After hysterectomy surgery it is essential to understand how to identify improper abdominal or core strength exercises. Many women unknowingly perform abdominal exercises with the potential for serious pelvic injury when returning to their gym workouts and fitness classes after hysterectomy surgery. Unfortunately, even well-intentioned fitness instructors are ignorant of this issue, leaving women uninformed, weak, and confused about proper exercise after pelvic surgery. These physical therapist guidelines are designed to help you identify unsafe abdominal exercises after hysterectomy.
Exercises involving the muscles of the upper abdomen (or “six pack”) pose the most risk to your pelvic floor. Ultrasound studies suggest that basic abdominal curl exercises lower the pelvic floor in women with poorly functioning pelvic floor muscles. The more intense the abdominal or core exercise, the greater the pressure on the pelvic floor and the greater the risk of pelvic floor overload and loss of pelvic support.
Lack of pelvic support can lead to a variety of pelvic floor problems, including; Vaginal prolapse, incontinence, pelvic pain and anorectal disorders. In hysterectomy surgery, the upper vagina is stitched inside a woman’s pelvis to support the vagina and prevent vaginal prolapse (i.e. the vagina descends down and sometimes exits the woman’s body). Research suggests that there is an increased risk of vaginal prolapse after hysterectomy surgery.
This means that it is imperative that you understand how to avoid overloading your pelvic floor with improper abdominal exercises after hysterectomy. The following abdominal exercises have the potential to overload the pelvic floor and should therefore be avoided after hysterectomy surgery;
- abdominal curl exercise Involves raising the head and shoulders from a lying position and is also known as a sit up exercise. Variations include; Incline sit ups, oblique sit ups (elbow to opposite shoulder) and fit ball sit ups.
- double leg raises Involves lifting both legs off the ground simultaneously. Variations include; Bicycle leg raise, double leg raise, Pilates “table top” exercise and ball raise fitted between legs.
- intense core abdominal exercises such as the “plank” or “hover” that are performed regularly in gym workouts, yoga and Pilates classes. Never assume that just because an exercise is a “Pilates” exercise, that it is safe and will help strengthen your pelvic support. Some Pilates exercises can put intense pressure on the pelvic floor.
- abdominal strength machines Those that exercise the upper abdominal and/or external oblique muscles against resistance. These machines increase pressure within your abdomen that is transferred directly to your pelvis. In fact these exercises will actually make your abdominal muscles even more effective at exerting downward pressure on the floor of your pelvis.
How to spot unsafe abdominal exercises after hysterectomy surgery?
- Exercises that involve lying down and elevating the head and shoulders and/or lifting both legs off the ground at the same time all increase downward pressure on the pelvic floor. All of these exercises have the potential to cause pelvic floor injury, especially after pelvic surgery and when the pelvic floor muscles are not working well.
- Exercises performed in the prone position (lying face down on the floor) and weight bearing through hands/fingers and feet (raising the body off the ground are intense abdominal exercises. These are modified by kneeling instead of lifting through the legs. Can be done. Sometimes these are. Performed further on a fitted ball. Once again, never assume that using a fitted ball makes the exercise safe for your pelvic floor.
- Abdominal exercise machines that exercise the abdominal muscles either upright or lying down have the potential to overload the pelvic floor. These types of machines are usually used for the purpose of “flattening the stomach”. Abdominal exercises are not possible to reduce belly fat but this myth is still prevalent in western society. To flatten your stomach you need to lose fat from your entire body, it is not possible to reduce it through exercise from just one spot.
It is desirable for women to return to exercise after hysterectomy surgery and ensure their long-term pelvic health by performing appropriate exercises. Most women take three months to fully recover from hysterectomy surgery. The pelvic floor is at greatest risk of injury during this recovery time. Women should only return to the types of abdominal exercises listed above with the approval of their medical specialist and when their pelvic floor muscles are strong and able to withstand the large downward forces associated with these particular exercises. For some women with poor pelvic muscle function, this may mean avoiding intense abdominal exercises altogether and instead doing more gentle core abdominal exercises that are better suited for their pelvic health and longevity .
Source by Michelle Kenway
