Walking After a Hysterectomy|Complete Physiotherapy Safe Guide Weeks 1-7 (Video)

Are you unsure how much walking is safe after a hysterectomy?

Walking after a hysterectomy is usually one of the best forms of exercise for promoting recovery and avoiding side effects.

This Physiotherapy video and information teach you:

  • Benefits of walking after a hysterectomy
  • Physiotherapy week by week walking guide after a hysterectomy (Weeks 1-7)
  • Safety tips for safe walking after hysterectomy

Hysterectomy Recovery Exercises e-Book

Hysterectomy Recovery Exercises e-book cover

Reduce the risk of common hysterectomy side effects and promote the speed of your recovery.

Ideal for:

  • 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.

Benefits of Walking After a Hysterectomy

Benefits of walking after a hysterectomy include: Walking after a hysterectomy

  • Minimizing physical decline in fitness1
  • Reduced the risk of blood clots in the deep leg veins (DVT)1
  • Decreased length of hospital stay1
  • Improved bowel function2 reduced gas pain and bloating
  • Greater physical comfort2
  • Feelings of well-being 
  • Increased energy
  • Improved standing posture
  • Relieving lower back pain and joint stiffness.

Week by Week Physio Hysterectomy Walking Guide

The scientific research is clear that prolonged bed rest should be avoided after gynaecological surgery2,3. Most women are encouraged to mobilise out of bed within 24 hours of surgery4.

Women are individual in terms of how much walking they can manage and how they progress walking exercise after a hysterectomy.

Your walking program depends upon many factors including preoperative fitness, type of hysterectomy, general health and post-operative complications.

Weeks 1-2 After Discharge from Hospital

Walking after hysterectomy weeks 1-2

This week-by-week information is not a substitute for medical advice. Always follow your surgeon’s instructions for walking during your hysterectomy recovery.

  • Most women comfortably continue their in-hospital walking routine at home after being discharged from hospital.
  • Aim for short regular walks throughout the day of approximately five minutes duration resting in between either lying down or sitting out of bed.
  • Walk on flat surfaces where possible rather than on an incline or stairs and wear full support briefs when you walk to improve your personal comfort.
  • By the end of the second week aim to do ten minutes of continuous walking if this feels comfortable for you.

Weeks 2-4 After Hysterectomy

  • Most women can comfortably increase their continuous walking by approximately five minutes per week after their hysterectomy surgery.
  • By the end of week four you may be able to walk continuously for twenty minutes.
  • Monitor your symptoms and progress the time you spend walking when you feel comfortable.
  • Discomfort during or after walking can be an indication that you have overdone things a little and that you need to ease off on your speed and your walking duration.

Weeks 4-6 After Hysterectomy

  • By six weeks after a hysterectomy many women can walk continuously for up to thirty minutes.
  • If you’re unable to manage one long walk or 30 minutes duration, you may find that walking is more comfortable when broken down into a few shorter duration walks during the day.

Week 7 Onwards

Most women have usually had a postoperative check up with their surgeon by week 7.

  • You may like to gradually start to increase the speed of your walking and the distance you walk when your surgeon has given you permission to return to general exercise.
  • Complete internal healing usually takes around three months on average so it’s important that you continue to progress your walking program gradually, especially during this time.

Physiotherapy Tips for Safe Walking After Hysterectomy

These tips are designed to help you improve your post-operative comfort and safety:

  • During early recovery time walking with your pain medicationSupport briefs
  • Cease any exercise that causes you discomfort during or after the activity
  • Walk on flat surfaces and avoid hills
  • Wear fitted and well cushioned footwear
  • Avoid repetitive treadmill walking in favor of walking outdoors
  • Wear quality support briefs or support pants
  • Short regular walks are just as beneficial as long walks especially within the first 6 weeks after surgery
  • Monitor your symptoms and rest if you’re tired or experiencing discomfort
  • If you experience discomfort with walking you may have done too much in which case stop, rest and do less walking next time
  • Walk at your own pace and avoid comparing how quickly you progress walking after your surgery with other women
  • Gradually increase your walking duration as your body heals and according to your level of physical comfort
  • Alternate walking with rest during your recovery
  • Contact your surgeon if you have any particular concerns when exercising after hysterectomy.

Hysterectomy Recovery Exercises eBookHysterectomy Recovery Exercises Book 1

with Pelvic Floor Physiotherapist
Michelle Kenway

Learn Physical Therapy exercises and techniques help you move well.

Know how to exercise safely and avoid major complications and common side effects of hysterectomy.

Includes exercises for constipation, gas pain, lower back pain, moving in and out of bed and safe return to activity after hysterectomy.

