If you have an ostomy, or may need one in the future, you have probably had thoughts like, “what if I can’t do what I love anymore” or, “I don’t think I will ever be able to workout again”. While on family vacations, maybe you are scared of getting into the water and going swimming so you stay and watch from the edge of the pool. I want to reassure you that having these thoughts and that feeling anxious is completely normal, but I also want to reassure you that you are capable of more than you might think possible.
Initially, after ostomy surgery, your main focus will be recovering, meaning you will likely spend more time in bed, limiting any heavy lifting and sticking to short walks. This initial recovery period is typically at least six weeks; however, the time can vary for each individual, so be sure to work with your healthcare team to create a personalized plan for returning to activity. After this initial period, you may feel like jumping right back into your regular routine, but it is recommended to take things at a slower pace so your body can adjust. Start with low impact exercise such as walking, biking or swimming. This will help increase your blood circulation and can also help lift your mood and can build confidence after surgery. It is also a good idea to focus on rebuilding your core strength with exercises such as pelvic tilts, sit ups, lying knee raises and bird-dogs. *The bird dog is a highly effective, bodyweight core-stability exercise that targets your abdominals, lower back, hips, and glutes.
Common questions about returning to exercise initially after surgery:
1. When can I start being active again?
Once being discharged from the hospital make sure to avoid any heavy lifting until six weeks of recovery have taken place. Once discharged from the hospital, most people can begin short walks around the house. After six weeks it is generally safe to begin more exercise; such as cycling, swimming, yoga, pilates, abdominal strengthening etc; however, you should always speak to your doctor before engaging in strenuous activity.
2. What should I avoid?
Avoid lifting anything over 10 pounds for at least 6 weeks, as this can lead to the development of a hernia or other complications. Also, avoid anything that your doctor or nurses have advised you.
3. Where should I start?
If you were an active person before surgery, you can likely get back to all of your activities soon after the initial recovery period. If you were not the most active before surgery and are hoping to start getting more fit, take it slowly. Begin with small short walks around your house, increasing the length of the walks over a few days or weeks. After the initial six weeks you can start incorporating walking up and down stairs, or try walking outside for a longer period. Another great way to begin exercising is to start with short workouts (2-3 exercises for 5-10 minutes a day) to strengthen your abdominal muscles. For example, glute bridges or bent knee leg raises from your bed or core twists, knee lifts or side crunches from a chair.
4. Do I need to be worried about a hernia?
While hernias are a common risk after ostomy surgery you do not need to let that stop you from engaging in your favourite activities. Initially, you can proactively manage your risk by avoiding heavy lifting initially, wearing a hernia support belt and strengthening your core both before and after having surgery. If you are particularly concerned about developing a hernia, speak with your ostomy nurse – they can help you with a custom fitted support belt.
5. Will exercise cause leaks?
Exercise alone will not cause a leak, but there are some factors that might increase risk. For example, some people might find that increased perspiration during exercise causes the adhesive to lift. To help manage this you can try using flange extenders for added security and confidence. Another tip is to empty your bag before activity as exercising with a full bag can be uncomfortable and can also increase leak risk.
6. What about swimming?
Ostomy bags are designed to be waterproof and maintain their seal in water! You can swim in lakes, rivers, hot tubs, pools, oceans – anywhere really! But if you are nervous, here are some tips that may help: make sure you don’t swim too soon after changing your appliance – you should try to change it at least 12 hours before swimming to allow the adhesive to fully set, which will decrease the chances of your bag peeling off. Also, if your ostomy has a filter, you should cover it with a filter sticker when swimming, as that will help it last longer. Flange extenders can also be used when swimming to help you feel extra secure.
So you have fully recovered – now what?
Now you can get back to doing anything and everything that you loved before surgery! Nothing is off limits; as long as you speak to your healthcare team beforehand. Many people with an ostomy are elite level athletes, competing in marathons, body building, figure skating, rugby, football, mountain climbing and more. Having an ostomy does not limit your ability to participate in activity or even contact sports as long as you are prepared!
