Physiotherapy Advice After Abdominal Surgery: Essential Exercises

The Importance of Exercise Following Abdominal Surgery

When it comes to exercise following abdominal surgery, knowing where to start can be challenging. Whether you’ve had a C-section, hernia repair, or another abdominal procedure, gradual and controlled exercise is key to your recovery.

Quick Tips:
1. Early Walking: Start with light, daily walking to boost blood flow.
2. Eat Well: Prioritize a healthy diet, rich in fiber and water.
3. Avoid Strain: Skip heavy lifting and strenuous activities for at least 4-8 weeks.
4. Wear Support: Consider an abdominal binder for added support.
5. Listen to Your Body: If it feels painful or uncomfortable, hold off and consult your doctor.

Recovery from abdominal surgery is not just about rest; it’s also about slowly and safely regaining your strength. Following the right physiotherapy advice makes a significant difference in how effectively and quickly you heal.

My name is Shlomo Widder, MD, and I bring over three decades of experience in cosmetic and plastic surgery. Throughout my career, I have emphasized the critical role that exercise following abdominal surgery plays in full recovery.

Let’s dig into the best strategies and exercises to ensure you get back on your feet with confidence.

Early Post-Operative Exercises (0-2 Weeks)

Pelvic Tilt

The pelvic tilt is a gentle exercise to activate your abdominal muscles without straining them.

How to Do It:
1. Lie on your back with your knees bent.
2. Place your hands on your hips.
3. Tighten your abdomen to pull your belly button towards the ground.
4. Tilt your hip bones backwards.

This exercise helps to engage your core and can be done multiple times a day to aid recovery.

Lying Knee Raise

The lying knee raise is another simple exercise to keep your core engaged while lying down.

How to Do It:
1. Lie on your back with your knees bent.
2. Raise your right knee up and then back down.
3. Repeat with your left knee.

This exercise helps in maintaining mobility and strengthening your core muscles without putting too much strain on your surgical site.

Core Tightening

Core tightening exercises can be done while standing and are essential for rebuilding core strength.

How to Do It:
1. Stand upright.
2. Tighten your core by pulling your belly button towards your spine.

This exercise can be performed throughout the day and helps in strengthening your abdominal muscles.

Standing Front Knee Raise

The standing front knee raise is great for improving balance and engaging your core.

How to Do It:
1. Stand upright and hold onto a chair or counter for balance.
2. Raise your right knee up and then lower it.
3. Repeat with your left knee.

This exercise helps in improving balance and core strength.

Walking

Walking is one of the best exercises you can do post-surgery.

How to Do It:
1. Aim to walk for 10 minutes daily.
2. Walk slowly and practice deep breathing.
3. Try to get outside if the weather allows.

Walking improves blood circulation, helps in deep breathing, and keeps your muscles active.

Deep Breathing Exercises

Deep breathing exercises are crucial for lung health and preventing pneumonia.

How to Do It:
1. Breathe in deeply and slowly through your nose, expanding your lower rib cage.
2. Hold for a count of 3 to 5 seconds.
3. Breathe out slowly and completely through pursed lips.
4. Repeat 10 times, resting longer if you become dizzy or lightheaded.

Using an incentive spirometer can assist you in these exercises, ensuring your lungs stay clear and healthy.

Coughing with Pillow

Coughing exercises help clear your lungs and should be done with support to avoid straining your incision.

How to Do It:
1. Support your incision firmly with your hands or a small pillow.
2. Breathe in deeply and cough firmly one time.
3. If you cough up mucous, spit it into a tissue.

Doing this exercise regularly helps in keeping your lungs clear and reduces the risk of pneumonia.

By following these early post-operative exercises, you can ensure a smoother recovery and regain your strength safely. Next, we’ll discuss intermediate post-operative exercises to continue your progress.

Intermediate Post-Operative Exercises (2-6 Weeks)

As you progress through your recovery, it’s time to add some new exercises to your routine. These intermediate exercises focus on strengthening your core and improving your flexibility. Continue with pelvic tilt, core tightening, and deep breathing exercises, but also incorporate the following:

Lying Heel Taps

How to Do It:
1. Lie on your back with your knees bent at a 90-degree angle.
2. Tighten your core by pulling your belly button towards the floor.
3. Slowly lower your right heel to tap the ground, then return to the starting position.
4. Repeat with your left heel.

Tips:
– Keep your core tight throughout the exercise.
– Perform 10 reps on each side.

