Returning to exercise after hysterectomy

Hysterectomy is one of the most common types of elective surgeries for Australian women, however it’s not exactly the most talked about! We tend to understand that there is a period of rehabilitation after any major abdominal surgery, but it can be challenging to know where to seek help on how and when to return to physical activities.

Firstly, to understand exactly what a hysterectomy is, this is an operation that removes the uterus and sometimes other surrounding organs like the ovaries, cervix and fallopian tubes. There are several reasons a woman might have a hysterectomy, with some of the most common reasons being cancer, pelvic organ prolapse, endometriosis, adenomyosis and fibroids (which are growths that form inside the uterus). The surgical techniques can vary but may be done via the abdomen, vagina or laparoscopy. Because the factors at play can be so different between individuals, there is no perfect rehabilitation timeline.

Your return to activity will largely be dependent upon your symptoms, which may include things like pain, pelvic weakness, urinary incontinence or wound sensitivity and healing. Another factor to consider is that a hysterectomy can initiate menopause, a change that can be quite dramatic for a younger woman, but even post-menopausal women may notice an increase in symptoms. There can be a psychological impact with this surgery and this is perfectly normal; having support around you and someone you can talk to about your feelings is very important.

After the initial recovery period, your doctor will advise that you can start to return to light activities (such as gentle walking). This is when I find women are often left in no-man’s land and are not sure when they can progress from these light activities back to their pre-surgery exercise levels. This is when an Accredited Exercise Physiologist can assist you.

You may be advised to avoid lifting anything heavier than 4kg in the first 6 weeks after surgery, along with avoiding prolonged standing. Be reassured that this does not mean you can never do these things again – it just means that we need to incorporate a graded approach to get you back to doing these things. Despite this, there are some exercises that are best to avoid immediately after a hysterectomy including anything high impact (such as running, jumping, burpees), certain abdominal exercises (like sit ups, crunches, planks), and any heavily loaded resistance exercise (that might make you hold your breath or grunt to lift).

The good news is that there is plenty we can work on! A good place to start is with
– Gentle mobility and breathing exercises.
– Pelvic floor strengthening and lengthening.
– Trunk strengthening (including core and glutes).
– Aerobic activity (non-impact).

It is important to incorporate a graded exercise approach and be guided by how your body is feeling. This means starting slow and seeking assistance from an exercise professional like an Accredited Exercise Physiologist.

Don’t wait! We know that early exercise after hysterectomy has many benefits including minimizing discomfort moving, relieving lower back pain and stiffness, helping to empty your bladder and bowels, relieving gas pain, protecting your pelvic floor, minimizing deconditioning and loss in strength, returning safely to home activities and avoiding chest complications.

If you need some support returning to exercise after a hysterectomy, give us a ring on 33 25 3678. I’d love to help you get back to being confident and doing the things you love!

Tamika Hassum
Accredited Exercise Physiologist
True North Wellness

References:
https://exerciseright.com.au/wp-content/uploads/2019/01/ESSA-Exercise-Womens-Health-eBook.pdf
Kenway, M (2009) Inside Out, Healthy Fit Solutions Pty Ltd, Brisbane, Australia