Question:
A young adult patient of mine recently underwent a colostomy due to her medical history. Before surgery, she was very active in sports, particularly baseball and hockey, and she’s eager to return once her stoma is fully healed. Do you have any specific recommendations for how she can safely resume hockey and baseball beyond the general information found on your website?
Answer:
It’s great to hear that your patient is looking forward to returning to sports after her surgery. With the right preparation and support, it’s absolutely possible for her to enjoy an active lifestyle. Below are tailored tips for both hockey and baseball players with a colostomy:
General Tips for Both Sports
- Wait Until Fully Healed: The stoma and surrounding skin should be completely healed before beginning any sport—this often takes several weeks to a few months depending on the individual.
- Use a Stoma Belt or Guard: A stoma support belt or guard provides protection against trauma and helps secure the pouch. For hockey, a tight-fitting abdominal binder can be worn discreetly under the gear for added security.
Pouch Management
- Placement: Position the pouch so it doesn’t interfere with gear or movement. For hockey, an angled or side position may be more comfortable.
- Adhesion: Choose waterproof or extended-wear adhesives to reduce the risk of sweating-related flange failures.
- Emptying: Encourage her to empty the pouch frequently during activity and consider using a smaller, low-profile pouch during games.
Hockey-Specific Advice
- Adjust Protective Gear: Ensure that any protective gear does not press against the stoma. Custom padding may be necessary to avoid discomfort.
- Extra Protection: Consider custom stoma pads to shield the area during physical contact.
- Secure Pouch During Movement: Use a tight belt or skin barrier film to keep the pouch from shifting during skating and fast movement.
- Emergency Supplies: Keep a bag with extra supplies in the locker room or with a coach. Wearing a stoma cap during ice time may help manage output when breaks aren’t possible.
Baseball-Specific Advice
- Movements and Contact: Rotational movements like swinging a bat or sliding may put pressure on the abdomen. A pouch worn on the side and extra stoma padding can help.
- Hot Weather: Since baseball is often played in warmer conditions, breathable and moisture-resistant pouches can help avoid irritation.
- Pouch Size: A smaller pouch may reduce discomfort while crouching or fielding.
- Hydration and Diet: Athletes with ostomies must stay hydrated and eat balanced meals to support energy levels and avoid dehydration. Water-rich foods are recommended.
- Managing Gas and Output: Some foods cause more gas or bloating. Help your patient identify what works best for her body to reduce the risk of leaks during play.
Mental and Emotional Preparation
- Build Confidence: Returning to sports can feel overwhelming. Encourage open communication with her coach and team. Let her take breaks as needed—comfort and safety should be the priority.
- Post-Activity Routine: After games or practices, she should inspect her skin for irritation. Clean the area with lukewarm water and avoid alcohol-based wipes. If any bleeding or pain occurs, it’s important to reassess the gear or pouching system and consult with her care team.
- Additional Support: If your patient faces specific challenges, a sports dietitian or NSWOC (Nurse Specialized in Wound, Ostomy and Continence) can help create a tailored plan for her return to sports.
With some trial and adjustment, she should be able to safely return to hockey, baseball, and more.
Answered by
Karen Bruton, RN BScN MCISc-WH WOCC(C)
Medical and Lifestyle Advisory Team
Ostomy Canada Society