Learn More



Further Reading

» How to Avoid Side Effects of Hysterectomy

» The Cause of Back Pain After Hysterectomy Women Need to Know

» 10 Solutions for Shifting Gas After Hysterectomy

» Yoga After Hysterectomy – Is It Safe For Your Pelvic Floor?


1 Kalogera E, Dowdy S. (2016) Enhanced recovery pathway in gynecologic surgery: improving outcomes through evidence-based medicine. Obstet Gynecol Clin North Am, 43:551–73.

2. Buckwalter J (1995) Activity vs rest in the treatment of bone, soft tissue and joint injuries. Iowa Orthop J.,15:29–42.

3. Terzioglu F et. al. (2013) Multimodal interventions (chewing gum, early oral hydration and early mobilisation) on the intestinal motility following abdominal gynaecologic surgery. J Clin Nurs. Jul;22(13-14):1917-25.

4. Nelson G. et.al. (2016) Guidelines for postoperative care in gynecologic/oncology surgery: Enhanced Recovery after Surgery (ERAS®) Society recommendations–part II. Gynecol Oncol. 2016; 140323-332

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  1. Hi, I just got my hysterectomy done las week on Nov. 25th I was having trouble sleeping laying on my back to much because my back started to hurt and I couldn’t lay on my side, until I watched your videos and read all this comments. They’re very helpful, I’m glad I searched for this and find you. I have been walking little since the 2nd day, just in the house of course but do you think in two weeks I’ll be able to walk for like 5 minutes outside?

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Luz
      I can’t see an issue with you starting 5 mins out of the house now. Walking will be helpful for your back, especially short frequent walks. All the best for your recovery!

  2. Hi. I.m 8weeks post op.had Hysterectomy/bladder repair.Vaginaly. This last week I have started walking again.Only been 2days walking 6miles each time.Friends say I should.nt be doing that much yet !My post op appointment has been cancelled due to what is going on.So I.m unsure what I can/Cannot do.Please could you advise.

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Frances most women start walking in the first few weeks after surgery around 5 minute increments per week. If you’re starting out, keep walking to around 15-20 minutes at a time and progress gradually based on time spent walking rather than distance, all the best

  3. Hina athar says

    Hey my name is hina and i feel that something inside my pelvic area i feel some thing is falling out it is hard for me to walk lhave been doing some physical therapy and it worked but iamm not fully cured please answer and give me some good advice

  4. Hi there I had keyhole hysterectomy in November I’m still. Experiencing pain across my tummy. I work as a carer and have to go up 2 flights of stairs at my work can this make the pain worse even though I had it 5 months ago

    • Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Shona
      I assume you’ve checked this ongoing discomfort with the surgeon that performed your procedure? This is the first priority. I’m no really clear on the stairs – do you walk up and down the stairs multiple times in a shift? Does your work involve heavy lifting of clients? Do you find when you’re not working the discomfort lessens?

      • Hi there yeah I go up and down the stairs alot to different rooms. I don’t lift clients but have alot of discomfort when going up and down. When I’m. Off its still sore but not as bad I have docs next Friday.

        • Author: Michelle Kenway Pelvic Floor Physiotherapist says

          Hi Shona

          I’m glad to hear you’re seeing your doctor soon. I think this is the best way to know what you’re dealing with and then you can manage accordingly. You may find that wearing some support briefs gives you some relief while working until you’re better informed from your doctor, meanwhile it’s difficult for me to advise. I’ll be keen to hear how it goes with your appointment and what your Dr advises if you have time.

  5. Hi Michelle
    I had a vaginal complete hysterectomy just over 3 weeks ago and felt really well in myself almost straight away. Just as well because my Mum had a heart attack the day after i got out of hospital. I had a week at home and from then have had my elderly Dad staying after my Mum was transferred to have bypass surgery. He’s no trouble but it means I’m up early, we go to the hospital to see mum every day (about an hours drive each way) then home, have lunch and a rest. I’m not cooking dinner but don’t get much time in the afternoon to rest as its the only chance i have to do anything. I still feel well in myself but I’m tired. Haven’t had my check up yet and i know you don’t have a crystal ball but I’m concerned that even though i feel well I’ve done damage. Can you feel it if it starts to prolapse?

  6. I had a partial hysterectomy with reconstruction of bladder and mesh with sling, and prolapse surgery done 4 weeks this Saturday and I’m supposed to be in a wedding on Saturday do u feel it’s ok to go or is it still to early for me to be up and around.

