Safe Exercises After a Hysterectomy- Health Professional Guidelines

Recovery Exercises After a Hysterectomy

Hysterectomy post-operative exercise guidelines for returning to safe exercises after a hysterectomy.

This pelvic floor physiotherapy recovery information applies to women seeking safe return to exercise after vaginal or abdominal hysterectomy. Always seek the approval from your medical specialist before recommencing any exercise after a hysterectomy.

Read on now to learn: hysterectomy recovery

  • How much walking after a hysterectomy;
  • Safe abdominal core exercises after a hysterectomy;
  • Posture exercises to promote recovery;
  • Pelvic floor exercises (Kegel exercises) after a hysterectomy;
  • How exercise promotes hysterectomy recovery; and
  • Exercise and some side effects of a hysterectomy.

Download these Hysterectomy Recovery Post-Operative Exercise Guidelines by scrolling down.

How Much Walking After a Hysterectomy?

During the first 6–8 weeks of recovery, walking exercises after a hysterectomy aim to maintain general condition and minimize decrease in fitness during recovery.

Walking after a hysterectomy tips:

  • Walk in the morning when well rested;
  • Wear quality support briefs for abdominal and pelvic support;
  • Walk on flat surfaces, avoid hills;
  • Wear well-cushioned footwear; and
  • Aim for a couple of short walks rather than one long walk when starting to build up endurance.

Commence walking on flat surfaces and follow your gynaecologists’ instructions for how much walking you should be doing. Most women commence walking for 5 minutes in the first week, and increase by approximately 5 minutes every week after surgery however this will depend upon initial fitness levels and whether any complications occur after surgery.

Always listen to your body and if you have discomfort associated with walking you have probably done too much. In this case reduce and/or slow down your walking program.

Abdominal Core Exercises After Surgical Recovery

Your deep abdominal muscles should work with your pelvic floor muscles to protect and support your insides. Core abdominal muscle exercises for hysterectomy recovery can be viewed here abdominal hysterectomy recovery exercises.

Avoid sit up exercises after a hysterectomy  Hysterectomy exercise guidelines

It is advisable to avoid sit ups and abdominal exercise machines after hysterectomy, particularly during the first 3 months recovery.

Sit ups increase downward pressure on the pelvic floor and the internal surgical site. Core abdominal exercises can increase the risk of pelvic floor problems such as prolapse and incontinence particularly if the pelvic floor is weak. Some exercise equipment in women’s circuits, gyms and even some Pilates exercises can also increase pelvic floor pressure and likelihood of strain.

Complete guidelines for pelvic floor safe abdominal and strength exercises to choose and those to modify and avoid after a hysterectomy are provided in Inside Out by Pelvic Floor Physiotherapist Michelle Kenway Physiotherapist with Dr Judith Goh Urogynaecologist.

Posture and Strength Exercises After a Hysterectomy

Practice sitting and standing with good posture following your surgery.

Good posture after a hysterectomy involves:

  • Standing tall;
  • Gently activating deep abdominal core muscles (discussed next section);
  • Lifting the crown of the head towards the ceiling when sitting, standing and walking; and
  • Avoiding the tendency to bend forward to protect the abdomen with movement.

Strength exercises after week 6

Some studies suggest studies there may be an association between hysterectomy and prolapse after hysterectomy surgery, however this link has not been firmly established. Heavy lifting is a risk factor for prolapse in women. Based on this information, avoid heavy lifting and perform pelvic floor safe exercise during your hysterectomy recovery and beyond.

Inside Out DVD

 

When you have your gynecologists’ approval, you may be ready to commence post hysterectomy pelvic floor safe strength training exercises using light hand weights as detailed in the pelvic floor safe strength workout DVD for women Inside Out Strength.

Kegel Exercises After a Hysterectomy

Pelvic floor muscles support the pelvic organs (bladder, vagina and rectum). The pelvic floor muscles will provide better support for hysterectomy recovery if they are strong and functioning well. Make sure you understand how to perform pelvic floor exercises correctly to avoid risk of internal strain with the wrong technique.

To learn more about kegel exercises after a hysterectomy, see our free pelvic exercise DVD Kegel exercises after hysterectomy.

General opinion varies widely as to the best time to commence Kegel exercises after hysterectomy, so always check your gynaecologists’ preferences before starting.

How Exercise Promotes Hysterectomy Recovery

Appropriate exercise after hysterectomy can improve your:

  • Ability to return to your everyday work and activities;
  • Confidence to move;
  • Strength, energy and well being;
  • Posture and deep abdominal (core) muscle control; and
  • Pelvic floor strength to support your surgery long-term.

Exercise and Side Effects of Hysterectomy

Some exercises can help prevent some side effects of a hysterectomy. These include:

  • Decreased fitness, strength and tone;
  • Lung problems or blood clots in the deep veins in your calf muscles;
  • Back pain and stiffness with prolonged bed rest and decreased movement;
  • Decreased bladder control; and
  • Feelings of sadness, stress and anxiety.

A sensible approach to exercises after a hysterectomy can help you to recover and return to your former strength and fitness. Understanding of the principles of pelvic floor safe exercises outlined in this article will also help you towards long-term protection of your pelvic floor to minimise the risk of prolapse.

Exercises after a hysterectomy Download Hysterectomy Recovery Recovery Post-Operative Exercise Guidelines as a user friendly PDF.

Inside Out Book and DVD Saver PackABOUT THE AUTHOR, Michelle Kenway

Michelle Kenway is a Pelvic Floor Physiotherapist and author of Inside Out – the Essential Women’s Guide to Pelvic Support. The Inside Out exercise DVD and book show women how to strengthen the pelvic floor and exercise safely and effectively after a hysterectomy with pelvic floor safe exercises.

Comments

  1. The information provided here is exactly what’s needed for all us post-op ladies in the UK. Finally, instead of the generalised ‘don’t lift this, don’t do that’ doctrine in the UK associated with hysterectomy and then basically left to fend for ourselves not knowing exactly what we can and can’t do for fear of causing damage, you’ve provided us with something we CAN do and how to do it safely. Thank you very much Michelle – I now feel more in control of my recovery.

    Claire

    • Michelle Kenway says:

      Thanks Claire
      I agree that it is empowering to know what you can do after surgery. If you progress gradually with your rehab exercises after your surgery you will set yourself up to be able to better support your wound and you will minimise your physical debilitation after your surgery too. This will position you better for when you do return to work and general activity, including regular exercise! Thanks for taking the time to comment. Michelle

      • Joann Cervantes says:

        Hi ladies I just had a total abdominal hysterectomy, on 02/12/2014, the surgery was longer than expected cause they pulled out 3 large tumors, I appreciate all on this site I was sent home with pain meds and told to rest for 6 weeks. I needed info on exercise the tumors made my body think is was pregnant and I gained alot of weight being put on meds for things that weren’t wrong with me until a specialist figured out what was really wrong. Thank you for all the great information.

    • Hello Ladies:
      So glad I found this site! My husband has been following me around shaking his head, “not yet!, not yet!”. Thank God he is the man he is! Well, I agree with the walking part, too much is not a good thing. Nice to know how to graduate the walking and other exercises for weeks in. Just going into my 4th week, guess I should be up to about 20 minutes walking, started Kegels two weeks ago. Just 5 at a time, now up to 15 about 4 times a day. Trying to hold my stomach muscles while walking. That is about it! Lots of sleeping! Went to the hairdressers, walked there, (into the mall and to the salon) and back out with a quick pit stop to get a pair of jeans, not such a great idea! Took me two days to recover from that exercise. So in conclusion ladies, Feet Up, time for another bubble bath! Take Care,stay tuned!

  2. Now I have a copy of your excellent book, which arrived very quickly, I feel empowered to give more shape to my post hysterectomy recovery, other than walking everyday. It is far superior to any of the limited general advice we receive in the UK. Time to go out and get my exercise ball. Thank you Michelle.

  3. THE INFO GIVEN WAS SO NEEDED . I AM 4MTHS POST HYST. AND WOULD LOVE TO START WORKING OUT AGAIN .
    HOWEVER I GOT SO MANY CONFLICTING ADVICE .SOME SAY TO DO CRUNCHES OTHERS SAY NO . THANK YOU ,YOUR INFO SEEMS SO REALISTIC AND PRACTICAL.

  4. I am in my 4 th week post op. I started walking on a treadmill in week 2, three times a week. Rest days in between as it was tiring and made me a little sore. I am now up to two session of 30 mins per day five days per week. I am starting to build some interval training into the walks with 2 minute bursts at a faster rate. Im feeling great.

  5. Margaret says:

    Now its been 5 months after my vaginal & abdominal hysterectomy. I’m putting on weight on my hips & abdominal.

    Can you show me the exercise to reduce it.

