On Post Hysterectomy Training
This is actually on behalf of my wife, who has recently (about 7 months ago) had a hysterectomy and prolapse surgery, and is basically unable to do a lot of the exercises I’m doing to lose a TON of weight (Craigz TT & now on to FPFL 2.0).
She can’t really do any exercises that require bearing down with her ab muscles, and even walking fast, or any bouncing motion, doesn’t really work for her. She is getting pretty disheartened, so I’d like to ask if you know of anybody out there in fitness land that you can recommend to give some women’s fitness advice along these lines (unless, of course, you already have a course to recommend).
I have been following Isabel’s DSP and just bought Dave’s Metabolic Cooking, so I’m working on converting the family to healthier eating, but I know you, and everybody else, agree that exercise has GOT to be part of the equation to lose copious amounts of fat. I’m hoping you can direct me somewhere to help her out.
Thank you for any advice you can give,
Awesome Subscriber (Name withheld for privacy, obviously)
Well, I thought, to be honest, that with a question about so feminine an issue, a woman would be much more comfortable taking advice from a female fitness professional than a dude.
And so, I went out and got two of the best to answer the question.
Recovery after a hysterectomy and prolapse surgery can be quite an ordeal the time to completely heal can vary. The best first step is for your wife to check with her doctor to ensure all is well and if any specific guidelines must be followed especially if she is unable to walk at a moderate to fast pace 7 months post operation.
Based on the small amount of information provided, if she is wanting to workout, it is best to begin with non impact, non weight bearing movements with a goal to strengthen the pelvic floor – not to flatten the tummy. It is a common misconception that in order get rid of the belly, you have to do lots of abdominal work. This spot reduction approach can cause a great deal of harm than render any type of flat tummy or fat loss results. Avoid movements that create and place downward pressure on the pelvic floor – even planks and exercises that have you lying on your back lifting your feet and/or shoulders up which all create downward pressure.
So when it comes to workouts, it is very important to start off slowly and perform movements that minimize pressure on the pelvic floor, strengthen the pelvic floor and help develop awareness of your deep core muscles – transverse abdominus – the muscles that wrap around your middle like a corset.
It is important to learn how to gently activate these deep core muscles and you can use a “drawing in” motion (also known as a vacuum). You can lie on your back or on your side, contract and hold your deep core muscles – imagine drawing your belly button in toward your spine – and hold for count of 10 as you breathe.
Additional Pelvic Floor Strengthening movements include …
Kegels – which engage the “PC” muscle that starts and stop the flow of urine. This is a very common exercise prescription for women for a variety of reasons. The Fit Yummy Mummy’s that I work with who have gone through prolapse surgery have noticeably improved results once they committed to regular kegel exercise.
Heel Slides, Pelvic Tilt and a number of Seated Stability Ball exercises – which take pressure off the pelvic floor – are great options all designed to strengthen, increase control and improve stability of the pelvic floor and deep core muscles.
If the pelvic floor muscles are still weak, keep in mind that it can take around 5 to 6 months of diligent pelvic floor training to increase strength and control. Consistency is Key.
Once this has been accomplished, it is easier to maintain pelvic floor strength gains and progress to more challenging exercises – while of course following the guidelines suggested by your doctor.
Final word of advice, when it comes to weight loss, if she is unable to progress to a more challenging workout program, she can still make progress by following the above guidelines as well as lose weight and inches by keeping a food log and identifying eating habits that can be changed in order to see (and FEEL) better results. Workouts can only take you so far if you are not willing to clean up what you eat.
Yours in Health,
As you mentioned, nutrition and exercise go hand in hand. However, as we’ve seen countless times, without proper nutrition, improved body composition will never be achievable, regardless of how much you exercise.
Thankfully, the reverse isn’t always true. Which means that, despite the physical limitations imposed by the surgery, if she really focuses on her diet and gets what little activity she can, she will be able to lose fat and improve her body mostly through sound nutritional practices.
Of course, it will be a slower road than if she was able to train without fear of injury.
On that front, what I recommend is obtaining proper advice from a physician as to the types of exercise your wife is able to preform without causing any harm to her physically.
As a general starting point, I’d also suggest for your wife to start slow, incorporate body weight training, and progress to weight training when she is medically cleared to lift weights. The main thing is to create a safe environment where she can perform exercises to strength the muscles that are not contraindicated by her surgery, while avoiding placing any unnecessary strain on those that are.
In this case, machines can be a great fit. While we fitness pros generally shy away from them, machines are good because they allow you to sit and truly isolate various muscles without engaging the core. At the moment, this would be beneficial for your wife.
Also, I would start with an incline on the treadmill or some uphill walking—very slow pace, very low impact. Stairs would also be a great conditioning and fat burning exercise to start with, assuming climbing doesn’t cause pain.
In situations such as these, it’s really important to understand your limits and not try to push past them too quickly—so listen to your body and don’t put yourself in pain. As the doctor always says, “if it hurts, don’t do it!”
Again, start slow and make sure she is medically cleared to do these types of exercise before she begins.
Best of luck in health and fitness,
Flavia Del Monte RN, CPT, PN Certified
Well, there you have it. An exceptionally complicated and provacative question answered by two of the best female fitness pros in the biz.
I hope this helps anyone out there who has need of it, and, more importantly, I hope that you’ll forward it around to anyone who you think can help.
Thanks so much to Holly and Flavia, and good luck!