by DR HITENDRA PATIL

Consultant Surgical oncologist & Director, Suyog cancer clinics, Thane

Exercises after the surgery

Exercises are required for following reasons:

• Avoid deep vein thrombosis
• Improves circulation to muscles
• Light exercises improve healing and prevent hernias.
• Exercises to pelvic floor
• Deep breathing exercises helps in lung expansion, better oxygenation and early recovery
• Ambulation and exercises makes early return to intestinal motility

Recovery time after the abdominal surgery is approximately one month.

During this time you have to avoid lifting and carrying heavy loads (maximum 1-2kg).

The following measures may be taken:

• Sit upright. It may help to sit at the edge of the bed with your feet hanging over the side. If you cannot sit like this, raise the head of your bed as high as you can.
• If your surgical cut (incision) is on your chest or belly, you may need to hold a pillow tightly over your incision. This helps with some of the discomfort.
• Take a few normal breaths, then take a slow, deep breath in.
• Hold your breath for about 2 to 5 seconds.
• Gently and slowly breathe out through your mouth. Make an “O” shape with your lips as you blow out, like blowing out birthday candles.
• Repeat 10 to 15 times,

Circulation exercises

 These help to maintain the blood circulation in your legs whilst you are not so active. This reduces the risk of getting a blood clot (DVT). 

• 

• Keep your legs and ankles uncrossed at all times

 • With your legs stretched out, briskly circle your feet and bend them up and down.

 Do these every hour while you are awake. You can do these when lying down or sitting in a chair

Basic exercises

 Start with exercises sat in a chair: 

• March your knees alternately for 30 seconds.

• Bend and straighten your knees. Hold your knee straight for 10 seconds, keeping your toes pulled up. Repeat 5 times with each leg as you are able.

After 2 weeks post surgery:

you can start exercises for the internal abdominal muscles. The purpose of this exercise is to regain the function of abdominal muscles and to prevent wound hernia. You should do this exercise 5 – 6 days a week.

After 6 weeks of surgery you can start exercises for the external abdominal muscles. The purpose of this exercise is to strengthen your abdominal muscles.

Core Stability Exercises

 Having major abdominal surgery will affect your abdominal muscles and hence your core stability. To improve your core stability, please do the exercises outlined in the following pages. The best position to do these exercises is lying on the floor. However, if you are unable to do so, you could do them lying on a bed. Aim to do them three times a day.

1. Deep Abdominals

• Lie on your back, knees bent, at hip width apart, feet flat

 • Put one pillow under your head

 • Breathe in, gently letting your tummy rise

 • As you breathe out, gently draw your tummy button towards your spine

• Hold for a few seconds, then relax

 • Rest for a few seconds

 • Repeat 3-5 times

2. Pelvic Tilting

 Lie in the same position as shown.

 • As you breathe out and draw your tummy in, gently tilt your pelvis and flatten the small of your back into the bed. 

• Hold for a few seconds, and then relax

• Repeat 3-5 times and gradually build up to 10 times

3. Knee Rolling

Walking & Yoga:

Aim to walk every day gradually increasing the distance. You should aim to be able to walk 30 minutes daily by one to two months after your operation. Start walking on level ground and gradually build up to inclines and uneven ground such as cobble paths. Walking on uneven surfaces requires small changes of direction which can cause some discomfort in the healing abdominal muscles. After two to three months you could consider moderate exercise like swimming or cycling. To progress your core stability exercises you could attend a Yoga or Pilates group. However, seek advice from the group’s instructor about an appropriate level of exercise. If you wish to return to a specific sporting activity please discuss this with your consultant.

You can return to your previous activities after 1 – 2 months.

Exercise summary

Exercises before your operation:

• General exercise

• Deep breathing exercise

• Core stability exercises

Exercises after your operation:

• Getting in and out of bed and walking

• Deep breathing exercises

• Exercises for clearing secretions

• Circulation exercises

• Core stability exercises

Exercises after you have returned home:

• Core stability exercises

• Exercises sat in a chair

• Once comfortable, exercises in standing

• General exercise