Common questions for returning to exercise after the initial recovery stage:
How should I prepare for more intense exercise?
If you will be participating in contact sports, you first need to get medically cleared by your doctor. Once you have been cleared, it is a good idea to start slowly and practice a lot before jumping right back in. You may also consider a stoma guard which protects the stoma from impact. If you are worried about your ostomy getting pulled off during contact, a stoma belt can help keep it secure by holding it tight to your body.
If you are engaging in more intense exercise, it is also important to maintain proper nutrition and hydration, as having an ostomy can increase the risk of dehydration.
Will I damage my stoma?
The stoma (once fully healed) is quite resilient, and damage is unlikely, especially if you use a stoma belt or guard.
Still unsure about returning to exercise even though you are fully recovered?
That is absolutely okay! No need to feel ashamed about being nervous. Try starting with something small in a low-risk environment, for example, try following a YouTube workout video from the comfort of your own home. Or get a friend or family member to go to the gym with you so you feel more comfortable. You can also look online for videos of ostomates who work out so you can see that it is possible for you, too.
Low impact vs strength training?
Low impact exercise such as walking, cycling, yoga or pilates likely feels safer especially at first. This is because these activities use only your body weight and put less strain on your body and on your core. Low impact is also more gentle on your joints and is great for recovering from injury. Strength training will likely feel less safe and scarier the first few times you try it after surgery. But that doesn’t mean it actually is less safe! As long as you have fully recovered and are using safe and proper lifting form you can participate safely with an ostomy. However, strength training does carry a greater risk for developing a hernia so it is important to wear a support belt or speak with your doctor to be proactive about preventing a hernia.
My Journey Rebuilding Confidence and Strength After Ostomy Surgery
In my personal experience, while it can be scary at first (and sometimes still is) the more you try, the easier it will feel. For the first six weeks after my surgery I stayed home, always wearing baggy pajamas, only walking from my room to the living room, bathroom or kitchen and taking the stairs super slowly. After those six weeks I started trying longer walks around the neighbourhood and slowly built up my confidence to walk five kilometers! I remember how strong I felt and how proud I was of myself. After that I began exercising three to four times per week at home using YouTube videos (Move with Nicole was my favourite) slowly building up the duration from 10 minutes to 45 minutes. It’s been five and a half years since my surgery now and I have come a long way. I have done a five-hour hike in the mountains, swimming in the ocean, lifting weights, attending fitness classes and going on runs. Sometimes I still feel anxious before I try something new, I think that is part of being human, not just about being an ostomate. Remember that if you never try, you will never know just how good life can be with your ostomy.
Resources:
- https://www.hollister.ca/en-ca/ostomycare/ostomylearningcenter/livingwithanostomy/exercisingafterostomysurgery6commonquestions (common questions about exercise after ostomy surgery)
- https://www.coloplast.ca/about-us/landing_pages-extra-pages/hernia-guide—ca/ (managing hernias)
- https://www.colostomyuk.org/active-ostomates/ (sport and fitness after surgery booklet)
Source
By Hannah Martin-Spencer, BKin, Ostomy Canada Marketing Team.
Hannah, a passionate 25-year-old from the Greater Toronto Area, is expanding her expertise in acupuncture at a Calgary post-secondary institution. With a Bachelor’s degree in Kinesiology and a minor in Psychology, she blends her knowledge into her new acupuncture pursuit. Diagnosed with ulcerative colitis at 16 and having undergone unsuccessful biological drug treatments, she underwent ileostomy surgery at 20. Hannah is driven to advocate for ostomy individuals. As a volunteer and Ostomy Ambassador, she supports Ostomy Canada with social media and writing health blogs. She enjoys outdoor activities, baking, and painting in her free time. Hannah’s journey of resilience and determination, with her ostomy transformation showcasing her strength, aims to inspire and support the ostomy community.
Edits made by Lisa Gausman, Senior Editor Ostomy Canada.