Exercise after stoma surgery

Sport and exercise after stoma surgery

Learn why sport and exercise are good for both you and your stoma..

 

 

Why exercise is important

Why exercise is important

An active lifestyle is one of the greatest gifts you can give yourself, and here's the good news: Everything counts! Why exercise is important
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Why exercise is important

Exercising makes your everyday life easier to manage. Especially in the months after your surgery, where it can really help speed up the recovery, as the physical activity gives you more energy and makes you stronger and better equipped to cope with illnesses.

Furthermore, exercise can prevent complications that may otherwise occur from sitting or lying down too long.

Being fit can make your pouch fit even better

A great side effect of exercising – and for many people the main reason for exercise in the first place – is weight-loss or weight-maintenance. Depending on the shape of your stoma a firmer, flatter abdomen could make it easier to get a tight fit from your ostomy appliance, thereby minimizing leakage risks.

So by exercising and losing weight there is a good chance you can reduce some of the problems you might have otherwise had.

Exercise will boost your confidence

As you start exercising, you will feel an almost immediate boost in your awareness of yourself. Exercising makes you feel better about yourself in ways that go far beyond looks and physique.

This appreciation is really good for building self-confidence and could help give you the energy and courage to really get back to the way you lived before your surgery.

How exercise can help stress

An active lifestyle means stronger heart, a better blood circulation, better breathing and healthier skin among other things.

It can also help boost your confidence and give you more energy overall. This can help against any stress you might feel after your operation.

If you are not used to exercise

It doesn't matter if you didn't do much exercise before your surgery; you can just as well get started now as you could before your operation. The simple rule is: Take it easy, start out slowly and built up gradually. You may start out with a daily walk to the end of the block.

Things to be aware of

Before exercising be sure to empty your pouch for greater freedom of movement and a reduced risk of leakage. And make sure you drink plenty of fluids before, during and after exercise.

Until your stoma and abdominal area are fully healed, strenuous activities can put you at risk for a hernia. Simple exercise will help, however you should avoid any kind of heavy lifting for the first six to eight weeks after your surgery. The Core 4 is a good set of exercise to start with.

Later on there are nearly no limits to what you can do, as long as you take the right precautions. But you should always ask your doctor or stoma care nurse to give the green light, before you start exercising.

This website includes general guidelines. Always follow the instructions by your healthcare provider.

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Sport and your stoma

Sport and your stoma

Tips for doing anything from yoga to team sports - and how to act around changing rooms. Sport and your stoma
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Sport and your stoma

Walking

Walking is an easy, gentle way to get back into a routine. It is also an activity that you can start soon after surgery. Whether you walk inside (e.g. up and down stairs), or outside in the fresh air, it is an activity that you can gradually increase in both speed and distance. Start at just 5 minutes and work up from there.

You can challenge yourself by lengthening your route, walking up a hill or taking a detour through a park. When you challenge yourself to walk farther, your strength and endurance will improve.

Running

If your doctor or stoma care nurse gives you the go ahead, running is a very good way to get and stay in shape. If you are not used to running, you will need to start out slowly, alternating between running and walking. The Couch to 5K programme is a great way to start.

Yoga

Yoga is another great way to get exercise. It reduces stress, strengthens muscles and improves balance and flexibility. Yoga can be done anywhere, making it a perfect choice to get you started.

Yoga is also very good if you haven't done much exercise before since it can be customised to any level.

Swimming

Don't avoid the pool because you fear "others will know" about your stoma, swimming and water aerobics are great ways to keep fit!

With your weight supported by the water, swimming gives your muscles a workout with minimal risk of injury. Swimming can also help you develop more flexibility, and it's a good option if you are bothered by arthritis.

Cycling

Before cycling, you should check with your doctor or stoma care nurse, as they will likely want to make sure your abdominal area is completely healed first. But after that, cycling is an excellent option since it is a low-impact exercise that does not put too much strain on your abdomen.

If you have had surgery to remove the rectum, you will of course need to wait longer to begin, to allow this area to heal. Sitting on a bike seat too soon will be uncomfortable and may cause injury.

In case you are not completely ready to exercise with others or where others can see you, getting an indoor bike to use at home can be a great and convenient option. Before you know it, you will have the courage to take your training outside your home.

Golf

Golfing can be a terrific way to combine exercise with getting fresh air and spending time with good friends. And with a little preparation, there is no reason to hold back if you are planning on hitting the links.

You should, however, be aware that because of the torque involved in a golf swing, playing golf could entail a need for some extra security to your pouching solution such as a support garment or additional ostomy accessories.

Strength training

A combination of strength training and cardio workout is the very best way to get fit. Strength training makes your body more enduring in other sports and reduces the risk of joint injury, it shapes your body and sends your calorie burning skyrocketing.

As we grow older, we gradually lose vital muscle mass. Strength training with weights or resistance bands will help you maintain or even build muscle, making your body more enduring and reducing the risk of joint injury, shaping your body and helping you stay lean and healthy.

Team sports

Having other people rely on your being there might provide that final spark to get out the door and develop the exercise habit, and many find it easier to overcome self-awareness issues and immerse themselves in team sports, rather than individual sports.

Competitive sports can, however, be strenuous, so they may not be the best choice to start with if you haven't exercised much before. In any case be sure to check with your doctor or stoma nurse, before you begin exercising.

What about changing rooms?

Being in a changing room with others can be a hurdle to overcome. As with so many other situations, just thinking through the likely reactions can be a big help. Will you try to hide the pouch? Or will you change as you would normally? There is no right or wrong, so just do what feels best for you.

