Preparing for hysterectomy with these Physiotherapy exercises helps you improve your recovery speed and reduce your risk of some common problems after hysterectomy.
1. Pelvic Floor Exercises (Kegels)
Hysterectomy may increase the risk of pelvic floor problems after surgery including prolapse and/or bladder control problems.
Starting your pelvic floor training before your surgery can help you strengthen your pelvic floor muscles. This prepares your pelvic floor to support your internal wound after you surgery.
2. Deep Breathing Exercises
Some women experience breathing difficulties and chest problems such as chest infection after hysterectomy.
Abdominal hysterectomy has a greater risk of postoperative chest problems than vaginal hysterectomy owing to the difficulty deep breathing and coughing with an abdominal wound.
Practice the correct deep breathing exercise technique before your surgery and learn to breathe into your abdomen. Knowing this technique allows you to start your breathing exercises immediately after your hysterectomy and during your early recovery.
3. Circulation Exercises
Surgery and immobility increase the risk of DVT (deep venous thrombosis or clots in the deep veins of the leg). Preparing for hysterectomy surgery includes knowing basic circulation exercises to do during early recovery and when resting in bed.
You can usually expect to move out of bed into standing and walking from the day after your surgery to reduce your risk of DVT.
Circulation exercises are usually commenced after waking from surgery. Regular circulation exercises are encouraged during bed rest. These exercises include calf pumps (shown right) and heel slides throughout the day.
4. Core Abdominal Exercises
Abdominal exercises help you prepare for hysterectomy. Your deep abdominal muscles help support your abdominal wound, firm your lower tummy and improve support for your lower back and pelvis.
Deep abdominal exercises are gentle exercises directed at the deep innermost layer of your abdominal muscles. These exercises are not the same as traditional abdominal curl exercises.
Preparing for hysterectomy involves practicing the deep abdominal exercises similar to those demonstrated below in this core exercises video
These core abdominal exercises can often be continued during hysterectomy recovery.
Hysterectomy Recovery Exercises e-Book
Reduce the risk of common hysterectomy side effects and promote the speed of your recovery.
- Early hysterectomy recovery (abdominal or vaginal hysterectomy)
- Preparing for a hysterectomy
- Reducing the risk of common side effects e.g. back pain, constipation and gas
- Preparing your body for return to work and regular activity.
5. General Fitness Exercises
Fitness naturally declines during hysterectomy recovery.
Improving physical fitness before hysterectomy is a positive step towards reducing the risk of some post operative problems e.g. chest problems. Poor physical fitness increases the length of hospital stay for some patients.
Having a good baseline level of fitness helps you maintain better function and fitness compared with being unfit unfit.
Fitness exercise prior to hysterectomy may include regular:
- Stationary bike
- Water walking
It’s important to do what you can comfortably manage when exercising prior to hysterectomy. Some women have abdominal discomfort while others may be anaemic. Do what feels right for your body according to your general health and wellbeing before your surgery.
6. Strength Exercises
Physical strength affects hysterectomy recovery including the ability to move and function well after surgery. Simple tasks such as getting in and out of bed can be very challenging after a hysterectomy.
Simple whole body strength exercises that can help you with your hysterectomy recovery include leg and buttock exercises such as bridging exercises or mini squats.
Strength exercises that help daily movement such as sit to stand using a firm chair can improve your ability to stay mobile with ease after surgery.
7. Body Weight Control Exercises
Losing weight prior to your surgery can reduce your risks and improve your outcomes if you’re overweight or obese.
Dietary management is essential for weight loss – it’s very difficult to lose weight through just exercise.
Appropriate weight management exercises for women who are overweight involves low impact exercises with the large muscles working continuously.
Low impact weight management exercises for women who are overweight include:
- Stationary bike
- Water walking
- Elliptical machine
The amount of exercise you perform determines the success of your weight management program.
Small amounts of exercise (i.e. 10 minutes) can be repeated 2-3 times during the day if you’re unable to perform 30 minutes of continuous exercise. To lose weight you need to do at least 45 minutes of aerobic exercise on 5 days of the week. The more exercise you do, the more weight loss you can expect to achieve if you’re dieting.
8. Lower Back Exercises
Lower back problems are very common after hysterectomy.
Familiarising yourself with a good routine of lower back exercises is an important part of preparing for hysterectomy.
Appropriate lower back exercises for hysterectomy include:
- Modified lumbar rotations
- Pelvic tilts
- Heel slides
These lower back exercises are usually appropriate for most women to continue during after their hysterectomy recovery.
9. Correcting Your Bowel Emptying Technique
Constipation is one of the most common problems after a hysterectomy. If you’re prone to constipation take the time to practice good bowel emptying position and technique when preparing for hysterectomy. Using this method can help you avoid constipation and empty your bowels with minimal pain and without straining after surgery.
When emptying your bowels correctly adopt the correct bowel emptying position:
- Sit on the toilet seat with your feet apart
- Lean forward from your hips with your chest raised
- Support your upper body by resting your hands or forearms on your thighs
Practice using the brace and bulge technique demonstrated in this bowel movement video below.
10. Practice Getting In & Out of Bed Safely
Moving in and out of bed incorrectly after a hysterectomy can cause wound pain and strain.
Practice the correct technique for getting in and out of bed before your surgery. This technique makes moving after surgery safer and more comfortable.
Getting in and out of bed correctly involves:
- Rolling onto your side (log roll)
- Raising your body sideways into sitting
11. Practice Moving Within Bed Safely
Moving in bed is challenging especially during early hysterectomy recovery. Moving incorrectly for example sitting up forward increases the downward pressure on your internal wound.
Take the time to learn and practice moving in bed when preparing for your hysterectomy.
Moving correctly in bed involves:
- Sliding one heel at a time towards your buttocks
- Lifting your buttocks off the bed by pushing down through your feet and keeping your head resting on the pillow
- Moving your body around the bed using this technique rather than sitting forwards or using an overhead bar to move your body.
12. Knowing Your Hysterectomy Risk Factors
Knowing your risk factors helps you know how to direct your exercise preparation for hysterectomy.
These hysterectomy risk factors can be addressed with the exercises listed above:
- Circulation problems such as a history of DVT
- Chest problems including chronic coughing (e.g. chronic bronchitis or bronchiectasis or chronic shortness of breath (e.g. obesity, heart problems)
- Spinal problems including lower back or neck pain
- Weak pelvic floor muscles
- Bladder or bowel control difficulties
- Chronic constipation and straining
- Obesity or overweight