    • Michelle Kenway Physiotherapist says

      Hi Renee

      Thanks for the question. This really is a matter for your specialist to answer as it will depend on the nature of your surgery, your individual recovery and any other relevant factors to your condition.

      All the best for your recovery

  7. great website — Next week my doctor will clear me to go back to work after anterior and posterior repair. Before the repair I exercised 6 days a week trying to get my heart rate up. I plan to start back with water walking, then maybe some treading water and eventually exercise bike. Is the straight up bike better than the incline? I had tailbone pain before the surgery so I could not do the upright — I’m thinking that may still be the case unless some of the tailbone pain was from the prolapse. I so want to keep my heart healthy and I have a hard time keeping weight off without exercise. I’m catching up on all the reading on your site and book. thank you

  8. Thank you for your site…very informative….Im having my surgery….lift bladder and syterectomy…Im a bowler and very active….how long,,,do I wait before I start to bowl….small balls…is bending dangerious after surgery….thanks

  9. Isabelle says

    Hi Michelle
    I think your website is excellent and it is refreshing that you share so much expertise publicly for women to benefit from. It is clear that there is a gap in this type of follow up in the uk.
    I had a total hysterectomy (keyhole and vaginal) just over 5 weeks ago. I am keen to safely exercise to get myself back to work and back to playing regular tennis (club team standard – which is a key part of my life). I have been increasing my walking and doing more round the house. My body is definitely telling me if I do too much as I feel exhausted and heady/dizzy when I have. I just looked at your videos and on line discussions which will help.
    I’d like to get an idea of when I can safely pick up my racquet and gently start back on court and how long it may take to get back to normal so I manage my expectations better. Also if there are particular exercises eg cross trainer, cycling in the gym which are allowed and any breathing /yoga exercises or video you recommend. Also any tips on sleeping better at night.
    Lots of questions but I’d welcome your advice. Thank you

  10. Had totally heysteroctomy 3 months ago,back to work as a baker …my ovaries are sore and it’s painful when I pass the urine.please help

    • Michelle Kenway says

      Hi Khanyisile
      Problems like this that develop after hysterectomy really require medical assessment; you are best advised to see your doctor about this issue.
      All the best

      • Hi Mitchell.will do that and see if they gonna help me this time.the other thing after I finish passing the urine it feels like there is a drop of pee left,but when I go back to take it out nothing is coming out?

  11. Hi Michelle,
    My name is Jenny. I had my hysterectomy 3 weeks ago. My recovery has been very slow. It is very difficult for me to walk, and at the same time, I’m having a lot of back pain, muscle pain, and joint pain. I try to walk around the house, but it could be a big challenge. I live in a town house and the bedrooms are in the third floor. I’m now trying to go up stairs and down stairs by my self. Do you think it’s ok? Also, which exercise are good for my back. How fast can I walk? When can I start stretching?

    Thank you so much for your information. I was very happy when I found your videos and articles. You are a very knowledgable person. Once again, thank you!


  12. Lara Wallace says

    I am curious about your thoughts on using kettle bell exercises after a full vaginal hysterectomy, with a bladder sling and anterior repair surgery. I’m 38 yrs. old this surgery has been traumatic for me as I had a bladder sling and anterior repair done when it wasn’t necessary. I heavily bled and clotted and a few hours later they wheeled me into fix it. It’s been 5 days since the surgery and I’m still wearing a catheter. Is walking with a catheter bad? I’ve been doing what you suggested 3 times a day I walk around the block slowly for around 5 minutes. My pain has been ok. My favorite exercise was the kettle bell because it was low impact and worked on core muscles. When do you think I should start to add that into my routine?

    • Michelle Kenway says

      Hi Lara

      Thank you for your questions. Unless you’ve been advised not to walk, it is very important that women do walk after surgery to avoid the complications of prolonged bed rest and no walking with a catheter is not bad for you, most women are encouraged to walk post-op and your body will quickly tell you if you are overdoing things. A little bit of walking balanced with rest spread throughout the day is usually ideal.

      In view of your youth and the fact that you’ve now had one repair, unfortunately your risk of repeat prolapse is increased so it will be in your best interests to be very well informed about exercises to choose and avoid. Many of the common place Kettle Bell exercises are potentially risky for the ‘at risk’ pelvic floor and need to be modified or avoided completely, you can read more on Kettle Bell exercises to avoid in this article. Don’t forget you will be healing internally for 3 months at least so while you may appear recovered from the outside after 6 weeks, this is indeed not the case internally.

      I hope this helps you along Lara.

