The initial instinct after surgery may be to remain completely still to rest and heal. However, contemporary recovery protocols recognize that early, supervised movement, known as ambulation, is a fundamental component of healing. Ambulation involves getting a patient out of bed and walking short distances, often within hours of the procedure. This action initiates physiological responses necessary for a safe and accelerated recovery.
Preventing Deep Vein Thrombosis
One of the most serious risks following surgery is the development of deep vein thrombosis (DVT). DVT occurs when a blood clot forms within the deep veins, most commonly in the legs, promoted by venous stasis, or the pooling of blood. Prolonged inactivity, combined with the surgical process, slows blood flow and allows clotting factors to concentrate.
The calf muscles normally function as a “second heart” or muscle pump to propel deoxygenated blood back toward the heart against gravity. When a patient walks, the rhythmic contraction of these muscles compresses the deep veins, ensuring blood circulates efficiently. This action prevents the stagnation of blood in the lower extremities, which contributes to clot formation. Preventing DVT is important because a clot can break free and travel to the lungs, causing a pulmonary embolism. Early ambulation, often starting on the same day as the operation, restores this circulatory mechanism, reducing the likelihood of a life-threatening event.
Supporting Lung Health
Immobility after surgery affects the respiratory system, often leading to complications like atelectasis and pneumonia. Lying flat causes the lower lobes of the lungs to compress, leading to the collapse of small air sacs, known as atelectasis. This complication is compounded by the shallow breathing caused by post-operative pain and medications.
Walking encourages the patient to take deeper breaths, forcing the collapsed air sacs to re-expand and fully ventilate the lungs. The movement and deeper breathing also stimulate a cough reflex, which clears mucus and secretions that accumulate in the airways. By expanding the lungs and clearing this debris, ambulation supports oxygen exchange and limits the environment where bacteria thrive, protecting the patient from pneumonia. Studies have shown that patients who ambulate early exhibit faster recovery of lung function compared to those who remain sedentary.
Restoring Normal Bowel Function
The gastrointestinal tract suffers from the effects of surgery, anesthesia, and narcotic pain medications. These factors frequently lead to a temporary slowing or stopping of peristalsis, the wave-like contractions that move contents through the digestive system. This condition, known as postoperative ileus, can cause symptoms such as abdominal bloating, nausea, and an inability to tolerate food.
Movement stimulates the digestive tract by engaging the autonomic nervous system, promoting parasympathetic activity. Walking acts as an activator for the gut, helping to restore the rhythm of intestinal contractions. Reactivating peristalsis allows for the passage of gas and stool, reduces abdominal discomfort, and enables the patient to resume a normal diet sooner. A quicker return to a functioning gastrointestinal system is a milestone in overall recovery.
Accelerating Physical Recovery
Beyond specific organ systems, ambulation provides broad benefits to the musculoskeletal system and overall functional capacity. Prolonged bed rest leads rapidly to physical deconditioning, with patients losing muscle mass and strength quickly. This muscle catabolism can be observed as a loss of up to 20% of muscle strength within the first week of immobility.
Early movement acts as a countermeasure to deconditioning, helping to maintain muscle tone and limit the deterioration of strength and endurance. Walking re-engages balance and coordination, which are often compromised after trauma and inactivity. Regaining the ability to move safely and independently helps patients meet functional milestones, such as walking to the bathroom, often a requirement for hospital discharge. This renewed physical independence provides a psychological lift, contributing to a better overall outlook and a more resilient path to full recovery.