Physiotherapy for Gynaecology
You will shortly be undergoing surgery for hysterectomy or
You may not be seen routinely by a Physiotherapist on the ward
however, this leaflet outlines general advice given to you in the
preoperative 'GynaeSchool' (hyperlink to page on Gynae school (and
in future to video presentations) that you attend before being
admitted to hospital.
The modern approach to surgery is to follow an enhanced (early)
recovery pathway. This means a lighter and safer anaesthetic,
pain relief based on less sedating medications, the ability to eat
before and after surgery and hence a shorter stay in hospital
because you will feel well enough to go home sooner. You can
help yourself in this process by complying with guidance outlined
below. However, your recovery and the overall experience of
surgery will depend on you general health and fitness before the
operation and the reason that you required the surgery in the first
Physiotherapy exercises that will aid your recovery
1) Deep Breathing Exercise: Inhale and exhale
deeply x 10. Do this hourly and when you wake from sleeping or
dosing. This helps to keep your chest clear and expel the
anaesthetic. If you need to cough, draw your bent knees up and
always support the wound with your hands (you may also hold a towel
or pillow over the wound)
2) Ankle and Leg Exercises: Stretch your feet forward
and backward as if pedalling for 5 minutes every hour. Slide
your legs alternately up and down the bed bending and straightening
your knees. Do not lie or sit with legs crossed. These
exercises improve circulation and helps to avoid the risk of blood
3) Mobility Exercise: Once you are out of bed you
will be encouraged to walk at least 60 metres on
4 occasions during your stay in hospital to demonstrate you are
to be considered for early discharge from hospital.
4) Pelvic Floor Exercises: After any
gynaecological surgery it is very important to do pelvic floor
exercises. These muscles control the urethra and anal
sphincter and avoid problems with urinary or faecal
incontinence. They are also useful in the prevention or
recurrence of pelvic organ prolapse.
How to do Pelvic Floor Exercises:
Locate the muscles around the vagina and anal sphincter,
internally squeeze and hold the contraction 5 seconds as if
stopping the flow of urine or stopping wind from passing.
Repeat 5 times and do so hourly. Aim for 50 contractions each
day. Also brace the pelvic floor for support when you cough,
sneeze and lift to protect your internal stitches post
You should keep these exercises up for at least 3 months after
If you are struggling to perform pelvic floor exercises ask your
nurse to contact the physiotherapist to supply you with a
more detailed pelvic floor exercise leaflet.
5) Pelvic Rocking Exercises: This exercise helps
mobilise your lower back, tones your abdominal muscles and help to
relive the pain of trapped wind which can occur
Lying on your back with knees bent. Gently roll your
pelvis forwards and backwards so your lower back flattens against
the bed and then arches off a little. Repeat 10 times x 5 times
or you can do this exercise standing, leaning
on a work top or chair back flattening your lower back and tilting
your belly button and hips towards your head.
What can you do after your hysterectomy / repair
Household / Domestic
1 - 3 weeks
Light work - dusting. Make light snacks and
drinks. Peeling vegetables and ironing (both can be done
sitting down). Lifting weights under 3lb (i.e. kettle, pans,
4 - 6 weeks
Vacuuming (get someone else to place it in the room
to be cleaned if you can).
Carrying small loads of shopping, washing (split in to smaller
loads if necessary). Can do weeding, hoeing. Avoid
driving for 4-6 weeks. Before you return to driving check
with your insurance company that you will be covered.
Up to 12 weeks
Avoid turning mattresses, heavy D.I.Y jobs and strenuous
Sports / Hobbies
1 - 3 weeks
Walking, gentle and on level ground 15-20 minutes.
Increase distance and increase speed gradually over 6 weeks.
Abdominal pelvic rocking exercise from your exercise sheet to
improve 'core' stability and get ready for other
6 - 8 weeks
Low impact swimming, cycling or static bike after 6
weeks. Add yoga or Pilates at 6-8 weeks. Return to racquet sports,
jogging, netball and gym when comfortable after 8 weeks.
At 4 weeks: You can return to a non-manual job (i.e. clerk /
typist) but no heavy lifting.
At 6 weeks: Can return to a manual job (i.e. nursing /retail).
May wish to negotiate 'light duties' for a few weeks upon return to
work or a phased return to work. Consider a workplace risk
assessment if you are expected to lift in your job.
Any further enquiries regarding activities telephone
physiotherapy office - 01244 365176.