Why abdominal exercise matters

When you go through ostomy surgery, your abdominal muscles become weak. Doing exercise to strengthen your core will help you recover faster - and reduce the risk of suffering from back pain and developing a hernia.

What’s the function of your core?

The abdominal muscles, that form the ‘core’ of your body, are extremely important for your everyday movement. You might not think about it, but you use your abdominal muscles when you move and twist, lift things, cough, laugh and sneeze. They sort of act like a corset around your internal organs and spine, helping you keep posture and stand up straight.

That is why you suffer from back pain and other symptoms of bad posture when your abdominal muscles are weakened. This is also the reason why people with an ostomy should put much effort into making their core strong again.

After surgery, your abdominal muscles are weakened due to the incision that is made to create the ostomy. If you do not work hard to rehabilitate those muscles, the pain will linger - and you are more likely to experience other complications such as a hernia or problems getting a tight fit between your body and your ostomy solution.

Forget about crunches and sit ups

Usually when you think about abdominal exercise, you might think about crunches, sit ups, and other exercises designed to push your core strength to the limit. But when it comes to rebuilding your abdominal muscles after ostomy surgery, a ‘slow and steady’ approach is absolutely key.

So do not be afraid that you will not be able to perform the exercises meant to strengthen your core. The exercises presented in the Core 4 programme below are designed with the sole purpose of re-engaging the weakened muscles in your abdomen. Think of them as part of the healing, something you do at your own pace.

Don’t hesitate - start today

Even though it can take up to 3 months for the affected muscles to fully recover, you can start exercising lightly when the healing is occurring. And don’t be discouraged by minor setbacks - it is all part of the process. If you keep an exercise diary you will most likely discover that you are, indeed, moving in the right direction!

Note! You should always consult your ostomy care nurse or surgeon before starting exercising.

Before you start

The following exercises are designed to aid your recovery and help restore muscle function in your stomach. They are entry-level exercises that everybody with an ostomy should be able to do. However, if you have any concerns about whether or not you should do the exercises, talk to your ostomy care nurse or surgeon before you start.

Tummy Tightening Breathing

When to start

This exercise can be started within days of surgery. Provided all is well, you can even start while you are still in hospital, and your recovery is progressing normally.

How to do it

Lie on your back, with your head supported by a pillow and your knees bent as far as is comfortable. Simply take a deep breath in and slowly exhale through your mouth.

As you exhale, gently tighten up the deep muscles in your lower tummy. You should feel a very gentle ‘tightening’. Don't try to lift your bottom or press your back into the bed. Just hold this ‘brace’ feeling for a count of 3-5 seconds, and then release. Breathe and relax and then repeat 3-5 times.

As you progress, you can do the exercise on the floor without a pillow and aim for a ‘stronger’ tightening feeling. Hold the ‘brace’ for a count of 10-15 and breathe deeply in and out 2 or 3 times. Repeat up to 5 times. Place your hands on your tummy so you can check and feel the muscles tightening.

Try to do this 2 or 3 times per day.

Pelvic Tilt

When to start

This exercise can also be done just days after surgery. Just start very gently and work within a small pain free range.

How to do it

Lie on your back, with your head supported by a pillow and your knees bent as far as is comfortable. Very gently rock your pelvis upwards and flatten your back into the bed or floor. You should feel your tummy and bottom muscles tighten a little. Rock back to your starting position and repeat. Initially just aim for 5 repetitions and go very gently.

As you progress, allow your back to arch up a little more and tighten your tummy more strongly as you push your back into the floor. Build up towards 20 reps.

Try to do this 2 or 3 times per day.

Hip Lift/Bridge

When to start

Introduce this exercise 7-10 days after surgery and, initially, make sure you do it very gently and with a small movement, only going as high as it feels comfortable.

How to do it

Lie on your back, with your head supported by a pillow and your knees bent as far as is comfortable.

Very gently tilt your pelvis backwards and tighten your pelvic floor muscles. Lift your bottom off the bed/floor and slowly lift up vertebrae by vertebrae until your bottom is off the bed. Lift your bottom as high as you comfortably can. Hold this for a moment, and then slowly lower your spine and pelvis back down. Imagine you’re lifting a string of pearls off the floor and back down again.

Repeat 3-5 times initially, building up to 10-15 repetitions in time and lifting higher as you feel more comfortable.

Try to do this 2 or 3 times per day.

Knee Rolls

When to start

Introduce this exercise 7-10 days after surgery. Always work within a pain free range and keep the movement very small to begin with.

How to do it

Lie on your back, with your head supported by a pillow and your knees bent as far as is comfortable. Put your arms out to the sides. Keep your knees and ankles together and gently let your knees begin to drop over to one side. Only go as far as is comfortable, then carefully tighten your tummy muscles and roll your knees over to the other side. Try to keep your shoulders down and your head relaxed, looking up with your eyes. Aim for 5 rolls.

As time goes on, you can increase the range, so your knees drop lower and build up to 20 repetitions.

Try to do this 2 or 3 times per day.

Keep track of your progress

One of the great things about exercising is the feeling of being able to do more every time you exercise. By keeping an exercise diary, you can keep track of how many reps you are able to do of each exercise. You will probably be surprised to discover how quickly you get stronger and able to do more.