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Exercise Options After a Hysterectomy

Walking is a great exercise to start with.
Walking is a great exercise to start with.

A hysterectomy is the second most common surgery performed on women of reproductive age. In 2004 the Centers for Disease Control estimated that 600,000 women underwent the procedure each year. By age 60, it's estimated that 1/3 of all women will have had a hysterectomy.

There are several reasons women get hysterectomies, including cancer, unmanageable bleeding, infection or serious complications during childbirth. Here are the various types and what steps someone can take to help speed their recovery.

During a hysterectomy a woman's uterus is surgically removed. The operation is classified into three degrees: partial, total and radical.

  • In a partial (or supracervical) hysterectomy, just the uterus is removed; the cervix is left intact.
  • A total hysterectomy removes both the uterus and the cervix. Depending on the reason for the procedure, doctors may also remove ovaries and fallopian tubes.
  • In a radical hysterectomy, the uterus, cervix and structures around the uterus are all removed. This procedure is generally done if cancer is suspected or found.

The basic surgical options include abdominal, laparoscopic or vaginal hysterectomies. In each case, an incision is made and the uterus is removed through it. The recovery time for laparoscopic is best at between six days and two weeks. Vaginal hysterectomies typically take two to four weeks for recovery. Abdominal hysterectomies are the most invasive and take the longest to recover from, with typical recoveries stretching out six weeks or more.

What to Avoid

Once the surgery is over, here's what you should avoid until your doctor clears you. Nothing high impact like jogging, running or burpees. No crunches, planks, situps or deep abdominal work. And skip heavy weights that might make you grunt or hold your breath.

What to do: Walking

Walking is an ideal exercise to start with. Short frequent walks help prevent clots, get the blood circulating and improve healing. If regular walking is too easy, look for a hill to walk up and down. Stairs can be OK, as long as you're not holding your breath or pounding the steps too hard.

What to do: Kegels

Your pelvic floor may be weakened after surgery, so strengthen those muscles with Kegel exercises. Here's how to figure out which muscles they are. When you're going to the bathroom, abruptly stop and then start the flow of urine. If you're able to stop the flow, you've located the PC or Kegel muscles.

Start with Slow Contractions: Lie down flat on the floor so there's little stress on the muscles. Bend your knees or elevate your legs so they're relaxed. Then draw in and tighten the muscles, just like you're stopping a urine flow. You'll squeeze, lift UP and then hold the muscles, don't push down. Hold the contraction while you count to five, then slowly release and relax. Your body should have a feeling of "letting go."

Rest for up to 10 seconds, then squeeze, lift up and hold again. Repeat this movement up to 10 times. As you get more advanced, you'll increase the length of time you're squeezing and lifting the muscles until you're able to hold them a full 10 seconds each time. You should also keep increasing the number of contractions, until you're eventually doing 30-50.

Immediately after you finish the slow contractions, you'll do 5-10 short fast and strong contractions. Instead of holding each one a few seconds, you'll squeeze, lift up and then immediately let go.

Repeat this exercise a total of 3 times a day. As you get more experienced, try doing the Kegels while sitting up in a chair. For the really advanced, practice them while standing upright. It's OK if you have to lie down on every set the first few weeks. As you build up strength, the sitting and standing versions will get easier to do.

What to do: Core Activated Breathing

Breathing can also be difficult following surgery, so practice something called core activated breathing.

Core Activated Breathing

STEP ONE - Start by placing your hands on your abdomen. Inhale feeling your abdomen distend. Exhale, imagining a string attached to your belly button, pulling the belly button to the spine.

This technique will engage your deep abdominal muscle, the transverse abdominis. Careful not to exhale so much that your abdominal muscles cave in. Practice this technique for 5 to 10 breaths until you are comfortable with it.

STEP TWO - Flatten out your hands with the palms up and fingers together. Place your fingertips directly underneath your shoulders below your ribs. Push your fingers under your ribs into your sides. While keeping the belly button string taught, inhale into the belly so the pressure builds into your abdomen without your abdomen distending. Exhale. If done properly, your abdomen won't distend but your fingers will be pushed out on both sides.

These three options should get you through the initial, more difficult part of the recovery. As you get better, work with your doctor or a physical therapist to keep challenging yourself with more exercises.

National Womens Health Network
For more information on Hysterectomies, visit the National Women's Health Network. The link is: https://www.nwhn.org/hysterectomy/

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CAUTION: Check with your doctor before
beginning any diet or exercise program.