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Pelvic Floor Exercise After Hysterectomy

Updated: 3 days ago

Advice From a Pelvic Floor Physical Therapist


Recovering from a hysterectomy requires a thoughtful approach to exercise, especially considering potential weight restrictions in the initial weeks after surgery. In this blog post, we'll explore a series of exercises designed to help you gradually rebuild strength, focusing on the core and pelvic floor.


It’s important to note that it is always beneficial to consult with your healthcare provider before starting any exercise routine post-surgery. If your medical professional is able to clear you from risk of injury, you should be safe to start a routine.


As a pelvic floor physical therapist, I understand the lack of direction that most women feel following a common surgery such as a hysterectomy. My goal is to provide you with the basics for recovery following this type of surgery in hopes that it gives you the confidence to take control of your healing process. The following exercises are crafted with the assumption of weight restrictions, emphasizing diaphragmatic breathing and mindful movements to aid in your recovery.

Phase 1: Seated Gentle Core Engagement

a woman seated on her yoga mat

To begin, create a comfortable space using a yoga blanket or a regular blanket folded into a makeshift cushion. The goal is to ease into exercises, considering potential weight restrictions and ensuring comfort. Start with diaphragmatic breathing, coordinating breath with engaging the pelvic floor and deep core muscles.


The diaphragm is one of your main core stabilizers and it’s important to emphasize coordination of this muscle when starting any exercise program - especially when related to the pelvic floor. If you’re interested in learning more about the importance of diaphragmatic breathing, check out my blog post here.


Exercise 1: Upper Extremity Resistance


For this next exercise, sit cross-legged on the blanket, placing a stretchy band around your hands. Inhale, then exhale as you lift your arms up and over, maintaining rib alignment over your pelvis. Follow with external rotation, engaging the core and shoulder blades.


It’s important to refrain from holding your breath during any of these movements. Ensure controlled movements and coordination with your breath.


Follow along with the video demonstration of this exercise here.


Exercise 2: Functional Shoulder Movement


Transition to a seated position with one hand on a knee, using the stretchy band for diagonal arm movements. Inhale and exhale as you reach up and over, alternating sides. Emphasize controlled, functional movements to engage the core and shoulders while maintaining breath coordination.


Follow along with the video demonstration of this exercise here.


Phase 2: Core and Pelvic Floor Exercises on the Floor

A woman laying on her back on a yoga mat.

Lay on your back on the floor, using a yoga blanket for support if needed. Introduce a yoga block between your knees to enhance core engagement. Focus on slow, steady breaths and controlled movements.




Exercise 1: Posterior Pelvic Tilt


To start, Inhale, then exhale, squeezing the block between your knees. Continue to exhale, flattening your back and tilting your pelvis until you feel a gentle engagement. Repeat for 5-second intervals, gradually building strength and endurance.


Follow along with the video demonstration of this exercise here.


Exercise 2: Controlled Knee Drops


To progress, while maintaining core engagement, let one knee fall to the side at a time. Emphasize slow, controlled movements to enhance coordination and build stability. Increase repetitions as your strength improves.


Follow along with the video demonstration of this exercise here.


Exercise 3: Pelvic Marches


The final progression involves lifting one foot off the ground at a time while maintaining core engagement. Monitor pelvis stability and avoid movements that allow improper muscles to do the work. Gradually increase difficulty by lifting both legs, focusing on control and breath coordination.


Follow along with the video demonstration of this exercise here.


Phase 3: Functional Movements with Added Stability


A woman practicing yoga in standing.

Once you’ve mastered the seated and supine positions, you’re ready to stand with support. When we move into the standing position, we are transitioning to more functional movements. These are the movements that help you throughout your day to day tasks.






Exercise 1: Toe Raises


While standing with the support of a chair or hard surface, inhale and exhale as you raise and lower your toes, focusing on controlled movements. Use the chair for stability and gradually increase repetitions and sets as strength improves.


Follow along with the video demonstration of this exercise here.


Exercise 2: Hinging Squats


Face the chair, maintaining rib alignment over the pelvis. Inhale as you hinge at the hips, exhale as you return to a standing position. Focus on building functional movements with controlled breath.


Follow along with the video demonstration of this exercise here.


Exercise 3: Standing Hip Abduction


Holding onto a stable surface or chair, shift your weight to one foot, extending the other to the side. Inhale and exhale as you maintain balance and control. Use the chair for support and gradually increase difficulty as you gain strength and stability.


Follow along with the video demonstration of this exercise here.


Prevent Pelvic Floor Dysfunction Following Hysterectomy


Recovering from a hysterectomy involves a gradual approach to exercise, starting with foundational movements and progressing to more functional activities. These exercises prioritize breath coordination, core engagement, and mindful movements to rebuild strength gradually.


Remember to consult with your healthcare provider and listen to your body throughout the recovery process.


To wrap things up, it’s important to have grace for yourself and your body as you are healing. Recovery after any surgery is a marathon, not a 100 meter dash. Take your time and focus on taking care of yourself, not on how quickly you can get back to the daily grind.


If you are looking for more guided direction following hysterectomy, contact your local pelvic floor physical therapist. They are the experts in their field and can develop an individualized program specific to your needs.


If you’re interested in learning more about this topic or have questions, feel free to reach out to us at 502-939-8564 or book a consultation call with us here!



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