      All the best

  13. Hi Michelle Thank you very much for your valuable book and this website which helps many women around the world I am 41 yrs old and had an abdominal hysterectomy 10 days ago for multiple leiomyomas and abnormal menstrual bleeding. I am single and hadn’t any child bearing or pregnancy. I also had a vertebral surgery 4 years ago because of a large central osteophyte at T12- L1 level which had pressure effect on my conus medullaris. The spinal canal was decompressed by laminectomy and my vertebrae were stabilized by plaques and screws and rods ( permanent internal fixator) but that osteophyte is still present.

    Please advise me when I can begin Kegel exercises and then which exercises are suitable for my case?
    I wish you the best things in your life

    • Michelle Kenway says

      Hi Kathy

      For most women Kegel exercises can commence around 4 weeks post op hysterectomy providing they are having a normal uncomplicated recovery – if in doubt check with your surgeon. It is very important to start Kegels gently and in view of your history of back surgery very important to attend to good posture keeping the normal inward curve in the lower back during exercises and avoiding slumping or arching excessively.

      Most women commence Kegels after hysterectomy lying down – side lying or lying on the back are both fine, usually just a few gentle sub maximal strength contractions at a time and then rest and see how the body feels afterwards. This is gradually progressed over time with recovery to longer holds, gradually becoming stronger and then into sitting and standing upright. This video outlines pelvic floor exercises after hysterectomy and will give you some more information https://www.pelvicexercises.com.au/after-vaginal-surgery/

      Also lying on the back during recovery when resting with a pillow under the knees provides great back and pelvic floor relief.

      Hope this helps you out Kathy & all the best for your recovery

  14. Ok I had hysterectomy one week ago is it better to sit or stand during the day or lay down

    • Michelle Kenway says

      Hi Dotti

      It’s best to mix it up during your early recovery from a hysterectomy. Most women usually alternate spending time lying down with a pillow under the knees to unload the back and relieve the abdomen, some time sitting and a little time walking around during the course of the day. Standing places the most pressure on the wound versus lying down which involves the least. Mix it up regularly and listen when your body feels tired and lay down to rest.

      All the best

  15. Hi Michelle,

    I am 35 yrs old and had a total abdominal hysterectomy 8 weeks ago. I am walking everyday but not at the pace nor the distance that I used to before.

    I used to do aerobics and Tae-bo, but now I’m afraid to do those exercises, especially after the gynae told me that I only have 3 ligaments (tied together) holding, what is left up.

    Is my fear unfounded and perhaps exagerrated or is this normal?

    Would swimming be ok?
    Thanks and kind regards


    • Michelle Kenway says

      Hi Kara

      In view of what your gynae has said I don’t think this concern about Tae-bo and aerobics is unfounded at all, maybe some low impact form of aerobis in time but with modified core abdominal work. Swimming is a great low impact form of exercise during first 3 mths after gynae approval to exercise – water walking and gentle stroke swimming too to start with are both great. Also focus on your pelvic floor strengthening, your ligaments need all the active support they can get and this comes from your pelvic floor muscles.


  16. Hi Michelle,
    I'm so glad to have found your website.  I am in Vic, Australia and I am due to have a total abdominal hysterectomy in 4 weeks time due to a uterine fibroid over 1 kilo in size and according to my gyno a 'massive uterus' as a result. I am 32 with no children (several failed IVF attempts due to male infertility) and now a fibroid causing severe cramping along with all the other menstral related problems that go with it. I currently use my treadmill for up to 1 hour a day, either walking at a very brisk pace, or interval training. I aim for 500 cals per workout. Some days my stomach looks and feels like a rockmelon so I can ony walk, but still push myself to complete my workout. I also use the ab circle pro. I put on weight very easily and am worried about the lack of exercise I can do after the hysterectomy. I am going to order your book and the brace. The docs offer very little advice re excercise, in fact I haven't even been told to do pelvic excercises, it's through my own research I find this out. I have total faith in my surgeon though. A personal trainer told me to keep up my excerise until the OP as this will have my body in it's best possible state for recovery – would you agree with this? Thanks, Lisa

  17. Michelle…I am using your book Inside Out and have just ordered one for a friend about to have pelvic floor surgery for prolapse/hysterectomy.  I am five months out from my surgery and have returned to my aqua power classes and am participating in physiotherapy as part of my training and recover.  Your book is invaluable!!  Thank you.  I have a question regarding my walking on a treadmill, however.  To what extent are the pelvic floor muscles engaged during my 30 minute, 3.2 mph walk?  Do I relax them the whole time, or keep them firm constantly, some of the time?  Does it matter?  Thanks again, Barbara

    • Walking and pelvic floor muscle contraction

      Hi Barbara

      This is a great question, thank you.