    • Hi Margaret
      Thanks for your question regarding weight gain after abdominal hysterectomy

      Weight gain really is a very common problem after hysterectomy surgery, so do not feel you are alone in dealing with this matter. The confusing issue is often which exercises are safe and which should be avoided.
      The best weight loss exercises after a hysterectomy are low impact exercises. Remember that you will never spot reduce fat from a specific region with specific exercises. The best way to lose weight off your hips and abdominal areas after hysterectomy surgery is through weight loss achieved through a sensible approach to diet combined with low impact exercises. Appropriate exercises at five months post op include stationary cycling, walking, dancing, bushwalking – exercises that involve keeping at least one foot in contact with the ground at all times. Avoid high impact exercises such as running and jumping – these will increase the pressure on your pelvic floor and may increase the likelihood of prolapse after hysterectomy.
      Also consider a graduated resistance training program 2-3 times per week. Appropriate strength exercises will help you strengthen, tone and manage your weight better amongst a host of other health-related benefits. Be very cautious about the strength exercises you choose. A good place to start is by looking at some of our free online videos such as http://www.pelvicexercises.com.au/2010/strengthen-your-legs/ and http://www.pelvicexercises.com.au/2010/tone-strong-arms/ Inside Out (http://www.pelvicexercises.com.au/products-page/hysterectomy-recovery-products/hard-copy-book//) features a complete strength training program for women like yourself, especially for pelvic floor protection.

      Hope this helps you Margaret and thank you for your contribution
      Michelle

      • Am I correct to assume that I should never jog/run again?  I can accept this, but I'm really curious about it.  It is my goal to get back to lap swimming, as I did this years ago.  What about spinning class, or Zumba?  Also, will yoga and pilates always be risky as well?  I'm saddened by the fear of prolapse, and I am willing to do, and not do, whatever it takes to keep that from happening.  I am ordering Inside Out  :)

        • Safe exercises after a hysterectomy

          Hi Briana,

          Thanks for your comments. I assume that your question is with regards to exercise after hysterectomy and regarding your question about running and jogging.

          The information that I can give you is that we know that there may be an increased risk of pelvic prolapse after hysterectomy and that the studies remain inconclusive in this regard. There are some studies however advising that there may be an increased risk and others suggesting otherwise.

          What we do know is that after Gynaecological surgery that there is an increased risk of pelvic floor dysfunction and that high impact exercises such as running increase the pressure on the pelvic floor and when repeated this can increase the likelihood of pelvic floor dysfunction.

          Swimming is a great low impact exercise that usually places minimal pressure on the pelvic floor. Spinning cycle classes are also low impact however caution needs to be taken in relation to standing in the saddle and using high gears as this will put pressure on the pelvic floor. Zumba classes can sometimes involve high impact exercises. Therfore, to keep them pelvic floor friendly they should be made low impact keeping one leg on the ground at all times. Some Yoga and Pilates exercises will increase pressure on the pelvic floor and these can be readily modified. Refer to this Yoga article for more information on Yoga and pelvic floor pressure.

          What is important after hysterectomy is ensure the strength of the pelvic floor muscles to support the type of exercises undertaken and continue exercising with a particular focus on pelvic floor safe exercises.

          Best of luck Briana.

          Michelle.

  6. Hi
    I am 7 weeks post op today. Feeling good mentally. tried to get back to Gym last Saturday but only managed 1.8km’s before I felt a pulling sensation under my ribs. I then managed to swim 350m on Sunday but was disappointed as I usually swim 2km’s in one sesssion. I have quickly realised how much Iam physically weakened at this point. I am still fairly tired at the end of the working day but have been resting a lot. I am eager to get back to some strength exercises so feedback is really appreciated. Also, I noticed today thatI had what looked like a small piece of padding, or stitches on my underwear. It was soft and string like and a greyish colour. Was wondering if this is just internal stitches dissolving. I am still bloating on and off as well. My weight is fairly similiar to when I went in however my clothes are definately tighter than before. Im assuming its due to the swelling still. I wont complain too much though because I seem to be recovering well compared to other stories I have read. Is anyone else still having issues with swelly belly or dissolving stitches?

  7. Wow! very helpful information and comments. I’m 5 weeks post-op and have felt fine the past two weeks. Went back to my desk job on monday and have been in bed with abdominal and back pain the past two days. My post op recovery plan from my doctor was the worst! He didn’t tell me specific excercises to do nor what to expect. Who know sitting up in a chair would make me so sore? I think I’m better equipped and have a better level of expectation for my body. THANKS ALL!!

  8. Hi,
    Thank you very much for the useful information that one can practise after hysterectomy.
    I have a question which worries me so much at present. i have undergone hystrectomy for more than 2 years nw. the problem is normally i will pass motion daily. but lately i feel like i’m having bowel movement problems. is it something normal for a post hysterectomy patient. i wonder if my intestine has drop filling the loop after the removal of the uterus. thank you.

  9. Ok, Ladies, NOT thrilled about the information I am reading. Please, those of you who are in the career of fitness….20+ years…..who RUN and LIFT for a living…..give me some sensible advice for recovery from a transvaginal hysterectomy. I am two days post- op,,,,,,NO INTENTION of lifting or pulling…let alone running at this point, but no sit ups , for ? what months???? I took off 5 days from work——–which is teaching fitness classes….yes I can coach my class through any workout and do NOTHING……but I was NEVER TOLD recovery was MONTHS away. Anyone? Keep in mind, I just went from teaching 15 exercise classes a week to 0….and running 3-4 x a week to 0……..

    • Abdominal core exercises and hysterectomy recovery

      Hi Liz

      Thanks so much for your comment. I will start by saying I completely understand your dilemma. It can be extremely frustrating to minimise your exercise program during hysterectomy recovery, especially having been as active as you have been with your classes and running.

      I think it is worth remembering that during a hysterectomy the uterus and it’s supportive ligaments are detached and removed. The top part of the vagina merges into the cervix and the uterus. This means that after a hysterectomy the vagina has lost a large portion of its’ uppermost supports. These days most surgeons place a firm supportive stitch from the top part of the vagina to the inside of your pelvis to keep it held up. There is suggestion from some good studies that the hysterectomy procedure makes a woman then more prone to prolapse after surgery. If you think about it this makes sense as the supports for the vagina are reduced and if too much pressure is placed downwards during recovery, or if support is inadequate post op. the risk of pelvic organ prolapse may be increased.

      How long does it take for complete internal healing after a hysterectomy? 3 months for most women all going well.

      Why is there a risk with sit ups and intense core abdominal exercises after hysterectomy?
      We now know from excellent studies that sit ups increase the downward movement of the pelvic floor in some women with pelvic floor dysfunction, and particularly for women who have undergone previous vaginal delivery. So if this type of exercise is recommenced prior to full healing or in women with pelvic floor dysfunction, then the risk of long-term pelvic floor injury may be increased.

      It may well be that for women with excellent pelvic floor muscle function, that they can return to sit up exercises, this has not been thoroughly researched to my knowledge. What we do strongly suspect however is that when women return to intense core exercises after pelvic surgery before they are fully recovered, then their risk of long-term pelvic floor problems may be greatly increased.

      Ultimately what the individual chooses to do long-term with exercise is completely up to them. If you are fully informed then the hope is that you can make appropriate decisions for your own body and prevent long-term pelvic floor problems long term.

      Best of luck and thanks again for raising this important hysterectomy recovery issue.
      Cheers
      Michelle

  10. THanks Michelle,
    The last thing i want to do is PROLONG the recovery process. I guess I am facing a reality that I did not expect. I was completely MISinformed about the recovery time and was told I would be back to work in a “WEEK” but to “JUST BE SMART & TAKE IT EASY”….no jumping. (I was very clear about my JOB DESCRIPTION and ACTIVITY LEVEL) MOST of my activity includes Plyometrics, core engagement, fast turning and ALL OUT INTENSITY bursts…..that being said, it is what is is now, and there is ABSOLUTELY NOTHING I can do about it NOW. (Can anyone make time move fASTER?) Clearly I have to stay within safety guidelines for the FASTEST recovery possible. Of course there is a “coaching” aspect to my job, which I love, and I will be doing my best to be an example to my students that “doing what is necessary to produce the results you want…..applies in recovery as well. By my following the rules to a safe & effective recovery, I will have the opportunity to help many women and men see it is possible to take the necessary recovery time away from intense exercise, and THEN, step by step, regain strength and rebuild muscle after a major surgery.

    • Hi Liz

      Yes you are in a wonderful position to help many other women recover appropriately from their hysterectomy surgery and avoid long term problems. You are absolutely correct about step by step regaining and rebuilding after a major surgery such as a hysterectomy.

      Isn’t it incredible that hysterectomy is now perhaps the most commonly performed surgery for women in the western world and yet there is still an immense lack of understanding and education about appropriate exercise for hysterectomy recovery to assist women return to good health, work and exercise. You are in one of the most challenging positions doing heavy work (exercise) for your livelihood.
      It would be wonderful to have female trainers such as yourself understanding appropriate exercise for women after hysterectomy and running special services to help them to return to exercise safely long term, especially if you were also able to work and communicate with their specialist. We would have women returning to activity, strength, avoiding unnecessary weight gain and feeling good about themselves through appropriate education and exercise. At present many women are given minimal guidance regarding safe return to exercise only to find themselves back in the gym 6 weeks later having no idea what is safe and what to avoid.

