A hysterectomy is a common surgical procedure that involves the removal of the uterus, and sometimes other reproductive organs. While the body requires time to heal from this major surgery, incorporating structured, safe physical activity is recognized as an important part of recovery. Gentle movement aids in promoting better circulation, which helps to reduce the risk of complications such as blood clots (DVT). Maintaining activity also supports muscle strength and overall well-being. This article provides general information and is not a substitute for medical advice from your surgeon, physician, or a physical therapist.
Gentle Movements for Initial Recovery
The earliest phase of recovery, typically spanning the first week post-surgery, centers on low-impact movements to stimulate circulation and prevent stiffness. Deep breathing exercises should be performed frequently throughout the day to help maintain lung function, which can be temporarily compromised after anesthesia and surgery. This involves slow, deliberate inhalations that expand the abdomen, followed by gentle exhalations.
Simple circulation exercises, such as ankle pumps and calf slides, are also highly beneficial and can be performed while resting in bed. Ankle pumps involve rhythmically pointing the toes up toward the head and then down away from the body. Calf slides require bending the knee and sliding the heel along the bed or floor toward the buttocks, then straightening the leg back out.
Mobilization begins very early, with short, gentle walking encouraged within 24 hours of the operation. These brief, frequent walks are the best initial exercise to improve blood flow, aid digestion, and prevent blood clots. Walking should be confined to flat surfaces, focusing only on gentle movement.
Restoring Pelvic Floor and Core Strength
After a hysterectomy, the deep core muscles and the pelvic floor require specific, focused rehabilitation, as the surgery can disrupt the surrounding tissues and muscle function. Pelvic floor exercises, commonly known as Kegels, are essential for restoring support to the bladder and bowel and preventing issues like urinary incontinence. These exercises should be started gently once the initial acute pain subsides, often around Week 2, and after receiving clearance from a medical professional.
To perform a Kegel, imagine you are trying to stop the flow of urine or hold back gas, feeling a gentle lift and squeeze within the pelvis. The contraction should be held for a few seconds, with a complete release afterward, avoiding the use of the buttocks or inner thigh muscles. This practice helps to retrain the muscles that support the pelvic organs.
Targeting the transversus abdominis (TVA), the deepest layer of the abdominal wall, is crucial for internal stability without straining the incision. This can be activated by lying on the back and, on an exhale, gently drawing the lower abdomen in, as though hugging the muscles around the spine. This engagement is a subtle, inward hug, not a forceful crunch or motion that causes bulging or strain. Connecting the breath with this gentle contraction is the foundation for restoring the deep core.
Gradually Returning to Full Mobility
Once the initial healing phase is complete, typically after the first few weeks, the focus shifts to gradually increasing overall physical conditioning and endurance. The most immediate progression is an increase in walking, safely progressing the duration and frequency. By the end of Week 4, many individuals can walk continuously for about 20 minutes, increasing to around 30 minutes of continuous walking by Week 6.
After a medical check-up, usually around six weeks, low-impact cardio activities can be introduced to build fitness without stressing the healing tissues. Stationary cycling is a good option because it allows for cardiovascular work with minimal impact on the abdominal area. Light stretching, particularly for the hips and back, is also beneficial to counter stiffness that may have developed during the recovery period.
It is important to monitor the body’s response closely during this progression. Use pain or any increase in vaginal spotting as clear signals to reduce activity. The goal is to build strength and endurance incrementally, ensuring the body has time to adapt before increasing the speed, distance, or intensity of any movement.
Activities to Avoid During Healing
To protect the surgical site and promote complete internal healing, several activities must be strictly avoided during the initial recovery period. Heavy lifting is the most common contraindication, with most surgeons recommending against lifting anything over 10 to 15 pounds for the first six to eight weeks. Exceeding this weight restriction can place excessive pressure on the incision and internal tissues, greatly increasing the risk of a hernia or delayed internal healing.
High-impact exercises, such as running, jumping, or intense aerobics, should also be avoided for at least 12 weeks or until explicitly cleared by a doctor. These movements create jarring forces that transmit through the torso, potentially compromising the healing tissues. Similarly, exercises that cause significant abdominal straining or bulging must be postponed.
Standard crunches, sit-ups, and planks are examples of exercises that engage the superficial abdominal muscles too intensely and should not be started too early. Twisting or forceful rotational movements, like those found in some yoga poses or sports, should also be avoided as they can pull on the healing tissues and cause discomfort or damage. The guiding principle is to avoid any activity that causes you to hold your breath or bear down, as this increases intra-abdominal pressure on the surgical site.