Exercise Post-Hysterectomy

By the age of 60, it is estimated that over one third of women will have undergone a Hysterectomy. Yet, it is not well understood nor talked about as much as other common procedures.

A Hysterectomy is a common gynaecological procedure which involves the removal of the uterus. There are different types depending on which additional female organs are also being removed.

1. Total Hysterectomy: removal of the uterus and cervix.
2. Partial Hysterectomy: removal of the uterus, leaving the cervix.
3. Radical Hysterectomy: removal of the uterus, cervix, fallopian tubes, and ovaries, as well as the upper part of the vagina and lymph nodes along with possibly some tissue from the pelvic cavity. This is generally only performed when cancer is present.

There are many reasons why a woman may decide to undergo a Hysterectomy, some include:

• Fibroids and heavy periods.
• Cancer.
• Endometriosis or intense, prolonged pain through the pelvis.
• Uterine prolapse.
• Urinary incontinence.
• Adenomyosis.

There are three common ways a Hysterectomy is performed, including:

1. Abdominal Hysterectomy: An incision is made through the abdomen and the organs are removed through the incision.
2. Vaginal Hysterectomy: An incision is made at the top of the vaginal tube and organs are removed through the vaginal opening.
3. Laparoscopic Hysterectomy: A scope and small portals are used to remove the organs laparoscopically or vaginally.

Returning to exercise: When is the right time?

Firstly, it is important to remember that everyone responds to surgery differently. We need to remember it is normal to feel some pain, pelvic discomfort, pelvic weakness, urinary incontinence and scar sensitivity.

Another consideration is that if a woman has had their ovaries removed before menopause, menopausal symptoms will start to occur. These symptoms need to be monitored and considered in line with a return to exercise plan.

Finally, it is important to remember that the abdominal and pelvic muscles are recovering from a traumatic surgery. For these reasons, timelines for a return to exercise should be guided by your Surgeon and Specialists.

Generally speaking, the first 2-4 weeks should be spent resting and returning to light walking.

After 4 weeks, it may be appropriate to return to normal activities of daily living, however scars will still be healing and there should be no heavy lifting.

At 4-6 weeks post procedure, we may like to focus on breathing, pelvic floor movement, walking and light stretching.

At 6-8 weeks post procedure, it is time to engage with a women’s health exercise professional to ensure you are completing the appropriate exercises to help return to normal strength and function. Depending on the type of surgery undertaken, this will influence the exercises you may commence with.

Remember – there is no “perfect” exercise plan for women recovering from a Hysterectomy. There are far too many variables to just have one program.

Engage with your Exercise Professional and create a program that is best suited for you!