      Thanks so much for raising this important exercise issue for women Liz.
      Best of luck for your recovery!
      Michelle

  11. Michelle
    I really appreciated your feedback. I posted a few articles on my website about my hysterectomy. Please feel free to check it out. I would love to know what you think. I’m no professional when it comes to writing, but I really love helping women and I hope someday I can make a positive impact with people who are trying to be healthy & fit.
    Liz:)

    • Hi Liz

      I really like your honesty in your blog articles. Especially your fear of temporarily losing control of your body that you have exercised to hard to keep fit and strong, and your understanding that this will return in time with safe exercise after your hysterectomy. Yes I am sure you will continue to inspire other women through your work as a fitness leader and now perhaps with a new insight into having a lack of control which so many women feel in relation to their body.

      Best wishes
      Michelle

  12. Hi Michelle – thank you for this article. I’m 5 months post-op and have been struggling with terrible back spasms. I felt so good after my surgery, I started walking within a week. I was taking it slow and easy until I returned to work at 8 weeks. I started walking to and from work (just over 2 miles each way) and felt awesome for 3 weeks. Then the spasms hit and I haven’t been able to walk since. I’m frustrated because I love walking – it’s great for my body and mind. I’m going for physiotherapy and it seems to be helping a bit, but it’s so slow. I guess I just need to recognize that it will take time to regain my strength. Any words of encouragement would help!

    • Back pain after pelvic surgery

      Hi Sue

      It sounds as though you’re having a really tough time. First the surgery to contend with and just when you were feeling good again your back issue emerged. This must be making your back pain and not being able to exercise even harder to deal with.

      Sue what type of pelvic surgery have you had? I ask as in my experience some types of pelvic surgery involve and can affect the stabilising mechanisms of the pelvis and low back. Your stabilising muscles may not have been working as they were prior to your surgery and this may have made you more prone to back injury. Back pain is a reasonably common side effect of pelvic surgery simply from the rest involved, let alone the physical deconditioning that also takes place during your rehabilitation from surgery.

      Has your physiotherapist diagnosed a pelvic problem or a low back problem? This is usually a short term thing and it sounds as though you are pursueing an appropriate course of treatment in seeking the assistance of a physiotherapist. Perhaps you might like to discuss some appropriate exercise alternatives to commence when your physiotherapist sees this as appropriate such as water exercise/water walking/stationary cycling. Also, have you discussed other self help alternatives with your physiotherapist for example using a brace or support knickers to allow you to mobilise more comfortably, massage, heat that you can apply for relief. These are all worth discussing to give you some relief and control over your condition.

      I hope this helps you a little Sue and gives you some useful information to help you move forward.
      Best wishes
      Michelle

  13. I had a full abdominal hysterectomy at the end of July – 4 months post op not 5 (feels like a long time ago!). I also have a history of back problems – a herniated disc 4 years ago and some ongoing mild deterioration in my other discs.

    My physiotherapist has given me some exercises and I’m very slowly starting to see results. Thank you for the other suggestions – I’ll discuss them with my physiotherapist. I very much want to be walking again – I guess I just need to be persistent with the exercises and learn to be more patient.

    Thanks again,
    Sue

    • Hi Sue

      Thanks for this information. The very important thing that comes to mind in your situation is the importance of very good core muscle rehabilitation. A comprehensive core muscle rehabilitation program addresses the pelvic floor muscles, deep abdominal spinal support muscles and the stabilising back muscles. All these muscle groups are potentially compromised with chronic back pain, and research tells us that rehabilitation of the whole cylinder of support around the trunk is vital in this situation. The abdominal hysterectomy and the chronic back pain you describe both have the potential to interfere with the stabilising muscle supports around the trunk.

      As far as time frame goes for back rehabilitation, everyone is different and healing depends on many different factors including the nature of the injury and exacerbating factors. Once again a good question to ask your physiotherapist. Finally if your condition does not improve and at a resonable rate, then I would assume that your physiotherapist would send you to your doctor for review.

      Best of luck for your recovery
      Michelle

  14. Hi,
    What an interesting site! I’m 4 weeks post op after abdominal hysterectomy and although taking it really slow and trying to follow what I consider good guidelines for do’s and don’ts I am getting interested in when I can expect to get back into my running routine. I realize it is still some time away but how long? I’m no professional runner but try to do 6-7 KM a couple of times a week. I seem to be reading that it is mainly recommend to walk – not run. Have I understood that right? And with sit-ups – not that I am good at getting them done, but when would it be safe to start doing those – if ever? Thank you for getting back to me about this as I really want to do what is best for my body – to stay away from what is not good but also to get back into a good routine when it is safe to do so! kind regards, Tamara

    • Hi Tamara

      Sounds as if you are being careful and sensible following your hysterectomy and you are wise to do so.

      Regarding your question about running- definitely avoid running and other forms of high impact exercise during the post op period. Full healing actually takes on average 3 months for most women. While the external wounds appear healed, internally tissues are still healing and your body still repairing.
      During this healing time it is advisable to protect the pelvic floor by adhering to low impact exercise only – this means one foot on the ground at all times during exercise. This minimises the jarring associated with high impact jogging. This is for a number of reasons; to ensure that the internal tissues heal well, to avoid straining newly healed tissues/wounds, and to minimise pressure on the pelvic floor. There is some evidence to suggest that there is an increased risk of pelvic prolapse after hysterectomy surgery.

      Sit ups increase the downward pressure on the pelvic floor, a fact well established in recent scientific studies. Sit ups will never flatten the abdomen, this is a myth, it is not possible to spot reduce fat with sit up exercises. Whether or not to recommence sit ups long-term is really dependent upon how well a woman’s pelvic floor is functioning and how strong it is. If in doubt with pelvic floor capacity to withstand downward pressure then definitely avoid sit ups, they too can increase the likelihood of pelvic floor problems such as prolapse with a weak pelvic floor.

      Suitable core exercises for many women include those shown in this floor based core exercise video, which provides more information. See also this core fit ball exercises for after hysterectomy

      Let me know if you have any further questions
      Cheers
      Michelle

  15. I am a week post vag. Hysterectomy and am feeling very frustrated already. I really enjoy my exercise and am sad that I will not be able to do any for a while. I usually do 4 sessions a week of high impact ex but feel that I will need to make some serious changes. Is that
    right? How long before I can actually run 5 km’s again? Thanks for your info. I really have enjoyed the comments and especially the exercises.

    • Running after hysterectomy

      Hi Christie

      Thank you for your comment. Yes it can be very frustrating when not being able to exercise during hysterectomy recovery especially if you are accustomed to regular exercise or a regular runner.

      Have you been given permission to commence walking exercise? This is usually the exercise of choice in the early post hysterectomy. These post hysterectomy walking guidelines may assist you in devising your walking program if you have approval to do so.

      Regarding high impact exercise such as running post hysterectomy this really needs to wait until you are completely recovered. There are some studies that suggest women are at increased risk of prolapse after a hysterectomy. Hysterectomy surgery involves removing and replacing some of the suspensions of the upper vagina. This can’t be seen externally but it is really in your best interests to ensure that your tissues are fully healed internally before recommencing this type of exercise. While some women are given medical approval to return to general exercise 6-8 weeks post op, full healing takes 3 months so it is wise to ensure that you are fully healed and that your pelvic floor muscles are in good shape to support your insides for high impact exercise.

      Some women choose to avoid high impact exercise altogether, particularly women with combined hysterectomy and prolapse repair surgery. Until further research is done, it is difficult to be conclusive about the long-term safety of high impact exercise after hysterectomy.

      There are useful ways of modifying or avoiding high impact exercise long-term and still getting a great workout:
      Cycling/spin classes (low gears and no standing for climbing)
      Brisk walking
      Water based exercise – water running is low impact and a great workout
      Swimming – especially squad training groups
      Low impact gym equipment- stepper
      Alternating sessions of higher impact exercise with low impact- useful if you are a runner to do this
      Choosing surfaces and good footwear to reduce impact- again important for runners
      And of course long term pelvic floor safe resistance training check our information library on Safe Exercises after a Hysterectomy for further details.