Lying Bird Dawgs

How to Do It:
1. Lie on your back with knees bent at 90 degrees.
2. Extend your right arm and left leg simultaneously, keeping your pelvis tilted back.
3. Return to the starting position and repeat with your left arm and right leg.

Tips:
– Focus on keeping your core engaged and your movements controlled.
– Perform 10 reps on each side.

Cat / Cow

How to Do It:
1. Start on your hands and knees.
2. Inhale, round your back, and tighten your core (Cat position).
3. Exhale, relax your core, and rotate your hips forward (Cow position).

Tips:
– Move slowly and gently.
– Perform 10 rounds of Cat/Cow.

Walking

Walking remains one of the best exercises for your recovery. Aim to walk for 20 minutes daily without stopping.

Tips:
– Walk at a comfortable pace and gradually increase your speed.
– Practice deep breathing while walking to improve lung function.

By incorporating these intermediate exercises, you’ll continue to strengthen your core and improve your overall recovery. Next, we’ll discuss advanced post-operative exercises to further improve your progress.

Advanced Post-Operative Exercises (6+ Weeks)

At this stage, you can start incorporating more challenging exercises to improve your core strength and overall fitness, while continuing with pelvic tilt, core tightening, bird dogs, cat/cow, and deep breathing exercises.

Plank Low or High

Planks are excellent for targeting your core muscles.

Progression:
1. Plank on knees – Start on your knees and forearms.
2. Plank on knees with feet raised – Lift your feet off the ground.
3. Full plank – Keep your body straight from head to heels, supported by your toes and forearms.

Tips:
– Hold each position for 10-30 seconds.
– Focus on keeping your core tight and your back straight.

Crunch

Crunches help strengthen your abdominal muscles.

Progression:
1. Chin tuck – Lie flat, pull your belly button to the floor, and lift your chin and shoulders.
2. Knees raised – Raise your knees to 90 degrees while performing the chin tuck.
3. Full crunch – Simultaneously lift your chin/shoulders and knees towards each other.

Tips:
– Perform 10-15 repetitions.
– Move slowly and control your movements.

Flutter Kicks

Flutter kicks are great for lower abdominal strength.

Progression:
1. Single leg raise – Lift one leg to 45 degrees, then lower it and repeat with the other leg.
2. Flutter kick – Prop on your elbows, keep your core tight, and alternate lifting legs in a fluttering motion.
3. Balance (no hands) flutter kick – Perform flutter kicks without using your hands for support.

Tips:
– Perform 20-30 seconds of flutter kicks.
– Keep your lower back pressed to the floor.

Oblique

Strengthening your obliques helps with side stability.

Progression:
1. Lying flat – Reach towards your right heel, return, then repeat on the left.
2. Standing – Slowly drop your right shoulder to a slight side bend, return, then repeat on the left.
3. Standing with weights – Hold light weights (1-2 lbs) and perform side bends.

Tips:
– Perform 10-15 repetitions on each side.
– Move slowly and keep your core tight.

Reverse Knee Roll / Curl

These exercises target your lower abs and hip flexors.

Progression:
1. Knee roll – Roll your knees to your chest, one vertebra at a time, then roll back.
2. Reverse curl – Raise your knees to 90 degrees, roll your hips and lift them.
3. Full reverse curl (leg raise) – Extend your legs, bend knees to 90 degrees, roll hips, lift legs skyward, then return to start.

Tips:
– Perform 10-15 repetitions.
– Keep movements slow and controlled.

Walking

Walking remains a cornerstone of your recovery.

Goal:
– Walk for 30 minutes daily.
– Try to keep your heart rate up and increase your distance weekly.

Tips:
– Maintain a brisk pace.
– Focus on deep breathing to improve lung capacity.

By following these advanced exercises, you will further strengthen your core and improve your overall fitness. Next, we’ll cover deep breathing and coughing exercises to ensure your lungs stay healthy.

Deep Breathing and Coughing Exercises

Deep Breathing Exercises

Deep breathing exercises are essential after abdominal surgery. They help expand your lungs, clear mucus, and prevent pneumonia. Here’s how to do them:

1. Sit Upright: Sitting up makes the exercises more effective.
2. Inhale Deeply: Breathe in slowly through your nose, expanding your lower rib cage and letting your abdomen move forward.
3. Hold Your Breath: Hold it for 3 to 5 seconds.
4. Exhale Slowly: Breathe out slowly and completely through pursed lips.
5. Repeat: Do this 10 times every hour while you’re awake. Rest longer if you become dizzy or lightheaded.

