently, often in lying down and are graduated on a regular basis according to your surgery and your tolerance. Pelvic floor exercises after surgery may progress from lying down, to sitting and then standing. In addition they often progress in terms of intensity of the contraction and the number of repetitions performed with healing. Postoperatively pelvic floor exercises should be pain free.
This video on pelvic floor exercises after hysterectomy and prolapse surgery will give you some more information on how to do pelvic floor exercises post operatively
4. As far as pelvic floor exercises go the technique is to squeeze and draw up through the anus, vagina and urethra (urine tube). It is prudent not to practice stopping the flow of urine post pelvic floor surgery in particular as you want to ensure complete empty. Visualising or imagining that you are stopping the flow technique of stopping the flow is often a useful technique to feel the pelvic floor muscles contracting.
5. Once again outdoor sport and social tennis is recommenced at the discretion of the treating specialist. This can vary from specialist to specialist, and woman to woman depending on many factors including the type of repair performed and rate of recovery. It is always worth remembering that full healing takes approximately 3 months following prolapse repair. It makes sense to be very cautious in terms of the types of exercises undertaken during this time.
Hope this helps your understanding a little Caza. You may need to make a list of questions to take to your next specialist appointment so that you are sure to get specific answers regrading your repair.
Cheers
Michelle
Hello Michelle,
Your book is so excellent I only wished I had known about the book (and you) earlier.
This information about walking is so important and too late in my case. At 4 weeks I walked up a steep hill carrying about 6 pounds of groceries. The surgeon told me not to lift more than 10 pounds so I thought I was safe. When I got home I was bleeding and felt awful. That was 2 weeks ago and I am fine now. Wished I had followed your advice!!!!
I had a few other questions:
3. Can I start swimming and weight training after 6 weeks? My doctor has a already cleared me but I don’t think he knows anything about exercise. Of course I will follow your instructions about water walking and weight training. When I do weight resistance I actually use no weight at all due to shoulder problems so that is safer.
4. I am scheduled for direct anterior approach hip replacement 11/30/11 not quite 3 months after my 9/9/11 hyst, cyst/rect repair. Do you think this is enough recuperation time or I should I wait at least 6 months or something like that? For insurance reasons I’d like to have it done this calendar year but want to do what is best for my body. Of course the hip surgeons say it is OK- but they don’t really know about this!
I’m so glad I read your book. I’ve always been suspicious of Pilates. it never felt safe to me so I didn’t do it.
Thanks again Michelle!
Exercise after a hysterectomy and prolapse surgery
Hi Laura
I think every woman is different regarding return to exercise depending on many factors such as the type of surgical procedure, her pre existing fitness and strength, her pelvic floor capacity, previous surgery. I don’t think it is appropriate to have one rule for all women returning to exercise post op pelvic floor surgery as there are so many different factors involved.
This means that women should follow the advice of their specialist regarding safe return to exercise, and then select those exercises that are appropriate once given the all clear. This will usually include continued walking, water walking forwards, backwards and sideways. Appropriate progressive supported weight programs such as the program you have read in Inside Out, modified according to any other physical problems such as pre-existing shoulder problems and always recommencing with light weights and correct technique.
I think your question regarding hp replacement following pelvic floor repair surgery is an interesting one. Once again you are best advised by the surgeon performing the surgery who I imagine has consulted fully with the surgeon who has performed your particular pelvic floor repair surgery. It is worth remembering that full healing from pelvic prolapse surgery takes 3 months on average for the tissues to fully heal. It would be also worth asking about any risks known by your surgeons associated with the time frame you mention here. I also think other important factors to consider regarding further surgery here are age, remembering that with increased age surgery can be more difficult to overcome and how well you actually feel emotionally and physically to meet the challenges of dealing with a hip replacement which is another major operation. I would think that it would pay to be at your best physically and mentally when undergoing hip replacement surgery.
Finally many women find that support briefs help to provide external support when returning to exercise and activity post operatively. These don’t need to be tight to be supportive, some designs offer far more abdominal and pelvic support than others. To my knowledge there is no research into the effect of support underwear post operatively. Women frequently report improved comfort and support post operatively when wearing support briefs that assists them with activity and confidence.
Hope this helps you Laura and thank you for your correspondence.
Michelle
Oh one more question:
I don’t understand the purpose of the support briefs. Anything tight does not feel good (even one size bigger) but if I understand the reason of course I will wear them.
Thanks!
