After an ostomy surgery, you must give your body plenty of time to recover. This means resting and avoiding putting too much strain on yourself. However, if you're typically an active person or are looking forward to getting back to moving your body, this post-op period can be challenging. You'll need to wait until you've fully healed to exercise again. Although this can be frustrating, it's one of the best ways to help reduce the risk of complications and keep yourself healthy. Once you're cleared, however, there are several great abdominal exercises to strengthen your core with a stoma. Here, we'll go over a few of our favorites along with some general tips about exercising with an ostomy.
Understanding Exercise and Core Health After Ostomy Surgery
Strengthening core muscles after ostomy surgery can help with overall stability and long-term health. Plus, your abdominal muscles play an integral role in your posture, which can help protect your stoma; a strong core can reduce the risk of developing complications. This is especially true for parastomal hernias, which occur when part of the intestine pushes through the abdominal wall near the stoma. These hernias can be uncomfortable and may require medical intervention, making prevention essential.
When to Start Core Strengthening Exercise
While you might be eager to start, it's best to wait at least six weeks to do gentle exercises. At this time, your focus should be on walking and exercises that can improve your overall range of motion. Always follow your doctor's instructions, but it's typically best to wait at least 12 weeks after surgery before starting core exercises. This is enough time for your body to heal without risking incision problems. Still, always get medical clearance before starting any exercise regimen.
Precautions Before Starting Abdominal Exercises
You should also keep a few things in mind before you get started. First, you may want to talk to your ostomy nurse about using a support garment or hernia prevention belt during workouts. These provide gentle compression around the stoma area and can help reduce the risk of hernias. You should also know how to recognize complications such as a hernia or other stoma-related issues. Some of the most common ones to watch for include:
- Bulging or swelling around the stoma
- Pain or discomfort during or after exercise
- Increased fatigue or unusual weakness
- Pouch leakage or changes in stoma output
Once you begin exercising, don't rush. Start slow and listen to your body. Try keeping an exercise diary to help you monitor your progress and ensure you're advancing at a healthy pace. If you experience pain or discomfort, discontinue the exercise and contact your doctor.
Safe and Effective Abdominal Exercises That Can Be Done With an Ostomy
Staying active and exercising after ostomy surgery is excellent for overall health and well-being. These exercises are designed to help you strengthen the core muscles and reduce the risk of developing a hernia after stoma surgery. However, as mentioned, do not start exercising immediately after surgery; you must wait until you've recovered and have been cleared by your doctor, surgeon, or stoma care nurse. Once you've been given the green light, start with the beginner-friendly options and slowly advance as your muscle strength grows. Remember to always engage your core gently, not forcefully, and stop immediately if you feel any pressure or pull near the stoma.
Beginner-Friendly Exercises (Post-Recovery Phase)
Start with these gentle, low-impact movements after you’ve healed and been medically cleared. They help you reconnect with your muscles and lay the foundation for more advanced movements.
Diaphragmatic (Deep Belly) Breathing
Lie on your back with your knees bent or sit comfortably in a chair. Place one hand on your chest and the other on your abdomen. Inhale slowly through your nose, allowing your belly to rise as you fill your lungs. Exhale slowly through your mouth, letting your belly fall. During the exhale, gently tighten the muscles in your lower abdomen. This breathing exercise can help you create awareness of your body while gently engaging the core.
Pelvic Tilts
Lie on your back with knees bent and feet flat. Gently press your lower back into the floor by tilting your pelvis upward. You can gently rock to get into this position, and you should feel your muscles tighten a bit. Hold for a few seconds, then release to neutral. Start with five repetitions and build your way up. You can also tighten your pelvic floor muscles during this exercise if it feels doable.
Heel Slides
Lie on your back with one leg bent and foot flat, the other leg extended. Slowly slide the heel of the extended leg toward your body while keeping the movement controlled and your core lightly engaged. Slide it back out and repeat on the other side.
Knee Rolls
Lie on your back with knees bent and feet flat. Slowly let both knees roll to one side while keeping your shoulders on the ground and your knees and ankles together. Then slowly lift your knees to return to center and roll to the opposite side, engaging your core along the way. Repeat five times.
Intermediate Core Strengthening Exercises
These exercises build on the basics and help increase your strength and stability while minimizing stress around the stoma.
Modified Bridges
Begin by lying on your back with your knees bent. Engage your glutes and core as you slowly lift your hips off the floor until your body forms a straight line from shoulders to knees. Hold briefly, then lower with control. This strengthens your posterior chain and supports core stability. Repeat 10 times.
Bird Dog
From this tabletop position, extend your right arm forward and your left leg back while keeping your spine neutral and core engaged. After holding for a few seconds, return to the start and repeat on the opposite side. Try to do about 10 on each side.
Advanced (With Clearance and Guidance)
These exercises may require more strength and can be challenging in certain situations, so only proceed if your doctor has given you the go-ahead. If, at any point, you feel discomfort, discontinue and check your stoma for signs of irritation.
Plank (Modified)
For a wall plank, stand facing a wall and place your forearms on the surface. Step your feet back slightly and hold the position with a straight line from your head to your heels. For a knee plank, position yourself on your forearms and knees on the ground, keeping your back flat and core engaged. Hold for 30 seconds, gradually increasing the time as you progress.
Standing Oblique Crunches
Stand with feet hip-width apart and hands behind your head. Lift your right knee as you bring your right elbow toward it in a side-crunch motion. Return to the starting position and repeat on the left side. Do about 10 on each side.
Resistance Band Core Press
Anchor a resistance band at chest height. Stand sideways to the anchor, holding the band handle with both hands at your chest. Step away from the anchor to create tension. Slowly press the band straight out from your chest and hold, resisting the urge to rotate. Return and repeat about 10 times.
Exercises to Avoid or Modify With an Ostomy
While rebuilding core strength after ostomy surgery is important, not all core exercises are suitable for someone with a stoma, especially during the early stages of recovery. Some movements can place too much pressure on the abdominal wall or cause issues with the pouching system. The exercises that you should avoid, or at least modify, include the following:
- Traditional sit-ups and crunches
- Leg raises
- Bicycle crunches
- Twisting sit-ups
- Full planks (with no modifications)
- Weighted abdominal workouts
If you have any questions or concerns, it's important to talk to your doctor. People with an ostomy can still work out and maintain a high level of physical fitness; it just takes a bit of time to adapt after surgery and the proper support. At Byram Healthcare, we offer a full range of ostomy products, including support belts and garments designed to help you exercise confidently and reduce the risk of complications like hernias. Whether you’re just starting gentle core exercises or returning to a more active lifestyle, we’re here to help simplify ostomy care.