Tip: Place your hands on the sides of your ribcage to feel it expand as you breathe in.

How to Use an Incentive Spirometer

If you have an incentive spirometer, use it to help keep your lungs clear. Here’s how to use the Voldyne® spirometer:

1. Hold Upright: Keep the spirometer upright and breathe out normally.
2. Seal Your Lips: Place your lips tightly around the mouthpiece.
3. Inhale Slowly: Breathe in slowly through your mouth, raising the white piston while keeping the yellow float between the blue lines.
4. Hold Your Breath: Hold for 3 to 5 seconds.
5. Exhale Slowly: Remove the mouthpiece and exhale slowly.
6. Repeat: Do this 10 times every hour while awake. Rest if you feel light-headed.

Tip: Move the yellow slider to the highest level you can reach as you improve.

Coughing Exercises

Coughing exercises help clear mucus from your lungs. Here’s how to do them:

1. Get Comfortable: You can lie on your back with knees bent or sit up in bed or a chair.
2. Support Your Incision: Use your hands or a small pillow to support your incision.
3. Deep Breath and Cough: Take a deep breath and cough firmly once. If you cough up mucus, spit it into a tissue.
4. Repeat: Do this once every hour while awake.

Tip: Take breaks if you have a lot of mucus to avoid getting too tired.

By practicing these exercises regularly, you can reduce your risk of pneumonia and help your lungs recover more quickly. Next, we’ll discuss foot and leg exercises to further aid your recovery.

Foot and Leg Exercises

After abdominal surgery, it’s crucial to keep your blood circulating and prevent blood clots. These foot and leg exercises are simple but effective in aiding your recovery.

Ankle Pump

Ankle pumps are excellent for boosting circulation and reducing the risk of blood clots, especially if you’re wearing SCD stockings.

1. Sit or Lie Down: Get comfortable.
2. Move Your Ankles Up and Down: Quickly bend your feet up towards you and then point them away.
3. Continue for 1 Minute: Do this exercise several times a day.

Tip: This exercise also helps with relaxation, so try it before bed.

Ankle Circles

Ankle circles keep your ankles flexible and further improve blood flow.

1. Sit or Lie Down: Get comfortable.
2. Circle Your Ankles: Move your right ankle in a circle 10 times, then switch to the left ankle.
3. Change Directions: Repeat, but circle in the opposite direction.

Tip: Do this exercise whenever you are sitting down, like watching TV or reading.

Heel Slides

Heel slides help to gently stretch and strengthen your leg muscles without straining your abdomen.

1. Lie Down: On a flat surface like your bed.
2. Bend Your Knee: Slide your right foot up towards your buttocks, bending the knee.
3. Straighten Your Leg: Slide your foot back down.
4. Repeat with the Other Leg: Do this 5 times for each leg.

Tip: Keep your movements slow and controlled for the best results.

By incorporating these foot and leg exercises into your daily routine, you will improve your circulation, reduce the risk of blood clots, and aid in your overall recovery.

Next, let’s look at how to change positions safely to avoid complications.

Changing Positions

Changing positions frequently is crucial after abdominal surgery to prevent complications such as lung infections, blood clots, and weak muscles. Follow these steps to move safely and use your leg and arm muscles instead of your abdominal muscles.

Turning from Back to Side

1. Bend Your Knees: Place your feet firmly on the bed with your knees bent.
2. Roll Onto Your Side: Keep your shoulders and hips in a straight line to avoid twisting your abdomen.
3. Use the Bed Rail: Hold on to the bed rail (if available) to finish the turn.

Tip: Call your nurse if you need assistance.

Turning from Side to Back

1. Bend Your Knees: Start by bending both knees.
2. Push with Your Hand: Use your hand to push into the bed or bedrail to help you turn onto your back.

Sitting on the Side of the Bed

1. Raise the Head of the Bed: Ask someone to help if needed.
2. Bend Your Knees: Place your feet firmly on the bed.
3. Roll Onto Your Side: Keep your shoulder and hips in a straight line. Your bent knees should be near the edge of the bed.
4. Push Down with Your Upper Hand: Use your upper hand to push down into the mattress until your lower elbow is underneath you. Rest on this elbow.
5. Lower Your Legs: Push down on your arms as you lower your legs over the side of the bed.
6. Sit Up: Sit on the edge of the bed, using your hands on the mattress for support.

