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Resuming your exercise routine and reestablishing your fitness, after bowel surgery, can be both an exciting and scary proposition. What you can (and should) do, and when you should do them are common questions. Below, I’ll provide some basic guidelines for exercise following bowel surgery. Please keep in mind, that surgeries involving complications may be exceptions to these general guidelines. If you have doubt, please check with your surgeon before beginning an exercise routine.
Activity Should Start Right Away
You’ll want to get up and moving almost immediately after bowel resection surgery. This activity should not be confused with exercise initially, the intensity should be low (you shouldn’t really increase your heart rate very much, and you shouldn’t break much of a sweat either). With that in mind, gentle walking is a great place to begin. Starting with 2 or 3 ten minute bouts of light walking is a safe place to start your post-surgery exercise routine. This light activity will not only aid in improving your mood post-surgery, but it will also speed up recovery and help digestive/bowel function.
Progressing from the light bouts of activity immediately post-surgery is your next important step. Gradually build up over the four weeks following surgery. As you progress towards the third week your activity can begin to become a little more intense (where you’re actually breaking a light sweat). Below is an example of general progression following surgery:
- Week 1: 2-4 ten minute bouts of low intensity walking each day
- Week 2: 2-4 fifteen minute bouts of low intensity walking each day
- Week 3: 2-3 twenty to thirty minute bouts of moderate intensity walking each day
- Week 4: 1-2 thirty to forty minute bouts of brisk walking each day
Resuming Normal Exercise
Through the first six weeks following surgery, you should not perform any exercise (or activity) that involves straining through the abdominal region. That means no weight lifting, crunches, or anything else that greatly increase the pressure through your abdominal cavity.
After the 6 week mark, your doctor will typically advise you it is safe to resume normal exercise. Here, again, it is important to be progressive. For aerobic exercise, it’s advisable to start with non-impact activity (like the Elliptical Trainer or biking), rather than running. For resistance training, starting with exercise that doesn’t directly utilize core musculature is wise.
Below is sample post-bowel surgery exercise routine you can follow the first 4 weeks you’re released to normal exercise (normally this will be weeks 6-10 post-op):
- 2 to 4 days week
- 20 to 40 minutes/session
- Elliptical Trainer or Biking
Do 2-3 sets, of 10-15 reps, of each of the following:
- Body Weight Squats
- Body Weight Heel Raises (no weights, use both feet)
- Modified Pushups
- Band Back Rows
- DB Bicep Curls
- DB Tricep Kickbacks
After you’ve progressed through four weeks of the above routine, you can pretty much resume all normal exercise. You do want to proceed with caution, however, in the following areas:
Heavy spinal loading or compression (like when you have a bar on your back for squatting, or when performing bent-over row, romanian dead lifts, and other similar movements). Ease back into these movements with lower loads, fewer sets, and fewer repetitions.
High impact exercise (like running or jumping). These activities can certainly be performed, just be progressive in terms of how you integrate them back in.
High volume abdominal work. This is an area that undoubtedly you’ll want to start training quickly, but take your time adding back in abdominal work. This area of your body has just undergone significant trauma, you want to add ab work back in slowly.
Resuming Abdominal Training
Your best strategy is to start by focusing on the transverse abdominal muscles (this is a layer of muscle that lies beneath the six pack we normally think of). Planks, side planks, and pelvic lifts are a great place to start here. When performing all of these exercises it is important to keep your belly button drawn in (like you’re pulling it through to your spine). Below is a sample post-op abdominal routine that can be performed 2-3 days per week):
- Modified (from knees) Planks: 3 sets x 15-4545seconds/side
- Modified (from knees) Side Plank: 3 sets x 15-45seconds/side
- Pelvic Lifts: 3 sets x 10-15 reps.
Take Home Message
It is clearly important (both physically and mentally) to resume exercise post-bowel surgery. Getting back to your previous level of fitness (or higher) is a critical aspect to effective recovery. As this article illustrates, be slow and progressive in how you implement your exercise. Follow these steps and you’ll be well on your way to taking control over your body once again!
Thanks for reading!
Michael Stack, CEO and Exercise Physiologist