      I hope this gives you some information to help your long-term planning. Hope your recovery goes well.
      Michelle

  16. Hi Michelle. Wow. Thankyou for your comprehensive answers and for getting all women post hysterectomy back on track. You have given me some hope that I can return to my pre op exercise routine at some point. I am getting the picture that I have had this op with limited knowledge but your website has so much info that has made me feel at ease. I will certainly be taking your advice and not rushing into anything. (although I feel like it!). Thanking you for your reply and enjoy Christmas.
    Christi

  17. I'm 4 days post-op and have found this really helpful. As a really busy working mum, I'm finding it a challenge to feel so debilitated and I think I'm expecting too much of myself.I will follow the walking plan as I have even been trying that but am in lots of discomfort tonight, trying too hard!!
    Thanks again, I intend to spend more time tomorrow having a closer look at your advice.
    Karen

  18. Great comments. It's helpful to hear other women tell their stories. I am 6 weeks post radical hysterectomy. I have had pelvic surgery twice before this for uterine prolapse. I have worked at a pkg. delivery co for almost 30 years and I'm sure lifting has contributed to my prolapse problems. I have lifted weights to help me keep in shape for my job for 20 years. I know how to safely lift now but my question is ….is an elliptical safe to use after a hysterectomy. I's like standing up and bicycling. I also do inward and outward leg lifts for my thighs. Are these ok? I do add weight on my ankles when I get to that stage. Thank you for helping.                                                         Mary
     

    • Elliptical and side leg raises after hysterectomy

      Hi Mary

      First and foremost ensure you have your medical specialist’s approval to return to elliptical exercise. Do take care in the first 3 months post hysterectomy as your internal wound is still healing even if it appears to be healed externally. Elliptical is a nice low impact exercise and you would anticipate minimal pressure on your pelvic floor when using such equipment. I definitely suggest against putting too much force into the arms and keep resistance low for the first 3 months if it is adjustable to minimise pelvic floor pressure. Always commence short duration and build up as your body tolerates this.

      Inward outward leg lefts perfomed lying down should not place adverse pressure on the pelvic floor, even with weight added on the ankles. This is a nice antigravity hip strength exercise and the abdomen and pelvis are not under load. I assume you do these leg lifts lying on your side and not in any other position?

      Regards
      Michelle

      • Thanks Michelle. I do leg lifts on my side, but I also do raises while on my forearms and knees I lift a leg while bent up toward the ceiling.(with toe pointed up.) These are great glut exercises. Im glad you warned me about the elliptical too soon.I will wait and walk a lot first. Mary

  19. Hello, I'm going in for a hysterectomy on Thursday and have gain weight from anxiety for the surgery. I'm pretty active, I love to swim and tan how soon may I do both?
     

    • Swimming after hysterectomy

      Hi Tonia

      Yes the lead up to hysterectomy surgery it is understandably an anxious time for many women.

      Your return to swimming will be determined largely by the rate at which your wound heals. Different specialists can have different guidelines about when to return to general exercise. Your specialist should advise you at your six week check up about when you can return to swimming. As far as tanning in the sun goes there is no reason why you shouldn’t be able to spend some time in the sun relaxing during your recovery during the first six weeks. This will be a pleasant part of your recovery I would think.

      Take your time when it comes to losing weight with exercise postoperatively and keep in mind the fact that that for the first six weeks post hysterectomy at least, the purpose of exercise is to prevent general debilitation and should not be used for the purpose of weight loss.

      Wishing you all the best for your surgery and recovery.
      Michelle

  20. Hi I a. Three weeks post op now.  I have kept my ovaries and cervix as there was no need to remove them.. I also had a combined spinal epidural and no general anesthetic.  In general I think I am doing well with my recovery went back to work after two and a half weeks (mainly office work) and am driving already.  However a couple of days ago I started getting a back pain (a certain point on my spine ) and the muscles surrounding it.  Could it be from the injection? After three weeks? But I think it is also a little bit above the injection site.  Are platform shoes (high heels) bad at this point ? Can they cause back pain during recovery or is back pain a normal part of post hysterectomy?
    thx
     

    • I am going in in 3 days for the abdominal hysterectomy. But I am 65…anyone here have any of the same “age” related recovery info?
      Thank you~

  21. I had a vaginal hysterectomy on 15th February and so far everything has gone smoothly up until the last 4 days. I have very bad back pain which is in the same spot (just right of my spine around the waist area). I have been doing short walks but have to stop as it is too painful. I have been taking Norgesics (prescribed by the doctor) for the pain and using deep heat cream or a wheatbag. Nothing seems to be working. Can you suggest what to do as i feel that laying around and doing nothing is making it worse. I would also like to go back to light swimming and walking in the pool. Do you think this will help my back complaint.
    Thankyou

    • Back pain after hysterectomy

      Hi Leanne

      Any sudden onset of pain post-operative hysterectomy should be assessed by your general practitioner or by contacting your gynaecologist – I assume you have not had your 6 week check up yet. Having said this it is also worth remembering that inactivity post hysterectomy will often contribute to the onset or recurrence of back pain post operatively. This can be due to laying on soft couches, soft chairs and general immobility. So there are a couple of possibilities and these need to be assessed by your doctor.

      With regards to swimming I agree that gentle water walking is a lovely low impact exercise for the spine and for recovery however you need to seek the approval of your surgeon before returning to water based exercise to avoid the possibility of infection. Until surgical review at 6 weeks most women are advised to commence a gentle graduated walking program as outlined in this article.
      Kindest regards
      Michelle

    • Hi Leane
      i have the same problem too .. I had an abdominal hysterectomy on 14 Feb.  My recovery has been fine except for the back pain which is located in the middle of my back Ina specific spot on my spine.  When I press on it or bend forward or back it really hurts.  Let s keep each other posted ! By the way I had my operation with a combined spinal and epidural. Did u have that too? I was worried that might b the cause of the pain!

      • Self management- low back pain after hysterectomy

        Hi Nevine

        Epidural/spinal block can occasionally contribute to back pain post operatively. Usually back pain after a hysterectomy is due to the inactivity post operatively. It’s a catch 22 isn’t it – you need to rest but this can aggravate the spine for some ladies.
        Simple self help strategies to avoid or minimise low back pain after hysterectomy surgery can include:
        • staying mobile with short regular walks
        • resting with the spine supported
        • choose firm supported chair/bed ( a taller chair can be easier to get in and out of and place less pressure on the low back)
        • avoid lying on soft lounges
        • avoid sitting for extended periods of time on low soft lounge chairs
        • using warm packs as required
        • gentle in bed mobility exercises prescribed by your in-hospital physiotherapist.

        Wishing you a good recovery
        Michelle

  22. Thanks Michelle for your reply, I did go and see my GP last week and she said it was ok for me to go back to light swimming. After 3 days of constant back pain i got my self to the pool. 4 days later and my back is so much better. I still have a small amount of back pain but nothing like i was experiencing at week 3 post op. I think that after 3 weeks of sitting around and resting and also the operation made my back so weak that now i have to strengthen it. The swimming has also made me feel so much better in myself. I have to see the surgeon next Thursday which will be just over 5 weeks post op. So far that has been my only complaint about the whole experience. I dont feel like i have had a vaginal hysterectomy and had very minimal pain from day 1. Hopefully with time i will fantastic. Thankyou once again for your help…
    Cheers
    Leanne

  23. Hi Im four months post op of a full prolapse vaginal hysterectomy, I work in a hospital as aphysio assistant and at the end of my 5 hour shift my legs feet and stomach are very swollen due to water retention. Have been given water pills by gp but they are not very effective. Can you tell me roughly how long this may last? I 'm struggling to find out what other excesises i can do. i use the stairs and do lots of walking.I still do my pelvic floor. but im gaining weight i try and have a healthy diet as well lots of fruit and fresh veg lots of chicken and fish and very little red meat.  looking forward to any help and advice

    • Hysterectomy weight gain and fluid retention

      Hi Helen
      Have you been told that your fluid retention is the result of your pelvic surgery? This is a little unusual after 4 months recovery time assuming you are in good general health and have not had any adverse events post operatively. The best way to manage your fluid retention will be determined by the cause and this needs to be established my a medical professional who understands your health.

      In terms of weight management it sounds as though you are doing well with your healthy diet. This is of paramount importance – watch everything you eat and drink.There are a range of appropriate exercises for weight loss you can do with your mainstay being walking and perhaps stationary cycling at this stage of your recovery. Water walking is also a great exercise although I don’t know how feasible this is where you reside in the UK.

      To promote weight loss after prolapse surgery /hysterectomy with exercise:
      - vary your exercise routine regularly
      -choose low impact exercises e.g. water walking, stationary cycle, low impact dance
      -gradually increase exercise duration as you are able to
      -consider wearing supportive briefs when you are mobile and exercising.

      For further details refer to this article on hysterectomy weight loss guidlelines and Inside Out Strength DVD.

      There are specific leg exercises for lower limb fluid retention (calf pumps), compression stockings and elevation of the legs when possible to promote fluid return to the heart. Once again the cause of your fluid retention needs to be medically assessed.
      Hope this assists you Helen
      Michelle
      Regards
      Michelle

  24. Hi there. I am almost 2 weeks post total vaginal hysterectomy. Feeling good overall besides being very tired some days. I enjoy regular exercise and usually do 3-4 spin classes per week. I was looking forward to getting back to that around week 6 , however after reading many of the comments here am second guessing that plan. Thoughts?
    Much Appreciated.

    • Spin classes after hysterectomy

      Hi Tanya
      Be guided by your medical specialist regarding when you return to spin classes. When you do the way to minimise pressure on your pelvic floor and your internal wound is by keeping the gears low and staying in the saddle rather than standing and climbing.