      Pelvic floor exercises strengthen and increase pelvic floor support for walking and everyday activities and this is one aim of pelvic floor rehabilitation programs – to improve the functional supporty of the pelvic floor for everyday activities.However, if pelvic floor muscle contraction is actively maintained for extended periods of time, the pelvic floor muscles can fatigue and work less effectively. Alternatively there may also be an increased risk of pelvic pain associated with pelvic floor muscle tension from constantly bracing the pelvic floor muscles and failing to relax them as they need to.

      In summary it is best to do pelvic floor/kegel exercises daily for support and then to use these muscles actively before and during cough/sneeze/lift/carry i.e. all those activities that create large increases in pelvic floor pressure. This technique is commonly known as ‘The Knack’. Avoid maintaining or constantly bracing pelvic floor muscles when walking.

      Thanks again Barbara

  18. Hi Michelle. I have recently had a posterior repair, perineal body repair and TVT surgery. Unfortunately the TVT was problematic and it was removed 3 months later. I am now 8 weeks post op from the removal. I am keen to start your exercises having put on some weight with all the surgery and subsequent recoveries. on page 53 of your book’inside out’ you show lunges with dumbbells. Could you advise on the wieght of the dumbbells? I can get kits which are 1,2 and 3 kg or kits with smaller ones. I have no idea where to start!
    Thank you, Jackie

    • Weights for lunges after prolapse surgery

      Hi Jackie

      Thanks for your enquiry, this is a good question indeed. I have to write in general terms Jackie, and what I can say is that when commencing resistance training it is usually advisable to commence without weights and to focus on establishing the correct form or technique of the exercise involved. When the exercise has been performed for a couple of weeks safely and without discomfort then weights can usually be added. When recommencing post-op pelvic floor surgery I usually suggest most women start at the lightest weight for lunges which is usually a total of 1-2 kg with a weight held in each hand, resting on the hips as shown in this pelvic floor safe lunge video demonstration. This weight is then gradually progressed over time as strength increases. There is definitely no rush or benefit to be gained for lifting heavier weights after pelvic floor surgery, the focus is on correct form, graduated progression and concurrent pelvic floor muscle rehabilitation, especially considering the fact that you have had repeat surgery.

      Hope this answers your question.

  19. Thank you Michelle for your feedback. I do have a 5 year old son at home and that keeps me busy. I have been approved to walk on my treadmill for 15 min per day as of right now. In about a month my Dr. will refer me to a Physiotherapist. Prior to my surgeries I had gone to a Physiotherapist for over a month but unfortunately I still had to have surgery. I am from the US and I think that prolapse is an issue but not as common in young women such as myself; so when they say that you can go back to your regular exercise routine I don’t think they quite know what a person does. Thanks to your book and your follow-up email I will be able to ask my Dr specific questions regarding low impact exercises. According to my Dr and studies done here in the US he doesn’t want me cycling as that would cause the same strain on my injury site as running would. It is a very long recovery process but once I am approved to do more exercises I am going to do the program that is outlined in your book. This has given me something to look forward to. At age 33 you could imagine how my world has been crushed as I have ran, played soccer and lifted weights for the majority of my life. Your comments have truly lifted my spirits. Thank you!

    • Hi Erika

      Can you advise me of the studies done that suggest that running and cycling place equal pressure on the pelvic floor. I am very interested to read this information as it really goes against what we know places pressure on the pelvic floor. Stationary cycling supports the pelvic floor, and sitting in the saddle, using low gears and sitting upright should not increase pressure on the pelvic floor. I would not however suggest cycling as an option for any women with pelvic pain or swelling in the perineum immediately post operatively.


  20. I wish I had found your book over a year ago. The information within it is so valuable and wish every Dr. has read this so they could better inform their patients of what to do and what not to do. I am 33 years old and at the age of 32 I had a hysterectomy, cystocele, rectocele, vaginal sling and a few other things done a year and a half ago. Within 10 months I was having another surgery to repair my prolapsed bladder. Then 3 months later I was back to the OR for a rectocele repair along with an iliococcygeal suspension. Then a week later had yet another surgery since a nerve was trapped within the stitches. Needlesstosay I am very pleased that I have this book now. After my 1st surgery I exercised and apparently have done everything wrong. I now know what to do and what not to do because of your book. Thank you for writing this book. I have lost 90lbs within the last 2.5 years and since my last surgery I(Oct) have gained some weight back since I haven’t been able to do anything. I am struggling with my weight. Since I am so young I feel as though I can’t be as active as I was prior to my surgeries and am afraid I can’t get back to running 5K’s. I have to redo my entire workout regime and don’t know where to start and feel a bit lost. Besides the information you have provided within you book Insideout, is there any other helpful exercises or resources that you could let me know about to help me get back on track with a workout regime that is safe for me?

