How to Avoid Unsafe Abdominal Exercise after Hysterectomy

Fitball abdominal curl exercise

Are you trying to return to safe exercise after hysterectomy?

Are you concerned about unsafe abdominal exercise causing internal strain?

Unfortunately many women are left to their own devices to navigate their safe return to exercise after hysterectomy.


This Pelvic Floor Physiotherapist information teaches you:

  • When to return to exercise after hysterectomy
  • 5 intense abdominal exercises you need to avoid 
  • How abdominal exercise can cause long-term pelvic floor problems

When Can I Exercise after Hysterectomy?

Your surgeon will usually advise you on whether or not you can return to general exercise during your 6 week post hysterectomy check up.

Even though your wound may appear completely healed from around 4-6 weeks after surgery, internal healing after hysterectomy takes on average 3 months.

  • During the first 6 weeks of hysterectomy recovery, exercise is usually directed at minimising physical decline while your body heals and preventing hysterectomy side effects. Women are usually advised to choose post-operative walking as their main form of exercise during this time.
  • From 6-12 weeks after surgery when approval is given to return to general exercise a modified approach to abdominal exercises is necessary.

It’s vital to avoid intense abdominal core exercises as your body heals. For some women who have prolapse repair and hysterectomy surgery and/or weak pelvic floor muscles, modified abdominal exercises are advisable long-term.

5 Abdominal Exercises to Avoid after Hysterectomy

Inappropriate abdominal exercises after hysterectomy can increase the risk of internal strain and injury causing long term pelvic floor problems (e.g. pelvic organ prolapse).

For more pelvic floor safe exercises refer to Inside Out – the essential women’s guide to pelvic support.

Exercise 1. Head and Shoulder Forward Raise Exercises

Abdominal exercises where the head and shoulders are raised forward off the supporting surface i.e abdominal curls or sit ups (shown right)abdominal curl exercise

Variations include:

  • Fitball sit ups (shown above)
  • Incline bench curls/sit ups
  • Medicine ball sit ups
  • Oblique sit ups (opposite elbow to knee)
  • Roll up (Pilates)

Exercise 2. Double Leg Raise Exercises Double leg raises

Abdominal exercises where both legs are raised simultaneously off the supporting surface.

Variations include:

  • Double leg raises ( shown right)
  • Bicycle legs
  • Double leg fit ball raises
  • Criss-Cross (Pilates)
  • Corkscrew (Pilates)
  • Rollover (Pilates)
  • Single-Leg Drop (Pilates)

Exercise 3. Combined Head/Shoulder and Double Leg Raises V sit exercise

Abdominal core exercises where the head/shoulders and both legs are all raised simultaneously off the supporting surface.

Variations include:

Exercise 4. Forward Plank Exercises

Intense abdominal core exercises where the trunk is held suspended above the ground weight bearing through either the upper or upper and lower limbs.

Variations include: Forward plank

  • Forward Plank (kneeling)
  • Forward Plank (weight through feet)
  • Forearm Plank/Hover/Low Plank (weight through forearms and feet)
  • Chaturanga (Yoga)
  • Crow Pose (Yoga)

Exercise 5. Abdominal Resistance Equipment Exercises

There are many different types of equipment-based resistance exercises for the abdomen with potential to overload the pelvic floor.

Intense abdominal exercise equipment includes:Abdominal roller

This exercise information applies to most women during their 3 month recovery after a hysterectomy. Always follow your surgeon’s instructions regarding your individual post-operative exercises.

This list of unsafe abdominal exercises is by no means exhaustive – the variations listed here are to help you identify potentially unsafe abdominal exercises.

How Abdominal Exercise can cause Pelvic Floor Problems

Intense abdominal exercises increase the pressure within your abdomen (known as intra-abdominal pressure).

This pressure generated by your abdominal muscles is then transferred downwards inside your pelvis onto your pelvic floor.

Your internal surgical wound and stitches are placed under the load of pressure generated which can cause strain in an effort to counteract this downward pressure.

Safe Abdominal Exercise after Hysterectomy

Returning to safe abdominal exercises after a hysterectomy involves an understanding of those specific intense abdominal exercises you need to avoid to reduce the likelihood of internal strain.

Women are different when it comes to their long-term ability to perform core abdominal exercises – women at increased risk of pelvic floor dysfunction after hysterectomy will benefit from a long-term program of modified abdominal core exercises.


  1. Hi, I am post op hysterectomy 9months, and back in the gym using bike, rowing and cross trainer.
    I love to horse ride but have been told I should wait a year, (not a medical comment) any thoughts or comments on this please?
    Thank you for the help and support of your emails, without which I’d be totally in the dark!
    Joanna UK

    • Michelle Kenway says:

      Hi Joanna

      Thanks for your question.

      The issue with horse riding will be the impact so this will apply to the amount of impact transferred to your body when the horse lands. I am not a horse rider so you will have a better understanding of the riding speed that imparts the most pressure onto your body (and pelvic floor). Obviously landing from a jump will increase pressure so this is the type of landing to avoid if you’re not confident in your pelvic floor support. It strikes me that a slow trot would impart greater pressure to the pelvic floor than a faster canter? What do you think? Try to think about the riding speed that causes impact for your body and this is the speed to minimise where possible.

      Day to day care of the horse lifting straw bales, shovelling and carrying a saddle are related activities with the potential to load the pelvic floor. Hoe much does the average saddle weigh? Having never lifted a saddle I have no idea but they look quite heavy.

      Also take care with the resistance in stationary rowing so that you avoid straining on the pull back and keep your spine straight throughout.

      Hope this gives you some ideas Joanna.


  2. Hello,

    I had a hysterectomy along with the removal of my cervix 4 weeks ago. I knew for some time that I would need the operation, so I spent the previous nine months losing weight and getting fit. I was going to the gym 4 times a week doing cardio and weight training. My recovery has been great, I am walking for about an hour at a time and have now started doing the pelvic floor exercises you suggest. My question is, when can I get back to regular exercise, and what type? I was never a runner (used the AMT machine for my cardio), but I am missing working out and do not want to undo all the hard work of my previous 9 months. My intention is to start in the New Year after about 12 weeks. I was also thinking about trying the PIYO exercise programme. Although I have never done it before, it is said to be low impact and I believe this is what is suitable. Your advice would be appreciated.

    • Michelle Kenway Physiotherapist says:

      Hi Beverley
      Only your surgeon can tell you when you’re safe to return to regular general exercise – there’s no one rule fits all unfortunately which makes this difficult.The main thing is that you return to pelvic floor safe general exercise that is low impact, light resistance and avoids intense core abdominal exercise. It’s also important to strengthen the pelvic floor after hysterectomy too.