Exercises after abdominal surgery

Physiotherapy Advice after abdominal surgery

Day 1 onwards

Whilst in bed after your operation, it is important not to slump down as this restricts your chest expansion and air cannot get to the bottom of your lungs. Try to sit up as much as possible or lie on one side or the other.

To reduce the effects of a general anaesthetic, practice the following exercises hourly throughout the day.

Deep breathing exercises

You should be able to comfortably take deep breaths. If you cannot due to pain, please tell the nursing staff so we can ensure adequate pain relief.

Sitting up in bed with knees bent and feet flat on the bed, slowly fill your lungs with air, hold for 2 seconds and then sigh the breath out of your mouth. Repeat four times then try to ‘huff’ the air out.

Huffing

Take a deep breath in, then breathe out quickly and forcefully through your mouth as if you were steaming up a window. This will help loosen any phlegm if needed.

Coughing

Be sure that you can cough strongly and effectively as needed after your operation to clear any excess secretions. You will not ‘burst’ your stitches. Your physiotherapist will help you if necessary.

You may find it more comfortable to cough in the same position as for your deep breathing exercises. Support your abdominal incisions with your hands over the dressing or hug a pillow to you. If you are sitting in the chair, lean forwards and hold your stomach in the same way.

Circulatory exercises

To improve circulation in your legs whilst lying in bed.

Ankles

Bend and stretch the ankles up and down firmly and quickly (repeat 10 times).

Knees

Tighten your thighs by pushing the backs of your knees down against the bed (repeat 5 times).

Buttocks

Tighten your buttocks regularly to relieve pressure from your bottom (repeat 5 times).

From day 2 onwards

Start all exercises by lying with your head on a pillow, knees bent and a shoulder- width apart, feet flat on the bed.

Abdominal exercise

Gently place your hands on your lower tummy. Breathe in through your nose and as you breathe out, gently pull your tummy away from your hands towards your back. Feel the muscles tighten, try to hold for a count of 3 and then relax. Breathe in and out normally.

2. Pelvic tilting

Place your hands in the hollow of your back. Tighten your tummy muscles (Exercise 1), flatten your lower back onto your hands and tilt your bottom. Breathe normally. Hold for 3 seconds and release gently.

3. Knee rolling

Tighten your tummy muscles (Exercise 1) and gently lower both knees to one side as far as is comfortable. Bring them back to the middle and relax. Repeat to the other side.

Do each of these exercises 3 times a day and repeat each one 5 times. Do more repetitions as you feel able.

Posture and back care

It is very important to be aware of your posture and take special care for about 6 weeks after your surgery. A good posture will help to prevent backache.

To get out of bed, bend both knees and roll onto your side by moving your shoulders and knees together. As you lower your feet to the floor, use your arms to push yourself into a sitting position on the side of the bed.

Sitting

Sit upright in a supportive chair, if possible with both feet on the floor. Do not slouch. You may find it helpful to place a small cushion or rolled towel in the small of your back.

Standing or walking

Avoid holding your tummy with your hands and slouching forwards. Stand upright with shoulders back, keep bottom and tummy tucked in.

Lifting

Do not lift heavy objects. When lifting, bend your knees and keep your back straight. Hold larger objects close to your body.

If you have any back pain after your operation, seek further advice from your physiotherapist.

Discontinue the exercises if they cause you any pain and seek advice from your physiotherapist.

Before you go home

The need for continued pain relief at home is very individual. Please discuss this with your nurse.

If you have any worries or concerns, please talk to the ward physiotherapist or nursing staff.

Advice on discharge

Exercises

Continue with your exercises for at least 6 weeks, preferably 3 months, if you are returning to a physical job.

Rest

Your body is using energy to heal itself so you will feel more tired than normal. Take a daily rest on your bed for about an hour. Continue to do this for as long as you need to.

Walking

Try to walk for about 10 minutes at least once a day. Hills and stairs are quite safe but build up speed and distance gradually. Walking is a very valuable exercise.

Driving

Check with your consultant and insurance company, but do not expect to drive for about 2 to 6 weeks, depending on your surgery. Make sure you can wear a seatbelt comfortably and perform manoeuvres and an emergency stop without undue pain.

Work and sports

Always get approval from your doctor to return to work.

Gradually build up your level of physical activity.

Also get approval to return to your normal exercise routine e.g. swimming, cycling, aerobics and other sports.

Gardening

Avoid gardening for a few weeks. Start slowly.

Household activities

Do’s

Independent personal hygiene; light housework; making drinks; washing and drying dishes; preparing light meals.

Don’ts

Decorating; heavy lifting; shaking the duvet or heavy bedding; cooking a large meal using the oven; heavy housework; gardening; D.I.Y.