    • Weightloss, fitness and pelvic prolapse surgery

      Dear Erika

      Thanks so much for sharing your personal story. You really have had so much to deal with, especially at such a young age. I have no idea whether or not you are running around after young children as well as dealing with your pelvic floor problems. Congratulations on your weight loss to date. This is a vital step in your long-term management and prevention of future pelvic floor problems and you have achieved a great deal with your weight loss.

      Yes I completely understand and sympathise with your your confusion about where to start with your exercise program now and what exercise is now appropriate, especially in view of your previous pelvic prolapse surgery. Yes you now have to be aware long-term of pelvic floor safe exercise and put these principles into practice.

      The better you understand appropriate and inappropriate exercises for your body, the better you will be able to exercise for your health in the future without compromising your pelvic floor.

      First of all before you start exercising make sure you have your specialist’s approval to do so.

      How to exercise for weight management with pelvic floor dysfunction?

      1. Cardiovascular exercise or aerobic exercise of moderate intensity that elevates the heart rate but allows continued conversation at the same time.
      60-90 minutes of moderate intensity exercise.
      Start with what feels comfortable for your body and gradually build up. Bouts of 10-15 minutes of exercise are appropriate when starting out.
      Low impact supported exercises see p38 Inside Out
      Water walking etc (exercises that involve the large leg muscles)
      Avoid running after recurrent prolapse surgery
      At least 5 days per week

      2. Resistance training
      Regular pelvic floor safe strength exercises – 8-10 exercises, 8-12 repetitions at least twice a week on alternate days. There is a full pelvic floor safe strength training program in your book Inside Out p51-64 Choose from these exercises commencing slowly and progress gradually.

      3. Pelvic floor exercises
      Perform daily pelvic floor exercises to increase and maintain your pelvic support to allow you to exercise long term. Once again there is a full program Ch 2 in your book.

      Erika I am not sure what country you are from. In Australia, there is an increasing awareness of pelvic floor safe exercise prescription among Women’s Health Physiotherapists. In view of your history it would be very wise to seek an appointment with such a specially trained physiotherapist for pelvic floor exercise prescription and general exercise advice.

      We also have a new Australian site run by the Continence Foundation of Australia and funded by the Australian Government called http://www.pelvicfloorfirst.com.au On this site you will also find information on pelvic floor safe exercise.

      I do hope this information helps you a little Erika.
      Best wishes and good luck

  21. Oh one more question:
    I don’t understand the purpose of the support briefs. Anything tight does not feel good (even one size bigger) but if I understand the reason of course I will wear them.

    • I am a week and a half following uterovaginal prolapse, rectocele, enterocele, lateral cystocele, bilateral paravaginal defect surgery and can’t pass my urine without catharizing myself. Is this uncommon? is there anything I can do to help this along? I also have a pulled muscle on the back of my left upper leg.

      • Author: Michelle Kenway Pelvic Floor Physiotherapist says

        Hi Pam, it’s disappointing when this happens but not entirely uncommon. Sometimes it takes a period of time for swelling to reduce and then voiding can be restored. This bladder emptying video (position and technique) may help you too, all the best

  22. Hello Michelle,

    Your book is so excellent I only wished I had known about the book (and you) earlier.

    This information about walking is so important and too late in my case. At 4 weeks I walked up a steep hill carrying about 6 pounds of groceries. The surgeon told me not to lift more than 10 pounds so I thought I was safe. When I got home I was bleeding and felt awful. That was 2 weeks ago and I am fine now. Wished I had followed your advice!!!!

    I had a few other questions:

    3. Can I start swimming and weight training after 6 weeks? My doctor has a already cleared me but I don’t think he knows anything about exercise. Of course I will follow your instructions about water walking and weight training. When I do weight resistance I actually use no weight at all due to shoulder problems so that is safer.

    4. I am scheduled for direct anterior approach hip replacement 11/30/11 not quite 3 months after my 9/9/11 hyst, cyst/rect repair. Do you think this is enough recuperation time or I should I wait at least 6 months or something like that? For insurance reasons I’d like to have it done this calendar year but want to do what is best for my body. Of course the hip surgeons say it is OK- but they don’t really know about this!

    I’m so glad I read your book. I’ve always been suspicious of Pilates. it never felt safe to me so I didn’t do it.

    Thanks again Michelle!