Getting Back into Bed

1. Back Up to the Bed: Move until you feel the bed at the back of your legs. Ensure you’re far enough up towards the pillow.
2. Sit Down: Sit with your bottom as far back on the bed as possible.
3. Lower Yourself: Lower yourself onto the elbow closest to the head of the bed.
4. Lift Your Legs: Lift your legs onto the bed as you go down onto your side.
5. Roll onto Your Back: Bend your knees and roll back onto your back.

Tip: If you need to move higher up in the bed, keep your knees bent and push down on your heels while lifting your hips.

By following these steps, you can change positions safely and comfortably, reducing the risk of complications and aiding your recovery.

Next, let’s discuss the importance of walking after surgery and how to do it safely.

Walking After Surgery

Walking is one of the most important activities you can do after abdominal surgery. It helps improve blood flow, prevents blood clots, and aids in your overall recovery. But, it’s crucial to do it safely.

Nurse Assistance

For your first walk after surgery, have a nurse or physiotherapist with you. They will help ensure you are steady and provide support if you feel weak or dizzy.

Nonslip Footwear

Wear comfortable, nonslip footwear to prevent slips and falls. Hospital socks with grips on the bottom are a good option.

Dizziness and Discomfort

It’s normal to feel dizzy or uncomfortable the first time you get up. Move slowly and take your time. If the dizziness or discomfort persists, let your nurse or physiotherapist know. They might recommend taking short rests between walks.

Gradual Increase

Start with short walks of about 10 minutes. Gradually increase the length and frequency as you get stronger. Aim to walk several times a day.

The goal is to be able to walk in the hall several times a day. This will help you recover faster and get back to your regular activities.

Next, let’s explore the importance of deep breathing and coughing exercises to prevent lung infections and other complications.

Frequently Asked Questions about Exercise Following Abdominal Surgery

What is the best exercise after abdominal surgery?

Walking is widely regarded as the best exercise following abdominal surgery. It’s low-impact, promotes blood circulation, and helps prevent complications like blood clots. Start with short walks of about 10 minutes and gradually increase the length and frequency as you get stronger.

Another beneficial activity is deep breathing exercises. These exercises help expand your lungs and improve oxygen flow, reducing the risk of lung infections like pneumonia. Using an incentive spirometer can be particularly effective.

Sitting out of bed and moving around your home are also essential. These activities help you maintain mobility and prevent muscle stiffness.

What activities should you avoid after abdominal surgery?

Avoid lifting heavy objects. This includes anything over 10 pounds, such as full laundry baskets, heavy shopping bags, and even large pets. Lifting can strain your abdominal muscles and disrupt the healing process.

Yardwork and other strenuous activities like vacuuming or mowing the lawn should also be avoided. These tasks often require bending and lifting, which can put undue stress on your core.

Lastly, avoid heavy objects like furniture and large appliances. Even if you feel capable, it’s best to wait until your surgeon gives you the green light to resume such activities.

How long does it take to heal internally from abdominal surgery?

Internal healing from abdominal surgery generally takes around 6 to 12 weeks. However, this can vary depending on the type of surgery and individual healing rates. During this period, focus on moderate exercise like walking and deep breathing exercises to maintain mobility without overstraining your body.

Building core strength is crucial, but it should be done gradually and under the guidance of your surgeon. Exercises like pelvic tilts and gentle stretches can help you regain strength without risking injury.

Always follow your surgeon’s instructions closely. They will provide personalized advice based on your specific surgery and recovery progress.

Conclusion

At Widder Cosmetic and Plastic Surgery Center, we understand that recovery from abdominal surgery can be a challenging journey. That’s why we are committed to providing personalized care custom to each patient’s unique needs. Whether you’re recovering from a tummy tuck, hernia repair, or any other abdominal procedure, our team is here to support you every step of the way.

Located in Northern Virginia, our center is led by the highly experienced Dr. Shlomo Widder. With over 30 years in the field, Dr. Widder emphasizes patient safety and effective recovery strategies. His approach ensures that each patient receives the best care possible, minimizing the risk of complications and promoting a smoother recovery.

If you’re considering a tummy tuck or any other abdominal surgery, explore our services to learn how we can help you achieve your aesthetic goals while ensuring a safe and effective recovery. We look forward to being a part of your journey towards a healthier, more confident you.