This leaflet aims to provide advice and education about getting you moving after your operation. Enclosed you will find specific exercises for breathing and muscular strength that can be performed whilst you are in hospital as well as on returning home.

Managing your pain

Pain after surgery is normal, it is important that pain is well managed to optimise recovery, to allow you to take deep breaths and complete your exercises. We advise taking your pain relief prior to doing your exercises. It is important to utilise pain relief to prevent it from becoming unmanageable.

Often additional pain medications are available, so please let your nurse know if you are in pain.

Getting up after your operation

We recommend getting out of bed, sitting in the chair, and walking as soon as possible after your operation. This helps to reduce the risk of post-operative complications, improve wound healing, and help you get out of hospital quicker.

On the first day after your operation, you should aim to sit out of bed and in a chair for a minimum of one hour with your nurse or therapist. Aim to increase this each day and try to sit out for all your meals.

You may need some assistance from a Nurse or Therapist when getting out of bed and walking initially and may require some additional support to help you get back to independence. It is normal to feel your wound stretch when trying to stand up straight, this will not harm your wound.

Daily activities

It is important to maintain a routine with your personal care throughout your hospital stay. If you are having difficulties, speak to your nurse or therapist about strategies to manage this. We encourage you to continue with your personal care tasks such as washing, dressing, and brushing your teeth, by walking to and from the bathroom. To avoid wetting your abdominal wound, you can sponge wash your body at the bathroom basin or at your bedside.

Deep breathing exercises

To help prevent the build-up of mucous and keep your chest clear following surgery, it is essential that you do deep breathing exercises and practice coughing every day, starting as soon as you can after your operation. Deep breathing should be completed for five breaths every hour that you are awake. Ensure you have adequate pain relief to be able to complete this effectively.

Supported cough

Using a rolled towel or pillow place it over your surgical incision site. Apply pressure over the towel when you cough. By doing this, it can:

  • Reduce pain associated with coughing
  • Improve the strength of your cough
  • Reduce anxiety around coughing

Coughing won’t cause damage to your wound.

ACBT (active cycle of breathing technique)

The active cycle of breathing technique (ACBT) is an exercise to help clear mucous from your chest that may be difficult to clear. We recommend completing it every 2 hours.

The three stages of ACBT

Breathing control or relaxed breathing

  1. Get into a comfortable position, sitting upright.
  2. Relax your breathing in and out through your nose for approximately 20 seconds. Avoid letting your shoulders rise.

Thoracic expansions (deep breathing)

  1. Take a long slow, controlled breath in through your nose to fill your lungs as much as possible, hold for 2 to 3 seconds.
  2. Breathe out through your mouth, at a comfortable speed.

Huff and cough

Take a slow breath in through your nose, then open your mouth to an ‘o’ shape and huff the air out (as if you are trying to steam up a mirror or your glasses prior to cleaning them).

Guide to active cycle of breathing technique (ACBT)

Seated exercises

Seated heel raises

  1. Lift heels off floor, keep toes on floor.
  2. Repeat x 10 each foot.

Seated knee extension

  1. In sitting, lift your foot upwards, straightening at the knee.
  2. Hold for 3 to 5 seconds. Repeat x 10 each leg.

A person and person doing exercises AI-generated content may be incorrect.

Seated marching

  1. In sitting, march your knees alternately in sitting.
  2. Repeat for 1 min.

Top tip: shuffle forwards to edge of the chair, try not to lean back.

Standing exercises

Marching on the spot

  1. Holding onto a stable surface in front, march in standing, lifting knees high. Complete for 30 seconds - 1 min.
  2. Progression: March in standing without holding onto a surface.

Mini squats

  1. Holding onto stable surface in front, complete small squats. Bend knees and stick bottom out behind. Repeat x 10.

Top tip: make sure to keep your heels on the floor and your knees behind your toes.

Heel raises

  1. Push up onto your toes. Repeat x 10.

Top tip: keep the movement slow and controlled.

A person standing in a room AI-generated content may be incorrect.

Progression: As above on one leg.

Sit to stand

  1. Start at the edge of your chair, use your hands push up from the arms of the chair until you are standing. Reach back for the arms of the chair and slowly sit back down. Repeat x 10.

Top tip: Start with your feet close to the chair and lean forwards when you stand (nose over toes).

Progression: As above but with your arms crossed over your chest.

Continuing rehab once at home

When you return home it’s important to try and increase the amount of activity you are doing daily. This will help you return to your previous activities quickly.

However, some people can feel fatigued with activities that would normally not make you tired. It is important to pace yourself and not do too much too soon.

It is important to avoid heavy lifting (more than 2 to 3kg) for 8 weeks while your abdominal muscles are healing.

What to expect after discharge home

One week after

Take it easy but avoid spending lots of time in bed. Try to go for a short walk each day. Continue with exercises in this booklet.

One to four weeks after

Continue daily walks and exercises. Start to complete light tasks such as preparing simple meals. It will be normal to feel better some days than others.

Four to six weeks after

Gradually increase household tasks, such as ironing and cooking. You should aim to be walking 30 to 45mins in six weeks.

Six to 12 weeks

Consider moderate intensity exercise like swimming or cycling. Aim to return to normal levels of activities by week 12. Please discuss returning to more strenuous exercise with your GP or surgeon.

How to look after your wound

Initially you will need daily dressings. When you are discharged, the nursing staff will advise you on the frequency of dressings and who will do this for you at home.

Returning to driving

It is recommended to return to driving after 6 weeks post op. You must be able to carry out an emergency stop safely and comfortably before returning.

When to have a bath or shower

If your wound has healed well, you will be able to take a shower or bath within a week of the operation. It is important to check this with your doctor before discharge. If you have a stoma there are also a range of aids/devices that may assist you in this (eg. covers), please speak with your stoma nurse for advice.

Back to work

It depends on the type of surgery and your progress. If your job is of a physical nature, you should expect it to take longer to return to work than a job that is more sedentary. Please discuss this with your surgeon.