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Exercise and advice after gynae surgery

Ward clerkThese exercises are recommended by the physiotherapist. If possible, practise them before your operation so you can get used to doing them.

Early exercises

Repeat the next exercises at regular intervals until you are up and walking about as usual.

Leg exercises

Move both feet up and down briskly at the ankles. Press back of knee down onto the bed tightening the front of thigh muscles. Hold for five seconds then relax. Repeat with other knee. Move each foot alternately up and down on the bed, bending your knee and keeping your heel on the bed.

Remember - try not to cross your legs as this can slow down your circulation.

Breathing exercises

These will help clear your chest of any secretions. Start your breathing exercises as soon as possible. Take a deep breath, fill your lungs with air then gently breathe out. Repeat at regular intervals until you are up and walking about as usual.

Coughing

If you have any secretions (phlegm) you will need to cough effectively to clear your chest. Sit forward with your knees bent and support your wound with your hands or a pillow. Take two to four deep breaths then cough and spit any mucus into a tissue. Repeat as often as you feel necessary.

Huffing

This is useful if you find it difficult to cough effectively. Take a medium size breath in and then breathe out fast through an open mouth, using your stomach and chest muscles. This will squeeze sputum along the airways to a point where you can cough it up. (Imagine steaming up a mirror).

Back care

Whether you are in bed or a chair make sure your back is well supported. Placing a small pillow or roll in the small of your back may increase your comfort and help to prevent backache. When turning over in bed have your knees bent and try to roll over without twisting. Try to always walk tall, without stooping. It will be more comfortable and will help to protect your back.

Getting out of bed

Bend both knees, roll over onto your side, keeping your knees together.
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Push yourself up into a sitting position with your elbows and hands allowing your legs to swing to the floor. Stand up slowly.

When getting back into bed sit close to the bed's back support and reverse the above process.

Early exercises from the second or third day

Important - when doing these exercises do not hold your breath.

Listen to your body:

  • stop if it hurts
  • stop if tired
  • never exercise if feeling unwell

Gentle abdominal exercises

Repeat each exercise about three times, approximately two to three times each day.

Try to continue doing them when you get home.

Tummy toner

This early abdominal exercise can be done lying on your back with your knees bent (as shown in the exercise 'pelvic tilt') or, if comfortable, lying on your side with a pillow between your knees, as shown below.

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Gently draw in your lower tummy muscles and hold for 3-10 seconds. Repeat up to 10 times. Do not hold your breath. 

Pelvic tilt

Lie on your back with your knees bent and pull in your  tummy muscles.

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Press the small of your back into the bed and tighten your buttocks.

Hold for a few seconds then slowly let go.

Knee rolling

Lie on your back with your knees bent.

Pull in your tummy muscles and take both knees to the right  side - just as far as is comfortable - this involves raising the left hip off the bed.

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Back to the middle and rest.

Then repeat on  the left side.

The two above  exercises can help relieve 'wind' and backache. Repeat five times, twice a day, if comfortable.

Pelvic floor exercises

If you have had a vaginal repair operation, check with the physiotherapist on the ward when you should start this exercise, otherwise start gently when comfortable.

Do not start this exercise if you have a urethral catheter. Wait until it is removed and you are passing urine normally.

The pelvic floor muscles are a sling of muscles which pass  from the base of the spine forward to the pubic bone at the front. There are openings for the bladder, vagina and bowel. These muscles support the pelvic organs.

To exercise these muscles:

Close and draw up the front and back passages.

Hold for as long as you can then let go.

Rest (for approximately four seconds).

Repeat as many times as you can.

Now do several short quick contractions.   

When doing the above exercises do not:

Hold your breath.

Squeeze your legs or buttocks together.

At first do the exercises in bed, then later they can be done while sitting or standing with your knees slightly apart. If the pelvic floor muscles become stronger they will give better support for your bladder and bowel and help you maintain control. 

Important - this is an exercise which you should never forget to do. Aim to carry on with these exercises after leaving hospital and then try to continue them several times a day for the rest of your life.

Stronger abdominal exercises

Approximately 4-6 weeks after your operation, start these exercises when you feel ready. Do them on a carpeted floor or a firm bed with a pillow under your head. Repeat each exercise about three times, slowly building up to 10 times, twice a day. These exercises should not be painful. If they are, leave them until you can do them comfortably.

Head and shoulder raise

Lie on your back with your knees bent and a pillow supporting your head.

Pull your tummy in.

Tuck in your chin.

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Lift your head and shoulders and slide your hands towards your knees.

Lower slowly back to finish.

Rest and repeat

Head and shoulder raising with diagonal movement

Lie on your back with your knees bent and a pillow  supporting your head.

Pull your tummy in.

Tuck in your chin.

Reach with your right hand diagonally across your body to  your left hand. This involves lifting the shoulders of your right side up off the bed as well.

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Make sure it is your tummy muscles working, not those of  your shoulder.

Back to the middle and rest.

Repeat on the other side. 

General guidelines

Listen to your body. Treat the first two weeks as a  convalescence. You can make a cup of tea and do easy housework such as  dusting.

It is quite safe for you to go up and down stairs from the day  you go home.

Housework and lifting

Try to avoid any heavy lifting for several months after  your operation. This includes - heavy shopping bags, wet washing, full saucepans, the hoover, the ironing board. When you do lift remember to do it correctly:

  • Bend your knees.
  • Keep your back straight.
  • Pull in your tummy.
  • Pull up your pelvic floor.

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Driving

Do not drive until your feel confident to do an emergency  stop. If you have had abdominal surgery, we advise you not to drive for four weeks. Check with your insurance company for any specific regulations.

Back to work

The doctor will advise you when to return to work. It may be any time between 6-12 weeks depending on the type of surgery you have had, the rate of your recovery, the type of work you do and the amount of travelling involved.

Exercise

Walking is an ideal exercise. When you feel ready you could  aim for a daily walk of 10 minutes which can be increased gradually. Try to find time each day to do your exercises. Remember to keep up the pelvic floor exercises once or  twice a day for 'the rest of your life'.

Gentle swimming for pleasure could be started at 4-6 weeks  providing any discharge has stopped. A gentle return to sporting activities is essential. A guide would be 8-10 weeks after the operation. It is important to listen to your body and not to push yourself.

Remember

Listen to your body. Stop if it hurts. Never exercise if feeling unwell or tired.

If you have any questions do not hesitate to ask to speak to a physiotherapist for further advice.