      You may choose to do some stationary cycling for a number or weeks before entering a class to ensure wound healing and to regain a little fitness before resuming classes. This way you can control your cycling and the effort and subsequent pressure involved.
      All the best for your recovery!
      Michelle

  25. What a fantastic site! I am absolutely shocked at the total lack of post op advice and care offered to people in the UK. I went to my GP (no chance of seeing an gynae here!) and was told that I was not 'clinically in need of' physio post op!! I could go to a physio privately (£30 per half hour) or do without. So, thank you, Liz , for your time and expertise.
    I am 4 and a half weeks post abdominal hysterectomy and removal of ovaries. I have had 3 caesarians and foolishly assumed that the recovery would be similar. How wrong!! I am very frustrated at the slowness of the recovery. I do not feel up to driving (and my husband won't allow it!!) and live on the top of a hill, so getting out for walks is difficult.  I have walked in to town a couple of times, accompanied by one or other of my sons, but I am still quite sore, especially at the sides of my stomach. I have no stomach muscle control and find that, when I need to empty my bowels, it needs to be done NOW! There is also some pressure and discomfort before I empty them. I am usually fit, healthy and active – I am a teacher and also coach sports – and I am dreading not being ready to go back to work after the Easter holidays in 2 and a half weeks. I am keeping busy – cleaned the oven yesterday and spent time shredding documents on Wednesday – but feel quite low. Any advice or reassurance would be appreciated. Thanks in anticipation.

  26. Lorraine says:

    Hi Ladies,
    So glad I found this site as it is so informative. I had a TAH/BSO and removal of a large ovarian tumour on 14 March, the tumour was the reason for surgery, it was urgent so all done in 5 weeks from Gp referral to op. Eternally grateful to our wonderful NHS.  I was informed of recovery period and op explained in detail. We listen and take info on board, Yet, somewhere in my brain I did not apply this to me!  I was not keen to have epidural but went ahead with the consultants advice.  Epidural was aborted due to a complication, Op was a success so far, results from histology back on 16 April when I have my post op check up.  I too run, am reasonably fit, Mentally strong under normal circumstances. (I have a disabled daughter which has made me the person that I am proud to be today.) The difficulty I have in my recovery is one day the physical me appears well the next the mental / emotional side is,but, never working together as a whole person. My gyny nurse explained it was a big op, I am normal to feel this way, also due to my bad experience with the epidural(I had neck spasms for a week after which seemed more debilitating at the time than the op) I have done gentle neck exercises and pelvic floor, running is not even on the radar at present. I am pleased for all those recovering at a good rate and getting back to normal life . For those of you who like me are weeping, feeling tired, frustrated, recovery is not happening soon enough, Know that you are not alone,  if it takes us a bit longer , we will have to adjust at our rate of healing. my eldest daughter said Mum , you thought you would have the op read a few books with your feet up for a couple of weeks and then be running in the marathon. That's exactly what my inner voice thought Despite listening to the Doctors and nurses giving all the invaluable advice.  I'm  glad to have found all you wonderful ladies who have shared their experiences and if my sharing has been of help to you that's a bonus. Keep well, listen to your bodies and be safe.
    Lorraine.
     
    ..

    • Hi Lorraine

      Thank you so much for sharing your personal experience – your account will undoubtedly help other women to cope following gynae surgery such as yours. I am also really glad you highlight the mental/emotional and physical side of your recovery as many women are unprepared for this as with many things in our lives.

      Yes you need to take all the time you need for your physical and emotional recovery, be kind to yourself and perhaps this will be another of those personal growth events in your life that helps you to understand and assist others as well as you already do.

      Once again thank you for taking the time to write and help others
      Best wishes for your recovery
      Michelle

      • Hi Lorraine,
        I can relate to your situation.I am four weeks post hysterectomy it's so nice to hear that I am not the only impatient person in the world.Like you I thought I could read a few books get a bit of attention and then pick up where I left off, because I am different. When I have had to face the fact that I am not . I will listen to my body and be safe.
        Thank you

  27. Thank you so much for this very useful advice, I was very fit before I had surgery and I can’t wait to get back to my exercise classes but I am very frightened of doing something that might result in a prolapse. Now I know what I can and can’t do when the time comes

    • Thanks Karen
      Yes yours is a commonly expressed concern, glad this artticle assisted you.
      Good luck
      Michelle

  28. Hi michelle,
    I am nearly three weeks post op after having a TAH and BSO and I am looking forward to going back to my exercise classes when I am fit enough. Before having surgery I was doing step classes, body pump and Zumba but I realise that it may be a while before I am doing those again. Would it be safe to go swimming after six weeks ?

    • Hi Karen
      Yes you are entirely correct in identifying step and body pump as classes to avoid post op. Swimming is a great low impact activity to commence with post operatively when you have the approval of your surgeon to recommence exercise. In view of the fact that your surgery was abdominal, then water walking is most advisable. Some times ladies experience some stretching through their wound area when doing freestyle initially. Gentle breaststroke may be more comfortable. Walking forwards and backwards, along with side stepping with gentle breatstroke arms are ideal since they are low impact and combine some gentle resistance for strengthening and some light cardiovascular work too.
      Hope this helps and thank you for your comment, best of luck!
      Michelle

  29. Hi Michelle,
    I’m so very glad I’ve come across your site.It is packed with so much useful and reassuring information and I am certainly going to be purchasing your book. I’ve had no helpful information from my surgeon and I’m due to have a total hysterectomy in 3 weeks (preserving the ovaries).
    Bascially I’m 33 and for the last 5 years have been in out of hospital with severe high grade cervical dysplasia resulting in the need for the hysterectomy. I haven’t been able to have children and now won’t get the chance and while the surgery itself doesn’t bother me I understand the need for it and the process, I do have concerns with long term phsyical activtiy. I know for the first 3 months I’m going to have to take it slow and ease myself back into things, but I’m normally a very active person and I’m wondering about the viability of jogging in the future if you can after a total hysterectomy return to jogging safely. Also I’m concerned about down force. I garden paticulary I have vegetable garden and I’m not sure with all I have read if I’m going to be to dig to turn soil or turn my compost. I know it must sound ridiculous I suppose my physcial health and gardening are in a sense my children so the thought I won’t be able to do these things again makes me very apprehensive. I’m already concerned about exercise I normally do a lot of crunching and upper arm work and it’s going to interesting enough trying to find exercises to substitute. I’d really appreciate any help you could give as to to the long term effects of hysterectomy and how physical you can be without risking damage.
    Thank you and Thank you for creating such a wonderful website.
    Keep up the fabulous work!!
    Tika…(Australia)

    • Hi Tika

      Thanks so much for taking the time to write and tell your story. The story you have described will undoubtedly assist other women, and it is indeed most generous of you to have done so. I am deeply moved by your story and I know many other women will be too.

      Your comment on intense core abdominal exercises is timely as we have just made a free online video on pelvic floor safe abdominal exercises. As you are aware intense core sit up exercises can have an adverse affect on pelvic floor function and support if the pelvic floor is at increased risk of dysfunction. You may wish to read this article on Unsafe Abdominal Exercises and view this short video on Core Exercises After Hysterectomy. We will upload the new abdominal exercise videos in the coming week, and I hope these help you with some more information.

      My very best wishes for your upcoming surgery Tika, please stay in touch – I’d love to hear how everything goes for you. I think many other women will too.
      Best wishes
      Michelle

      • Hi Michelle,
        Thank you for your reply and for posting the helpful links on exercise to avoid and exercises that are safe to do. It has been greatly reasuring to know that my life won’t change so dramatically in terms of physical activity and I will be able to continue to maintain a healthy and active lifestyle. I feel I can now go into my surgery with full confidence. So much so I have ordered the DVD for pelvic floor exercises. While I wait to be able to exercise again I think it will help me keep my spirits up and certainly be somehing to look forward to.
        Thank you for your good wishes and I’m touched you feel my story may be able to assist other women. I will keep you updated of my progress.
        Thank you so much again for you invaluable advice and taking the time to respond. It is deeply appreciated.
        Keep up the great work and best wishes to you.
        Tika.

  30. I had laparoscopic hysterectomy 11 days ago removing uterus & cervix. I’m wondering how soon I can get back to my elliptical? Normally I’m on it 5 days a week for 50 mins & love it. Anxious to get back any feedback would be appreciated.

    • Michelle Kenway says:

      Hi Shannon
      You will need to check with your surgeon on when he/she is happy for you to recommence general exercise based upon your surgery and recovery. Elliptical is quite a nice low impact exercise for the pelvic floor, it is important to start gradually with low resistance and short sessions only when you do recommence and you should be free of physical discomfort during and after your Elliptical exercise. During the first 4-6 weeks post hysterectomy walking exercise is usually the best recovery exercise for most women.
      Best of luck
      Michelle

  31. May13am2013 says:

    Today marked 3 weeks since my LAVH surgery. I am happy to report that I no longer need pain medication. However, I am having difficulties falling asleep at night; my BM is so irregular that I need to take dulcolax every other day in order to help me go. Yes, I drink lot of water, eat sensible meals, which include lots of fresh fruits and vegetables. My three weeks post-op check up is coming up in two days and I’ll have the chance to describe these issues with my doctor. In the mean time, I would like to hear from you ladies. Did you experienced these symptoms? I am also experiencing night sweats even thought I kept both of my ovaries.