Laura
I wish I had found your book over a year ago. The information within it is so valuable and wish every Dr. has read this so they could better inform their patients of what to do and what not to do. I am 33 years old and at the age of 32 I had a hysterectomy, cystocele, rectocele, vaginal sling and a few other things done a year and a half ago. Within 10 months I was having another surgery to repair my prolapsed bladder. Then 3 months later I was back to the OR for a rectocele repair along with an iliococcygeal suspension. Then a week later had yet another surgery since a nerve was trapped within the stitches. Needlesstosay I am very pleased that I have this book now. After my 1st surgery I exercised and apparently have done everything wrong. I now know what to do and what not to do because of your book. Thank you for writing this book. I have lost 90lbs within the last 2.5 years and since my last surgery I(Oct) have gained some weight back since I haven’t been able to do anything. I am struggling with my weight. Since I am so young I feel as though I can’t be as active as I was prior to my surgeries and am afraid I can’t get back to running 5K’s. I have to redo my entire workout regime and don’t know where to start and feel a bit lost. Besides the information you have provided within you book Insideout, is there any other helpful exercises or resources that you could let me know about to help me get back on track with a workout regime that is safe for me?
Weightloss, fitness and pelvic prolapse surgery
Dear Erika
Thanks so much for sharing your personal story. You really have had so much to deal with, especially at such a young age. I have no idea whether or not you are running around after young children as well as dealing with your pelvic floor problems. Congratulations on your weight loss to date. This is a vital step in your long-term management and prevention of future pelvic floor problems and you have achieved a great deal with your weight loss.
Yes I completely understand and sympathise with your your confusion about where to start with your exercise program now and what exercise is now appropriate, especially in view of your previous pelvic prolapse surgery. Yes you now have to be aware long-term of pelvic floor safe exercise and put these principles into practice.
The better you understand appropriate and inappropriate exercises for your body, the better you will be able to exercise for your health in the future without compromising your pelvic floor.
First of all before you start exercising make sure you have your specialist’s approval to do so.
How to exercise for weight management with pelvic floor dysfunction?
1. Cardiovascular exercise or aerobic exercise of moderate intensity that elevates the heart rate but allows continued conversation at the same time.
Duration?
60-90 minutes of moderate intensity exercise.
Start with what feels comfortable for your body and gradually build up. Bouts of 10-15 minutes of exercise are appropriate when starting out.
Type?
Low impact supported exercises see p38 Inside Out
Cycling
Walking
Water walking etc (exercises that involve the large leg muscles)
Avoid running after recurrent prolapse surgery
Frequency?
At least 5 days per week
2. Resistance training
Regular pelvic floor safe strength exercises – 8-10 exercises, 8-12 repetitions at least twice a week on alternate days. There is a full pelvic floor safe strength training program in your book Inside Out p51-64 Choose from these exercises commencing slowly and progress gradually.
3. Pelvic floor exercises
Perform daily pelvic floor exercises to increase and maintain your pelvic support to allow you to exercise long term. Once again there is a full program Ch 2 Inside Out.
Erika I am not sure what country you are from. In Australia, there is an increasing awareness of pelvic floor safe exercise prescription among Women’s Health Physiotherapists. In view of your history it would be very wise to seek an appointment with such a specially trained physiotherapist for pelvic floor exercise prescription and general exercise advice.
We also have a new Australian site run by the Continence Foundation of Australia and funded by the Australian Government called http://www.pelvicfloorfirst.com.au On this site you will also find information on pelvic floor safe exercise.
I do hope this information helps you a little Erika.
Best wishes and good luck
Michelle
Thank you Michelle for your feedback. I do have a 5 year old son at home and that keeps me busy. I have been approved to walk on my treadmill for 15 min per day as of right now. In about a month my Dr. will refer me to a Physiotherapist. Prior to my surgeries I had gone to a Physiotherapist for over a month but unfortunately I still had to have surgery. I am from the US and I think that prolapse is an issue but not as common in young women such as myself; so when they say that you can go back to your regular exercise routine I don’t think they quite know what a person does. Thanks to your book and your follow-up email I will be able to ask my Dr specific questions regarding low impact exercises. According to my Dr and studies done here in the US he doesn’t want me cycling as that would cause the same strain on my injury site as running would. It is a very long recovery process but once I am approved to do more exercises I am going to do the program that is outlined in your book. This has given me something to look forward to. At age 33 you could imagine how my world has been crushed as I have ran, played soccer and lifted weights for the majority of my life. Your comments have truly lifted my spirits. Thank you!
Hi Erika
Can you advise me of the studies done that suggest that running and cycling place equal pressure on the pelvic floor. I am very interested to read this information as it really goes against what we know places pressure on the pelvic floor. Stationary cycling supports the pelvic floor, and sitting in the saddle, using low gears and sitting upright should not increase pressure on the pelvic floor. I would not however suggest cycling as an option for any women with pelvic pain or swelling in the perineum immediately post operatively.
Cheers
Michelle