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)
- 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
Abdominal exercises where both legs are raised simultaneously off the supporting surface.
- 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
Abdominal core exercises where the head/shoulders and both legs are all raised simultaneously off the supporting surface.
- V sit (Yoga)
- Boat pose (Yoga)
- The Hundred (Pilates)
- Bicycle Twist (Pilates)
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.
- 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 (shown right)
- Abdominal wheel
- Abdominal crunch machine
- Captains chair
- Weighted cable crunches
- Ab/Back machine (ladies circuit)
- Specific Pilates Reformer and Cadillac intense core abdominal exercises
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.