    • Exercise after a hysterectomy and prolapse surgery

      Hi Laura

      I think every woman is different regarding return to exercise depending on many factors such as the type of surgical procedure, her pre existing fitness and strength, her pelvic floor capacity, previous surgery. I don’t think it is appropriate to have one rule for all women returning to exercise post op pelvic floor surgery as there are so many different factors involved.

      This means that women should follow the advice of their specialist regarding safe return to exercise, and then select those exercises that are appropriate once given the all clear. This will usually include continued walking, water walking forwards, backwards and sideways. Appropriate progressive supported weight programs such as the program you have read in Inside Out, modified according to any other physical problems such as pre-existing shoulder problems and always recommencing with light weights and correct technique.

      I think your question regarding hp replacement following pelvic floor repair surgery is an interesting one. Once again you are best advised by the surgeon performing the surgery who I imagine has consulted fully with the surgeon who has performed your particular pelvic floor repair surgery. It is worth remembering that full healing from pelvic prolapse surgery takes 3 months on average for the tissues to fully heal. It would be also worth asking about any risks known by your surgeons associated with the time frame you mention here. I also think other important factors to consider regarding further surgery here are age, remembering that with increased age surgery can be more difficult to overcome and how well you actually feel emotionally and physically to meet the challenges of dealing with a hip replacement which is another major operation. I would think that it would pay to be at your best physically and mentally when undergoing hip replacement surgery.

      Finally many women find that support briefs help to provide external support when returning to exercise and activity post operatively. These don’t need to be tight to be supportive, some designs offer far more abdominal and pelvic support than others. To my knowledge there is no research into the effect of support underwear post operatively. Women frequently report improved comfort and support post operatively when wearing support briefs that assists them with activity and confidence.

      Hope this helps you Laura and thank you for your correspondence.

  23. Hi Michelle,
    I am so happy I found your site, it’s so informative.
    I am 62yrs old. I had 3 vaginal births and tubes done at 28yrs old a few days after my third child. I weight 55 kgs, 165cm height.
    I had my prolapse bladder mesh repair along with incontinence strip three weeks ago. I am still having slight incontinence along with spotting. My surgeon advised me this would happen. However, he never mentioned anything about when to resume pelvic floor exercises. Said to not lift anything heavy until I see him for 6-week check up. Of course I am unable to lift my two youngest grandchildren and they are finding it very hard to understand.
    I have exercised all my life using the gym, weights, pilates and yoga along with enjoying walking, swimming, boogie board riding, dragon boat racing, bush walking and playing competition tennis.
    I am finding it so frustrating not being able to do any form of exercise apart from walking. I feel like I am losing my tone already, scary!
    1. When do I resume specific pelvic floor exercises?
    2. How long do I use little stool to double void?
    3. Do you have a suggested week by week exercise immediately after surgery programme for the pelvic floor area?
    I understanding the walking part of exercise, I am relating to pelvic floor area, do I squeeze, draw up, stop the flow ??????
    4. When can I resume playing social tennis and other outdoor sports?
    I look forward to your response in due course, thank you.
    Also I would like to purchase your DVDs and additional copies of your book to share with my girlfriends.
    Kind regards

    • Pelvic floor exercises after bladder repair

      Hi Caza

      Yes I agree it is really difficult when you can’t do anything but walk. You will regain your tone when you can commence strength exercises so you can relax about this.

      In answer to your questions:

      1. Different specialists often have different protocols regarding when to recommence pelvic floor exercises after prolapse repair surgery. This usually varies from 6-8 weeks but this is up to the discretion of your specialist so this would be a good question to ask when you return for your post op review.

      2. Use your double void technique as long as necessary to ensure complete emptying. Swelling can remain for 6 weeks and it is particularly important to empty completely without straining to do so.

      3. Once again different specialists and physiotherapists have different protocols regarding how to perform pelvic floor exercises after gynaecological surgery, so again this needs to be discussed with your specialist and/or physiotherapist. Usually pelvic floor exercises commence gently, often in lying down and are graduated on a regular basis according to your surgery and your tolerance. Pelvic floor exercises after surgery may progress from lying down, to sitting and then standing. In addition they often progress in terms of intensity of the contraction and the number of repetitions performed with healing. Postoperatively pelvic floor exercises should be pain free.

      This video on pelvic floor exercises after vaginal surgery will give you some more information on how to do pelvic floor exercises post operatively

      4. As far as pelvic floor exercises go the technique is to squeeze and draw up through the anus, vagina and urethra (urine tube). It is prudent not to practice stopping the flow of urine post pelvic floor surgery in particular as you want to ensure complete empty. Visualising or imagining that you are stopping the flow technique of stopping the flow is often a useful technique to feel the pelvic floor muscles contracting.