However, and especially if you exercise with someone you know, consider if it might be easier in the long run to be open and upfront from the beginning, rather than having to think about it every time you exercise together.

It can be good to think your explanation through ahead of time. Perhaps you can simply take the initiative by saying it is your first time in a while - or that you have to take it slow today – as you have had stomach surgery not too long ago. That is probably all the explanation you need.

This website includes general guidelines. Always follow the instructions by your healthcare provider.

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What to wear for different sports

What to wear for different sports

Learn which clothes and stoma products provide the best support for certain types of sports. What to wear for different sports
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What to wear for different sports

Walking

Walking doesn't require special measures. However, if you are doing longer walks or advancing into hiking, make sure you give your body the support it needs with a good pair of walking or hiking shoes.

Running

In most cases paying attention to the baseplate adhesive from time to time is enough, but if you want to feel even more secure using an ostomy belt will help keep your pouch in place.

Swimming

You can either use a standard-size pouch and simply empty it before swimming –or if you want to be more discrete, you can use small ostomy pouches designed to be less bulky.

Women might consider wearing snug swimsuits with dark colours or busy patterns, while boxer-style swimming trunks is a good choice for men.

Most pouches are waterproof - however do remember:

  • Water can cause the edges of your baseplate to lift, so make sure that the edges of the appliance are completely secure.
  • If you use hot tubs, be sure to check your pouch seal. Heat can affect your weartime, so you may need to change your ostomy appliance sooner.
  • If you wear a pouch with a filter don't forget to cover it with a filter sticker.

Golf

The torque involved in a golf swing can put some stress on your ostomy appliance. You can use tape to help your appliance follow your movement better. If you are using a 2-piece solution, an ostomy belt might be an option for you, to hold your appliance in place.

A standard round of golf can take anywhere between 4-5 hours, so it’s important to understand how far you may be from the nearest toilets. Plan ahead and make sure you have extra pouches and accessories with you should you need them.

Strength training

Heavy, uncontrolled, lifting can put you at risk for a hernia. When you are lifting and/or using abdominal muscles use a support garment to keep everything "in place". The support garment will need to be fitted to you, whether you do that yourself or ask your stoma care nurse to help you.

Team sports

To prevent any problems with your solution, you can wear an ostomy belt or girdle to keep the pouch securely in place.

In contact sports such as football, rugby, wrestling or martial arts there are protective ostomy guards that can help prevent ostomy injury.

This website includes general guidelines. Always follow the instructions by your healthcare provider.

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Athlete with a stoma

Michelle: I didn't let my stoma keep me from the sport I love.

Michelle: I didn't let my stoma keep me from the sport I love. Michelle's story
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Michelle: I didn't let my stoma keep me from the sport I love.

Michelle had always loved sport. Raised in the Staffordshire moorlands, she regularly ran, swam and cycled her way through her teens.

Whilst studying dietetics at Nottingham university she was diagnosed with ulcerative colitis.

This made training more challenging but it didn't dampen her enthusiasm for her sports. Instead she developed an interest in Triathlon, an event that brought together her 3 loves.

Surgery wouldn't stop me.

Her health deteriorated, until eventually in Christmas in 2010, Michelle underwent life-saving surgery and had her ileostomy formed. Almost the first thing on her mind was "How do I get my fitness back?"I knew I had a long journey ahead. I was doing some physio exercises on the floor and I couldn't get up. I was so frustrated by my weak and helpless body. I eventually had to roll across the floor, and prop myself against the wall.

I worked on building up my strength, focussing on my core and the exercises I loved. I remember the first time I swam after my surgery. I was so full of emotion I couldn't stop smiling."

My European adventure

Michelle ran her first triathlon just 5 months after her surgery, and hasn't stopped since. In 2015 Michelle entered the European sprint triathlon. This event involves a 750M swim, 20 KM Bike ride and a 5K run "The Race started at Lake Geneva. It was a late start, but we had to be up early. I enjoyed a big bowl of porridge, a banana and a mug of coffee. It was really hot, nearly 30 degrees. I had to be really careful with my hydration. I drank plenty of water with hydration tablets to make sure I held onto all my electrolytes."

The race itself was exhilarating and terrifying! At the start it was like the Hunger games, lined up together about to dive into the water. The start horn went and we plunged into the water. At first nervous energy almost consumed me, however I found my rhythm and kept a steady pace. I switched to the bike and felt like I flew round the 20KM, before beginning the 5K run. I felt strong, and overtook the British champion on the first hill. When I hit the home straight I realised there was just one lady ahead of me, and with my family looking on I sprinted through the finish line. I had won Silver.

I didn't become a medal winning triathlete because I had stoma surgery, I just didn't let it get in the way of achieving all I could. In reality my surgery instilled in me a sense of hope and determination."

Michelle went on to repeat the same success this year, with another Silver medal in Lisbon at the end of May, 2016.

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Why abdominal exercise matters

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. Why abdominal exercise matters
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Why abdominal exercise matters

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.

An alternative to 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 an absolute 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 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 you 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 to the right direction!

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

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Four great abdominal exercises

Four great abdominal exercises

The four exercises in the Core 4 programme are specially designed to help people with an ostomy. Do them two to three times a day to strengthen your abdominal muscles. The Core 4
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The Core 4

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.

1. 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.

2. 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 a 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.

3. 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.

4. 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. 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.
Print these exercises

 

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.

Print Exercise Diary

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