Physical Activity for Ostomates
Exercise can accelerate recovery, strengthen your heart, boost blood flow, enhance balance and flexibility, boost self-confidence, increase energy, and is a major stress buster (one of the Top 10).
Easing into it
- Be sure to confirm with your doctor before you start exercising.
- Too much physical activity can increase the risk for hernias. Muscles around the stoma that support it are a bit weaker after surgery.
- Avoid lifting more than 8lbs., especially for the first six weeks after surgery.
- Ostomy support belts are highly recommended when lifting or using abdominal muscles.
- Helpful tip to avoid hernia- keep weight in check and monitor.
- Always speak with a medical team (especially a surgeon) before trying any abdomen exercise or activities that could risk straining the area.
- Walking is the most effective (and easiest) exercise for healing.
- If dealing with a perineal wound, your body needs plenty of time for healing. Exercise is still a possibility, just keep in mind that just about any lower body movement and the wound could be affected. It will be tender (more than the incision) but will become resilient with time.
- If something is hurting- STOP. Listening to your body is very important.
- Work on a gradual build up- start slow and easy.
- Hydrate! Before, during, and after exercise, make sure to be drinking plenty of fluids (ORS recipes on this page).
- If at any time you experience lightheadedness- STOP!
- Empty bag before any exercise or activity.
Always check with a healthcare professional before trying specific sports and fitness activities. Gaining an understanding of your body after surgery and how it responded is so important. If the healthcare team approves, you can try almost any type of exercise (even swimming). Be sure to communicate about contact sports (e.g.soccer or rugby) and activities that involve bending (e.g.aerobics or bowling).
Start by walking. Can start soon after surgery. Slowly increase the distance and time over time.
Biking can be a healthy choice as long as the surgeon approves. They may have you wait until your abdomen and the surrounding area have healed completely before you can start. With its low impact and light strain on the abdomen, this can be an amazing activity. *If the anus has been removed, the healing time will take longer and you may need to wait longer before biking.
The water is supporting your weight which gives your muscles a nice workout without much risk of injury. This also helps with flexibility. *Look to see if the flange/wafer has a barrier that is waterproof. If not, options like Sure Seal or Brava Strips help "waterproof" your ostomy device. If using Sure Seal, remove it directly after swimming or it can cause irritation. Make sure the water did not damage the flange or create a leakage issue. Bring extra supplies with you for backups. If using a pouch with a filter, use an ostomy filter sticker to cover.
Helps to reduce stress, improve balance, improve breathing, and strengthen muscles. Incision sites and abdominal muscles should be fully healed before attempting (and with any exercise, check with surgeon and medical team that you are ready) since yoga and pilates uses lots of core strength. Make your own pace, don't rush. Many yoga teachers will understand. It is up to you if you want to tell anyone about your ostomy, including the teacher. Many ostomates that exercise wear tight-fitting layers and/or wraps to help keep their bag in place. Also, many skin barriers used on stomas are water-resistant and should stay adhered to your skin during movement and sweating.
As always, check with the surgeon. Competitive sports can put a strain on your body, so it is important that you are fit and in shape before you take part. Make sure your pouch is empty before starting. Some people also wear close-fitted waistbands or girdles to keep their pouch securely in place. For sports such as football, rugby, wrestling, or kung fu, there are protective stoma guards that can help prevent injury. ALWAYS inspect stoma after participating in heavy activity. If any injuries occur, contact your medical team.
Abdomen Specific Exercises
These activities are specific to help recover and restore muscle strength in your abdomen. These exercises should be possible for those with an ostomy. However, if you are feeling concerned about doing the exercises, talk to your surgeon/medical team before starting.
TUMMY TIGHTENING BREATHING
When to start: within days after your surgery. You may even be able to begin in in the hospital, with doctor approval and recovery is normal.
How to do it: Lie on back, support your head (a pillow works best) and bend your knees as far as you can. Breathe in deep and slow through your nose and exhale through mouth. While exhaling, be aware of your deep, lower abdomen muscles and gently tighten them (you should be able to feel the "tightening"). Do not push head back into pillow, or lift your bottom. Hold position for 3-5 seconds- release. Breathe, relax, repeat. Do this 3-5 times. With progression, you should be able to remove the pillow and try using stronger tightening motions. Hold, count to 10, moving up to 15 as you progress. Breathe deep and repeat 2-3 times. Use your hands to feel your muscles tighten by placing them on your abdomen.
When to start: Within days of surgery. Make sure to start slow and use gentle movements. Stay within a small pain-free range.
How to do it: Lie on back, support your head (a pillow works best) and bend your knees as far as you can. Using gentle motions, rock pelvis up and make sure back is flat on floor (or bed). You should be able to feel your abdomen and glutes muscles tighten. Rock yourself back into starting position- repeat. Start with 5 repetitions and take it slow. With progression, arch your back and use stronger tightening motions in the abdomen while pushing back into floor. Try this 2-3x daily and work up to 20 repetitions.
When to start: 7-10 days after surgery. Start with small, gentle movements and don't go out of your comfort zone.
How to do it: Lie on back, support your head (a pillow works best) and bend your knees as far as you can. Tilt pelvis gently back and tighten muscles of pelvic floor. Slowly lift your bottom from floor, moving one vertebra at a time until your bottom is completely off the floor. Lift bottom as high as possible and hold. Slowly lower yourself back down, starting at top of spine and working down to pelvis. *Pretend you are lifting a necklace off the floor and then bringing them back down. Try for 3-5x per day, working up to 10-15 reps at a time. Each time try to lift higher.
When to start: 7-10 days post-surgery. Be conscious of any pain- work within pain-free zone and use small motions to start out.
How to do it: Lie on back, support your head (a pillow works best) and bend your knees as far as you can. Place your arms out to your sides and keep ankles and knees together. Slowly let knees fall to one side, staying in a pain-free range. Tighten abdomen muscles and roll knees to opposite side. Work on keeping shoulders down, neck relaxed, and look up. Try for 5 reps, 2-3x per day, working up towards 20. Try to drop knees lower each time.
- Journal your progress: Feelings of accomplishment are some of the great things about exercise- each time you feel you can push harder and do more. Keeping a record will show your progress, probably surprising yourself by the speed of your recovery and strength building.
- Weight fluctuation is normal over time. It is important to evaluate your pouch from time to time to confirm it is still appropriate for your body.
- Healthy food choices should always be a priority, no matter how long you've had your ostomy.
- STAY HYDRATED- Dehydration is one of the reasons for getting readmitted to the hospital post-surgery. The body needs 8-10 glasses of fluid (at least eight ounces each) per day for full hydration. The large intestine's (AKA colon) main function is to reabsorb fluids back into the body. If a large portion or the entire colon has been removed (ileostomy), the small intestine has the ability to eventually adapt and absorb some of those fluids. But there is still a need to keep up on electrolytes and prevent dehydration. Having an ostomy does pose a risk of losing electrolytes, like potassium and sodium.