  32. I am now 11 weeks post vag hyst and repair. I am normally very active and finding the recovery very hard. I am walking every day and getting on with jobs around the house which don’t involve lifting. I have taken all of the post op advice given in the leaflets very seriously and am not overdoing it, but by the evening I have back and pelvic pain and feel similar symptoms to my prolapse. Is there anyone else feeling like this so long into the recovery. Am getting very frustrated as want to get my activity levels back.

    • Michelle Kenway says:

      Hi Emma
      A this stage things should be likely to be settling down for you. Have you had your 6 week post-op appointment with your specialist? I suggest you contact your specialist regarding this ongoing issue. After that the next step may be to see a Pelvic Floor Physiotherapist. My other suggestion is that if all is clear from your specialist, that you read up a little on pelvic floor muscle spasm – some women do get post op pelvic floor muscle tension, but I stress that you chack with your specialist as a priority first. A Pelvic Floor Physio can assist in the treatment of pelvic floor tension if this is found to be a factor.
      Hope this gives you some direction Emma
      Michelle

  33. lynne gormley says:

    It is nearly 5 weeks since my TAH/BSO.Not due for my OPA for 3 weeks, Gp said I can swim and would be OK to use my rebounding trampoline. I am a bit concerned this would increase pelvic floor pressure ?
    Recovering pretty well, BM starting to return to more normal.Is it safe to use the trampoline, at the gym they have hand cycles, you move the pedals with your hands, would these be OK to use? I did excercise previously and lost 3 stone so dont want it to come back on! very interesting site.
    Lynne

    • Michelle Kenway says:

      Hi Lynne
      Ultimately be guided by your gynae’s advice on when to return to exercise post op. As far as rebounding goes, it will increase pelvic floor pressure if you lift both of your feet high off the rebounder so that you land with impact. The way to keep this low impact is by keeping at least one foot in contact with the rebounder throughout exercise, hope this helps and best of luck.
      Michelle

  34. Hi. I had a LAVH plus removal of both ovaries last week. Feeling scarily good…. So am glad I found your site as I had planned to do far more exercise ( and the wrong type!) in the up coming weeks. I was wondering in you cover stand up paddling in your book? The Physio in the hospital, mentioned that while I couldn’t lift the board, I could perhaps recommence paddling about week 4? However after reading through your posts so far, I am not sure . My gynaecologist appointment is not until week 6.

    • Michelle Kenway says:

      Hi Jackie
      Thanks for your question – it’s one I haven’t had before. I would agree that carrying the board is one issue with the weight of the board potentially adding too much strain. Standing paddling will involve your abdominal muscles working quite hard which can also increase pressure within the abdomen and downward on your pelvic floor. This is one to check with your gynaecologist at 6 weeks post op. I agree that it can be an issue when you are feeling good the temptation can be to do too much too soon, in this case best to wait and give your body time to heal internally.
      Cheers
      Michelle

      • Thanks Michelle… I will wait till my appointment :) I am not that good a paddler, so I am not sure how tough the workout would have been! I am, however, quite good at falling off. All the more reason to wait. Thanks for the advice :) Regards Jackie

  35. Hi. I have been looking at ‘devices’ to help me train my pelvic floor eg pelvic toner
    http://www.pelvictoner.co.uk/

    Are these effective or, at risk of being indelicate, just a substitution for an index finger? After reading your site and watching your video I am keen to improve my kegel exercises. As someone over 50, I am the age where we were told to do a hundred a day.. Do them at every traffic light.. Particularly useless information, especially as I lived in a tiny country town with 1 set of lights!!
    Regards Jackie

    • Michelle Kenway says:

      Hi Jackie

      The pelvic toners are useful for women with really weak pelvic floor muscles and those that have diffiulty feeling the pelvic floor muscles contracting. Basically the pelvic toner contracts the pelvic floor muscles however the pelvic floor muscles also need to be actively contracted with the machine for strength gains. Using the machine without active pelvic floor muscle contraction will not strengthen the pelvic floor. Using the finger to feel the pelvic floor muscles is a great biofeedback method and gradually decreasing this as the pelvic floor muscles become stronger and the biofeedback is not required.

      Hope this answers your qn.
      Cheers
      Michelle

  36. Hi! I am three weeks post op from full abdominal hysterctomy (ovaries intact). I used to do a lot of core abdominal exercises and lots of walking. I am disheartened to discover that I may not be able to regain my almost flat tummy again due to the risk of prolapse. I have an Ab Circle Pro machine at home and really want to get back to using it, but not sure now, since I guess the internal stitches take a lot longer to heal… I haven’t gained any weight since the op and hope I don’t in the future. My tummy is still sore and tender especially on either side of the wound. I had problems with my back due to having an epidural (with general). I am walking a lot more now, but tire easily and that is so not me.. I am having a hard time accepting the fact that it will be along time before I am ever near ‘normal’ again.. I was never informed of the road ahead post op and I am so glad I have come across this site. Thanks to all those that have told their story and I hope we all are up and at em sooner rather than later :) !!!!

  37. tonya wilson says:

    I am discouraged about not being able to run or do sit ups. According to my Dr. I was informed I could return to my normal activities in 4-6 weeks.
    I am 6 weeks post op for an open hysterectomy to remove a tennis ball sized mass and my uterus.
    I bought a BOSU Ball and began core exercises and strengthening core and abdominal muscles.
    I have always been very active and I would like to return to being able to run and also do sit ups. Is this truly a discouragement? I certainly do not want to go through a surgery like that ever again.

    • Michelle Kenway says:

      Hi Tonya

      Thanks for your comments, I completely understand your concern about exercise after hysterectomy. I am not sure whether you also had prolapse surgery too at the same time. Really the jury is still out regarding the increased risk of prolapse after hysterectomy with some studies suggesting the risk is increased and others finding it is not. It is thought that after prolapse surgery the risk of repeat pelvic floor prolapse is increased and women need to choose pelvic floor safe exercises long-term.

      Your individual risk will depend upon a number of factors:
      - how well your pelvic floor muscles are working to support your pelvic organs (the less support the greater the risk of prolapse)
      - whether you have had prolapse surgery
      - how soon you return to exercise post hysterectomy
      - the distances you run (the longer the distance, the greater the pressure)
      - the number of sit ups you do and whether or not you perform intense core exercises repeatedly

      If your pelvic floor is functioning really well and you had hysterectomy only, then you may well be able to gradually return to running and sit ups. If not then it may be better to choose pelvic floor safe exercises to avoid the possibility of prolapse.

      I hope this gives you some information to help with your decision making Tonya

      Michelle

  38. Hi Michelle
    I am concerned that I may not be able to return to my high impact aerobics class of body attack and running after a total laproscopic hysterectomy, this was performed 6 weeks ago with a post op e-coli infection 2 weeks after the op which left me quite weak . Much better now but have read that there is more risk of vaginal prolapse if you do the above exercises. Can I ever return to doing these as I am a fitness fanatic and really enjoy these activities?
    Have not been able to start the pelvic floor exercises routinely as yet as I always feel uncomfortable afterwards. Also have had 2 cauteries for granulation tissue so have a way to go to healing but am managing 1x 30-40 minute walk in the morning and a 20 minute walk in the afternoon if I have the energy.
    Regards
    Val

    • Michelle Kenway says:

      Hi Val
      Yes there are some studies suggesting the risk of prolapse after hysterectomy is increased (however some other studies suggest it is not) making the whole issue very tricky for women indeed. I think it is important to consider that during hysterectomy the upper vagina is suspended to the pelvis internally by a stitch. In the past this stitch was not used and many women who had hysterectomies in years gone by found that the vagina prolapsed as a result.

      Your capacity to do high impact exercise is determined in part by a number of factors including:
      - your pelvic floor muscle function (strength and support)
      - the strength of your pelvic floor tissues
      - previous pelvic floor muscle trauma with childbirth
      - how soon you return to exercise (especially if you have been debilitated by infection return to exercise will take longer)
      - whether or not you have existing prolapse.

      We do know that high impact exercises, intense core abdominal exercises as well as heavy lifting all have potential to impact upon the pelvic floor especially if it is weak so I hope this information gives you some ideas on appropriate exercises, feel welcome to let me know if you have further questions.

      Cheers
      Michelle

  39. Hi,
    I wish I had found this site 6 weeks ago prior to my hysterectomy for fibroids. I have felt pretty good in recovering despite having some complications following having to go back for further surgery initially to stem a bleed. I was worried about what and how much I should be doing but am pretty sure I was probably planning too much too soon. I am 43 and not at all overweight but am keen to protect my pelvic floor so am sticking to walking at the moment. I would like to know if exercising on a rowing machine is considered high impact on the pelvic floor or if it is best avoided, as I did use it sparsely and gently prior to my surgery. Would love some advice regarding this as I need to do something to tone my belly, as I look like I recently gave birth! Love the site and thanks for all the useful advice,
    Mandy x

    • Michelle Kenway says:

      Hi Mandy

      Sounds as though you are taking the right approach returning gradually, good for you.

