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Life after cancer | Exercise

 What exercises can I do to get my abdomen back in shape after a hysterectomy?

See also: Ask the pros: How long do I have to wait before resuming my exercise routine after a cone biopsy?


 What exercises can I do to get my abdomen back in shape after a hysterectomy?

 Sue D., Pennsylvania, USA: Before you start any exercises after surgery, check with your doctor and make sure it is OK to start exercising again. Most doctors give a six-week restriction for lifting and other strenuous physical activity. Your body needs this time to heal -- not just the scar you see on the outside, but all the tissues inside, as well. Don't rush it!

My fitness trainer helped me get back into shape after my hysterectomy. I asked her to help me explain the exercises she had me do. First, she explained that whenever you work your abdominal muscles, you should also work your back muscles, and your pelvic floor muscles. These muscles form a cage around your pelvis and you should work on them equally.

Pelvic floor muscles. Before each repetition of the following exercises, lift your pelvic floor muscles, also known as the "Kegel" muscles, and hold them through the repetition. If you are unsure which muscles these are, stop urinating midstream next time you use the bathroom. Those are your Kegel muscles. When you exercise, think about lifting rather than squeezing for best results.

Abdominal muscles. This exercise is the safer version of the dreaded "sit-ups" we did in high school. "Abdominal crunches" look almost like you aren't working, but you are and you will feel it!

Lie on the floor with your knees bent, hands behind your head. Tilt your pelvis back (flatten the small of your back against the floor).

Lift your head and shoulders up until you feel your abdominal muscles contract (don't forget to Kegel first!). Do not bend your neck or let your chin drop (a grapefruit should be able to fit under your chin, so they say). Slowly lower your head to the floor again. Repeat 10 times, then stay up and do 10 mini-crunches before returning to the floor. You can gradually do more sets of 10 as your strength increases.

Roll onto your stomach. Kegel, then bring your arms and legs off the floor. Hold for a few seconds, then relax. Repeat 10 times, rest then do another set of 10.

Back muscles. Anytime you work your abdominals, you should work your back muscles, too, to keep your posture balanced. "Bridging" is a good back exercise.

Start in the same position as the abdominal crunches above -- Lie on the floor with your knees bent, hands behind your head. Kegel, squeeze your buttocks, then left your hips off the floor. Hold for a couple of seconds, then lower your hips to the floor. Repeat 10 times. On the tenth time, stay up and hold for a count of 10, then lower your hips to the floor. Repeat the set as many times as you can tolerate.

Abs and back together. This exercise works both abdominals and back muscles together to strengthen your whole trunk.

Start by kneeling on the floor on all fours. Slowly raise your left arm and right leg, keeping them straight as possible (remember to Kegel first!). Slowly lower your arm and leg again. Repeat 10 times. Then switch sides:

Good luck! Last words: take it easy, it shouldn't hurt. If it does, stop. Ask for help from a trainer or physical therapist who can make sure you are doing the exercise properly.

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 Trenna, Orthopedic and Women's Health Physical Therapist, Pennsylvania, USA: Here's an exercise that has helped me a lot. It can strengthen your abdominal muscles, your back, and your pelvic floor -- all at once -- and very effectively. It will relieve backache and reduce stress incontinence (urine leaks that happen when you cough, laugh and sneeze). It can help many more than just women who have had hysterectomies.

It is an exercise done standing, with heels softly together and big toes about four inches apart.

TALL: Lift your rib cage up away from your pelvis. Imagine that there is a string at the back of the top of your head lifting you up. Your chin is in a neutral position -- not down, not poked forward.

WASP: Suck in your belly as hard as you can, without pain or cramping, and without holding your breath. Aim your belly for your spine, and think "wasp waist". Make the contraction deep and complete.

BUTT: Let the belly tightness flow to your buttocks. Pinch them together. Your tail will automatically tuck under.

LIFT your pelvic floor up toward your belly button. PRESS your inner thighs together.

Hold all the tightness as long as is comfortable. Your breathing should be slow and steady, with deep breaths in and out.

That's it! Just remember: TALL WASP BUTT LIFT PRESS. Repeat four times if you can. Back off a little if you have a cramp; you will be able to work up to a stronger contraction quickly. Do another set of four at another time during the day -- while you are talking on the phone or even washing dishes!! When this is easier, rise up on your toes and balance there for a few seconds. Then add head and arm movements. Moving the head and the arms adds a dimension of demand for increased stability, and balance. Invent your own patterns -- be creative.

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