      5. Once again outdoor sport and social tennis is recommenced at the discretion of the treating specialist. This can vary from specialist to specialist, and woman to woman depending on many factors including the type of repair performed and rate of recovery. It is always worth remembering that full healing takes approximately 3 months following prolapse repair. It makes sense to be very cautious in terms of the types of exercises undertaken during this time.

      Hope this helps your understanding a little Caza. You may need to make a list of questions to take to your next specialist appointment so that you are sure to get specific answers regrading your repair.


  24. I am recovering from rectal prolapse surgery (laparoscopic&sling) which I had 10 days ago and was really pleased to find your website. I had a hysterectomy 2 years ago and it looks like I may need surgery for bladder prolapse later this year. I am 48 years of age and have two kids 15yrs and 10yrs. EMG of my lower left side showed only 40% nerve response and am due to have neuro stimulators inserted in the coming months. I enjoy walking and was doing at least 40mins per day before surgery and also pilates (but I am not sure that pilates is a good idea). I have osteopenia in my hips and I suffer from constipation.

    Your videos and website are the best I have come across and I have found them REALLY helpful. You are doing a super job and helping lots of women with problems that can be difficult to talk about and find help with.

    I am wondering how to proceed with starting to exercise as I still feel quite exhausted and a bit guilty to be sitting around and not doing much.

    • Hi Mary
      Getting back into exercise is a slow business after prolapse surgery. First and foremost follow your specialist’s guidelines. The first 6 weeks post op are a maximum protection stage, the next 6 weeks moderate protection. Full healing for most women takes place at around 3 months after prolapse surgery and many women do not realise that this is the case so you need to take things easy during this time. Exercise during the first 6 weeks should really be directed at simply minimising de conditioning and maintaining mobility. This means that walking is usually the primary form of exercise during this time. Many specialists will have specific requirements for how much walking post operatively. A general rule of thumb is to commence with a manageable 5 minute walk in the first week, and gradually increase walking duration by approximately 5 minutes weekly, so that by the time of the 6 week check up, most women can manage a 30 minute continuous walk. This will however vary from woman to woman and case to case. Some tips are to wear good supportive underwear when you walk, keep the walking surface flat, don’t walk when you are tired and prepare to have a short rest preferably lying down with a pillow under your knees when you return from your walk, particularly in the first 6 weeks. Some women find that it is helpful to do a couple of small walks rather than a longer one, particularly during this time. Hope this helps your exercise regime at present, please keep us posted as to how you progress, Michelle

      • Hi Michelle,

        This guidance is really helpful. I got very little direction from my consultant. The staged recovery programme makes sense and gives me a good timeframe to allow my recovery. I think there are a lot of women like me that feel we should be up and doing things. I find it hard to allow myself to rest but now I am reassured that I am doing the right thing for my healing.

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  26. Iwould like to start exercising again. Can I use the elliptical for cardiovascular exercise?

    What weight training can you do and are there limits to the amount of weight you can lift?

    Thank you!

    • Pelvic Exercises says

      Hi Sally
      We cannot answer you specifically on this. Once a woman has approval to recommence general fitness exercise after pelvic surgery low impact options ar best: walking, stationary cycle. Elliptical machine would also fall into the category of low impact exercise, I always suggest to use the arm handles gently to minimise abdominal muscle involvement which can cause pelvic floor strain.

      The limits for weight training are set by the specialist. In Australia these limits vary from specialist to specialist and woman to woman depending onm many factors such as level of fitness, age, type of surgery etc. We have an extensive library series of free vidoes and articles on exercises after pelvic surgery best of luck Michelle

  27. I had cystocil/rectocil/bladder repair on the 10th of January 2011. This is repeat surgery from 10 years ago. On day 7 I began having terrible pain in right leg. Was sent to ER where they confirmed it is not a blood clot. The pain is now through out the entire leg making even walking to the restroom excrusiating. I will be following up with my doctor but everyone seems stumped.. Have you heard of this with anyone else. What it might be.. Thank you..

    • Pelvic Exercises says

      Hi Jennifer
      You need to see you doctor about this problem following prolapse surgery. Unfortunately I cannot advise you about this problem, my apologies. Michelle

    • Jennifer I had my operation in June 2011. I have the very same problem you have and it’s still happening after 5 years all I do is complain about my legs the pain is horrendous but they say its sciatica and it is not. I am going for a ultrasound scan I hope they find something. I can not walk far before the pain kicks in and I have to stop till it subsides but as soon as I start walking again it starts up again please tell me did they solved your leg problems kind regards Elaine