      Rowing is a tricky one, it is a low impact exercise however there may be some potential for strain which might be avoided with the following:
      - keep the resistance on the rower low so that you never strain as you pull back
      - maintain the inward curve in your lower back thoughout and sit tall – this is very important, it means avoiding bending your truck forwards as your knees bend and you return to start position, try to stay sitting tall throughout as the bend forwards will increase pressure on the pelvic floor
      - if rowing outdoors consider speed, the faster the row, the higher the resistance and the greater the potential for strain so keep the speed slow and steady
      - when you start back use very short intervals i.e. 4-5 mins max and see how your body feels, any discomfort wait a bit longer

      Best of luck and thanks for your comment Mandy
      Michelle

  40. Hi,
    I wonder why we do not get post op advice and guidance at the hospital. I am 42 years old, in India. I had 3 CS – last one in February 2013 for twin boys, when something went wrong in the OT and 3 weeks later, in March 2013, I had emergency hysterectomy with ovaries still left in me. Apart from the physical strain, mental trauma and tiredness, I have a terrible back pain right at the center. My stomach muscles have become so weak and protrude out, I look 6 months pregnant all the time. Trying abdominal support belt. Some say don’t lift heavy things, don’t bend or it will cause hernia, but with 2 twin boy babies and 2 young girls in the house how can you avoid this? I need to be physically fit to take care of my children. Imagine I will be 50, when they turn 8 years! Can I join a gym? I have only walked before.

    • Michelle Kenway says:

      Hi Reshema
      What a terrible ordeal you have been through. In Australia som hospitals provide post op guidance after hysterectomy, some hosptials don’t – isn’t it such a shame that all women cannot access this for their physical and emotional wellbeing. Yes agreed with twin babies and two young children how can you avoid bending it’s not possible.

      There is alot women can do in terms of exercise and management after hysterectomy to help abdominal and back strength.While an abdominal support belt can help short-term, in the longer term it won’t help as it takes over the role of the deep abdominal support muscles so the belly and back actually weaken.

      The types of exercises for abdominal support after a hysterectomy include:

      *Learning to activate deep abdominal muscles correctly without contracting the abdominals too strongly which many women tend to do

      *Practicing deep abdominal control exercises after hysterectomy such as those in this video and also in the pelvic floor safe core abdominal exercise video

      *back strengthening exercises
      as shown in this back exercise video

      *safe lifting techniques especially when caring for babies and looking after the pelvic floor and lower back

      Reshma it may take a bit of time to work through these links however they provide more information than I can give you in one comment reply. Take a look and if you have further questions don’t hesitate to let me know I am happy to assist in providing you with information if I am able to do so.

      Wishing you all the best looking after yourself and your babies
      Michelle

  41. Hi thank you for all this information its fantastic. I had a tvh 5 years ago but kept ovaries, followed by a bladder prolapse op last April which was caused by too much exercise ie sit ups – which I had not been made aware of at the hysterectomy ! I was therefore lectured severely after the prolapse about not doing them and do not lift anything anymore. I am not allowed to run either ( not that I was a runner !) I am not fat luckily but I would like to tone up as I am 50 . I was wondering if it is ok to use a spin board – which involves waist twisting ? I can’t find any info on this related to hysterectomy or prolapse. Your advice would be most appreciated. thank you

    • Michelle Kenway says:

      Hi Mel
      Thank you for your comment and for sharing your post op experiences. Repeated twisting at the waist using a spin board shouldn’t have an adverse effect on prolapse repair if done slowly – I can’t see that it dramatically increases pressure on the pelvic floor. However I have to admit that in terms of efficacy for toning up this type of equipment is questionable. The other issue is that with repeated rotation at the hips, some women will irritate the small facet joints in the lower back, particularly if they already have some wear and tear. Are you seeking to tone your waist? If so kneeling side plank would have the desired effect with less potential for injuring your lower back. Side plank shouldn’t markedly increase pressure on the pelvic floor either. Let me know what you think about this alternative.
      Cheers
      Michelle

      • Thank you so much for answering me so quickly. Im a bit wary about doing the plank – even the side plank as I used to do the forward plank and could hold for 2 minutes – I was told that it contributed to my prolapse.
        The idea of the spin board was to do it fast to increase my heart rate. Although I’m slim I have high cholesterol and am supposed to do some form of aerobic exercise to increase my heart rate . I’m struggling to find something apart from walking which isn’t always possible (especially at the moment in UK with our heavy rain and floods ! ) Swimming is no good as I don’t live near a pool. I’m looking for something that I can do at home which doesn’t involve money ! I also used to do interval training fast running on the spot – not allowed anymore! Thank you for your help.

        • Michelle Kenway says:

          Hi Mel
          Yes I can understand you feeling this way about the Plank. The Forward Plank involves the strong Rectus Abdominis or “6 Pack” muscles – these muscles increase the pressure in the abdomen when they contract strongly and this pressure is transferred to the pelvic floor, so that if the pelvic floor lacks the strength to withstand this pressure it is forced downwards and can lead to prolapse. The Side Plank does not involve Rectus Abdominis contracting strongly and there is no evidence to suggest that it generates sufficient pressure to force the pelvic floor downwards so it can be an alternative for some women seeking to strengthen core muscles. This is not your goal Mel as you say you are seeking to increase your heart rate and agreed this is very challenging in some countries where it is difficult to exercise outdoors. I often suggest that after prolapse surgery and with prolapse women invest in a second-hand stationary cycle so that they can do seated exercises for fitness and protect their pelvic floor. Hope this helps you a little Mel,

          All the best
          Michelle

          • Thank you I will try the side plank then and see if I can find a second hand exercise bike thank you :)

          • Michelle Kenway says:

            Hi Mel
            Just take it steady with side plank, don’t strain. I do think that the stationary exercise bike will be a great way to use the large muscles in your legs and protecting your pelvic floor – exercising these large leg muscles will effectively promote your fitness. Always keen to hear how you go!
            All the best
            Michelle

  42. I am five weeks post-op following a sub-total hysterectomy, and whilst I can do pelvic floor exercises ok, I am having problems with chest tightness and SOB, can anyone offer any advice.

    • Michelle Kenway says:

      Hi Caroline
      Please contact your treating health professional immediately with post op shortness of breath. This requires prompt medical assessment.
      Kindest regards
      Michelle

  43. Hai
    I am 6 months post total abdominal hysterectomy. I am currently walking about 50 mins 6 days a week. Planning to start back my yoga, your suggestion Plz. Also can u tell me about the symptoms of prolapse. I have gained a little weight in my belly and biceps region, any particular exercise to reduce. I Take a normal indian Diet. Thank u

    • Michelle Kenway says:

      Hi Arthi

      Thank you for your question on safe exercise after a hysterectomy.

      The symptoms of prolapse vary from one woman to the next, in some cases there are very few symptoms whereas in others women can suffer debilitating symptoms. You can read a complete list of prolpase symptoms using this link.

      I have also written a couple of articles on Yoga and pelvic floor safe exercise. This particular article will give you information on choosing safe Yoga exercises and those to avoid to protect your pelvic floor after hysterectomy – this article is titled Yoga prolapse exercises but the same principles apply after a hysterectomy

      Let me know if you have any further questions after this reading
      All the best
      Michelle

  44. evonne estep says:

    4 weeks in recovery from abdominal hysterectomy and removal of huge fibroid I named Eugenia….it was the size of an 8 month pregnancy. Is there any different advice I need because of the fibroid issue. I am anxious to start exercising and have been walking my dog around the apartment complex twice a day for a couple of weeks now. I also care for my 6 month old grandaughter. I, too, was amazed at what you say recovery time truly is. I did’nt realize it would be months or about the prolapse issues. Thanks for the info!

    • Michelle Kenway says:

      Hi Evonne
      Great question! Yes I think ‘Eugenia’ would have been loading your pelvic floor a little like a pregnancy. You probably noticed increased bladder urgency because of the pressure on your pelvic floor along with other symptoms. This loading has the effect of stretching and weakening the pelvic floor muscles and tissues making safe exercise after a hysterectomy really important for you including a graduated approach with walking the main exercise in the first 6 weeks as you are doing.

      The other issue will be restrengthening your pelvic floor muscles to ensure good bladder & bowel control long-term and to minimise the risk of prolapse if the supports are weakened. This will involve progressive pelvic floor exercises or Kegels over 5-6 months. Just check with your specialist for when to start if you haven’t already done so.

      All the best for your recovery Evonne
      Michelle

  45. Hi,
    I’m 43 years Indian, mother of 12 year girl, PA to the Principal in an Engineering College under went total abdominal hysterectomy 9 months ago. Now i’m very much normal. It is a pleasure to share my experience in this site. Heavy and non-stop flowing made my decision strong to remove my uterus. At the time of operation small cist was found on my right ovary, which may cause cancer in the later time. So it was also removed. Now i can walk and comfortably ride my two wheeler also.
    Even though my schedule is very tight i am doing all my work in time. But i just wanted to know that having one ovary in me, can i go for long walk and participate in trekking events. Please advice me.

    • Michelle Kenway says:

      Hi Padma
      Walking is usually a good form of general exercise for women, including most women who have had a hysterectomy. Build up your distances gradually over time for trekking events and avoid carrying heavy back packs for long distances. Pelvic floor exercises are important for long-term support and staying active, you can read more about pelvic floor muscle exercises using this link.

      Thank you for your question

      All the best
      Michelle

  46. Hi Michelle- I had a hysterectomy just over a year ago and have made a good recovery but have gained one stone in weight which I am struggling to shift despite a relatively healthy diet. I’ve been doing pilates at a class and recently brought a DVD but found that my tummy muscles have been hurting the following day or two – initially I thought this was a good sign that I ‘was working’ but having reviewed a lot of the material on your site have decided that its probably not a good idea. I’m going to try and modify my pilates as you suggest – i.e. keeping head/shoulders down and only single leg raises.
    I have a few more questions though:
    1. when doing the core strengthening exercises on the ball, can I add hand weights? i.e. for the arms out/up movements?
    2. If I add weights to squats/lunges at pelvic height – isn’t this increasing pelvic pressure? Which I thought we should avoid??
    3. Can you clarify what is good for what and what is a good weekly combination? i.e. walking and/or exercise bike for cardio, exercises on the ball and floor and squats/lunges – are these for strength (in all muscles or just core?)
    Also, I note you mention bone density – is this covered in the ball/floor/squats type exercises?
    4. What about swimming – is this cardio? I’ve read that it isn’t particularly beneficial for weight loss but then its meant to be a good low impact exercise that’s good for the whole body?

    Its all quite confusing and I feel like I’m not sure what I should be doing for the best really – I really want to lose weight (although I guess this is a common struggle for women post hysterectomy) and also want to stay fit, strong and healthy in the years to come (I’m 47 currently).

    I’m glad to have found your site – like many ladies on here, I’ve found that there is a lot of poor information out there that is probably doing more harm than good for women’s health!
    Thank you very much in advance for your reply.

    • Michelle Kenway says:

      Hi Sarah
      Thanks for your further comments. Yes agreed good idea to back off on the intensity of your core abdominal exercises.
      In reply to your questions:
      1. Great idea to add light handweights to core exercises on the ball – I include all types of upper body strength exercises for women sitting on the fitball
      2. Some women with severe prolapse or very weak pelvic floor muscles should avoid loading with squats or lunges. The issue with weight is related to weight that sits on the pelvic floor and loads the pelvic floor i.e. abdominal weight. The other issue is heavy lifting causing straining. If you hold moderate weights against your hips as shown in my DVD you are not straining your pelvic floor or increasing the load placed directly upon your pelic floor.
      3. -Walking & cycling exercises that increase your heart rate are good for cardiovascular (heart) fitness
      -exercises involving moving the limbs on the ball promote core abdominal muscle control and adding resistance to the arms has the added benefit of strengthening as well as core control
      -sqauts and lunges are leg/buttock strength and core exercises, many women don’t realise the benefit for their core muscles from these whole body types of exercises as many under the misapprehension that the only sit up exercises are for the core which is not the case. Whole body exercises are great for core control, especially those incorporting a ball such as ball to wall squats
      - Bone density is promoted with resistance exercises and high impact exercises. With pelvic floor problems we discourage high impact exercises however it is very possible to promote bone health with resistance exercises such as squats/lunges for hip bone strength
      4. Swimming is low impact cardio exercise you are correct – it does not benefit bone density however it is useful for some women with osteoporosis for general fitness and movement. The best exercises for weight loss are high low interval cycling and brisk walking over swimming.

      Hope this answers your questions Sarah
      All the best and thank you for your comments!
      Michelle

  47. Dear Michelle,
    Firstly, thank you so much for such a helpful and informative website.
    I had a laparoscopic hysterectomy and bilateral salpingo oopherectomy a week ago for endometrial cancer and outwardly everything seems to be healing nicely. The physio said that I would be able to restart Pilates after 3 weeks which really surprised me because I know how strong some of the exercises can be. Even though I would obviously go back to the very basic level I wonder whether you feel that it would be best to wait for 12 weeks before trying at the very least. Also I’m a very average runner but I enjoy it and I read somewhere here that perhaps post hysterectomy women should forget about running altogether. Lastly (sorry, I’m going on!!) I play the clarinet reasonably seriously but can find no information about starting to blow again. Any ideas, please? I’m 54 and fortunately am not carrying any extra weight.
    My grateful thanks,
    Sarah.

    • Michelle Kenway says:

      Hi Sarah

      Thank you for posting these question. I will deal with each of your questions in turn.

      Safe return to any form of exercise post hysterectomy usually requires the surgeon’s approval at 6 weeks post op check up. In many cases women need to return to modified exercises. I am not sure whether your Physio has designed some specific Pilates style exercises for you to proceed with during your recovery? General Pilates should be approached with caution post hysterectomy particularly in view of the fact that internal healing takes up to 3 months so that while you may appear well, healing is still underway internally and this is a time when the internal wound is at risk with exercises that paces pressure on the pelvic floor.

      Running after a hysterectomy is an issue of controversy and definitely not appropriate for all women. Running is high impact and repetitive high impact exercises increase the pressure on the pelvic floor as shown in studies to date. On an individual level your ability to run depends on the strength and support provided by your pelvic floor to withstand the associated pressure. This article on prolapse and running will provide you with more information on running and risks to your pelvic floor – don’t be concerned at the title, the principles apply post hysterectomy too.

      I would agree with your that playing clarinet is likely to increase pressure on the pelvic floor – I am not sure what kind of resistance is involved in blowing through the mouthpiece having never played it, maybe you can tell me. I would be inclined to wait until fully healed before undertaking this kind of activity to be sure – unfortunately there is very little known about this but it makes complete sense that blowing out against resistance (like blowing up a balloon) increases pelvic floor loading.

      I hope this information gives you some direction Sarah!
      All the best
      Michelle

      • Dear Michelle,
        Thank you for your kind and thoughtful reply. I’m sorry not to thank you straight away.
        The physio didn’t give me any Pilates-style exercises, just the standard booklet of pelvic floor and gentle tummy exercises which seem similar to those I was given post-babies! So no change there!
        At the moment I will just carry on doing those exercises whilst gradually increasing them as suggested in the booklet. Also, I’m increasing the amount that I walk each day so as not to lose too much fitness.
        I’ve found out that I’m going to need radiotherapy and I think I’ve decided on just going for the brachytherapy (to the vaginal vault) rather than the full assault of pelvic radiotherapy. So I’m not sure what effect that will have on my poor old pelvic floor! Meanwhile I suppose that I shall just decide how my pelvic floor is coping with a full bladder etc and then if at 12 weeks all seems ok then I might go back to Pilates and start at the beginner level and see how it goes. If I’m not happy I might see if the gynae physios would assess me and offer advice- after all it says to contact them if I’m worried on the back of their booklet!
        I think that I’ll wait at least 12 weeks before a very gentle jog and see. One thing at a time, maybe. Thanks for the article, by the way!
        I can’t cope with not playing my clarinet so I’ll have a go in a couple of weeks with a nice easy reed and sitting down! I’ll let you know if it’s disastrous!
        Any idea about the effect of vaginal radiotherapy on the pelvic floor?
        Thanks so much for taking the time to reply last weekend.
        Best wishes,
        Sarah.

  48. pauline taylor says:

    Hi Michelle,
    i had a full hysterectomy by keyhole surgery sent home after 24 hours with instructions for pain and blood clots etc 4 weeks ago no exercise regime sheets from physio which apparently i should have had . I am an active person zumba and the gym, all of which ive put on hold for 3 months. the 2nd week I didn’t feel right so went to the Drs who said i had a small bowel prolapse! and was told to discuss in my follow up check, which i am not getting as they have discharged me by letter. Are there any exercises I can do to improve the prolapse or not, when is it safe to go back to the gym and what would you recommend to avoid?

    • Michelle Kenway says:

      Hi Pauline

      The exercises for prolapse are pelvic floor exercises – these have been shown to be effective for reducing prolapse symptoms and lifting mild to moderate prolapse within the pelvic floor. My book Prolapse Exercises outlines pelvic floor strengthening with prolapse at length and I also have guidelines online for pelvic floor exercises with prolapse here

      Return to the gym is decided upon by your surgeon depending on your recovery and your surgical procedure. You may wish to refer to this information on prolapse exercises and pelvic floor safe gym exercises to help you decide which exercises to choose and those to avoid. Obviously avoid heavy lifting and compromising exercises such as deep weighted squats and heavy leg press. Intense core abdominal exercises will also be unsuitable. I think you are wise to put the gym on hold until fully healed. Keep Zumba low impact which means keep at least one foot on the ground at all times and to avoid jumping.
      Hope this helps you get started Pauline and thanks for your questions!

      Cheers
      Michelle

Trackbacks

  1. [...] with prolapse symptoms, incontinence and after a hysterectomy or prolapse surgery (returning to exercise) are often unsure how to do strength exercises [...]

  2. [...] For further reading refer to our Hysterectomy Post-operative Exercise Guidelines. [...]

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