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Breathing & recovery

Exercises after a hysterectomy: the first 6 weeks

Based on the 2017 booklet for after gynaecological surgery from the Pelvic, Obstetric and Gynaecological Physiotherapy network (POGP), with doses from the Royal College of Obstetricians and Gynaecologists' (RCOG) recovery pages, for abdominal, keyhole or vaginal surgery. Start the breathing and circulation exercises on the day of your operation, and the pelvic floor exercises once your catheter is out and you can pee on your own, even if you have stitches. Lie on your back with your knees bent and a pillow under your head, or on your side if that's more comfortable. Work gently: nothing should hurt, and you should breathe normally throughout. If your surgical team has given you different advice, follow theirs.

15 minBeginner11 movesCardio machineCalves · Hip flexors · Abs · Pelvic floor · Glutes · Quads
Follow along: a timer, a cue and the next move, one step at a time.

Circulation and breathing (from the day of your operation, lying or sitting)

  1. Ankle circles30 s pumping, then 30 s circles, each foot
    Beginner · Calves, Shins · 3D demoPump each foot up and down briskly, then circle it. Repeat every few hours until you're moving about normallyHarder: Ankle CARs (controlled articular rotations)
  2. Supine heel slide3 times each leg
    Beginner · Hip flexors, Hamstrings, Quads · 3D demoSlowly bend and straighten one leg at a timeHarder: Hip windshield wipers
  3. Lateral breathing (Pilates breathing)4 to 5 breaths
    Beginner · Abs · 3D demoBreathe in deeply, feeling your lower ribs move out to the sides. Every hour while you're awake at first; hold a pillow over your tummy if you need to coughHarder: Roll-up (Pilates)

Pelvic floor (once your catheter is out)

  1. Pelvic floor exercise (Kegel)Up to 10 long squeezes, holding up to 10 s
    Beginner · Pelvic floor · 3D demoSqueeze and lift as if stopping wind and a wee at the same time, without clenching your buttocks. Relax fully after each. Fewer is fine at first: stop when the muscles tire
  2. Pelvic floor exercise (Kegel)Up to 10 short squeezes
    Beginner · Pelvic floor · 3D demoSqueeze and let go straight away

Deep tummy (on your back with your knees bent, or on your side)

  1. Side-lying tummy draw-in5 to 10 holds of 2 to 3 breaths
    Beginner · Abs · 3D demoBreathe in; as you breathe out, gently draw your lower tummy towards your spine and hold for 2 or 3 breaths, then relax fullyHarder: Bird dog, one limb at a time
  2. Pelvic tilt into bridgeUp to 10 tilts, hold 3 s
    Beginner · Glutes, Abs, Hamstrings · 3D demoTilt only: draw in your tummy and pelvic floor and flatten your low back. It can also ease trapped wind and backacheHarder: Glute bridge
  3. Hip windshield wipers3 to 5 each way
    Beginner · Glutes, Adductors · 3D demoKnee rolls: knees and feet together, tummy gently drawn in, slowly lower both knees a small way to one side and backHarder: 90/90 switch

When those are easy (often sooner after keyhole or vaginal surgery than after abdominal surgery)

  1. Knee fold5 to 10 each side
    Beginner · Abs, Hip flexors · 3D demoDraw in your tummy and pelvic floor, then float one knee up and lower itEasier: Supine heel slideHarder: Dead bug heel taps
  2. Bent-knee fall-out5 to 10 each side
    Beginner · Abs, Adductors, Hip abductors · 3D demoLet one knee fall out only as far as your pelvis stays stillEasier: Supine heel slideHarder: Dead bug heel taps
  3. Glute bridge5 to 10 reps
    Beginner · Glutes, Hamstrings, Abs · 3D demoPeel your back up bit by bit, a small way at first, and roll down slowlyEasier: Pelvic tilt into bridgeHarder: Glute kickback (quadruped hip extension)

Walk

  1. Treadmill walking5 to 10 min
    Beginner · Quads, Calves, Glutes · 3D demoOutdoors or around the house, twice a day at first, adding a little each day. The RCOG says many women can walk for 30 to 60 minutes after 2 or 3 weeksHarder: Treadmill jogging

Tips

  • Do the breathing and circulation exercises every few hours at first, the tummy exercises once or twice a day (our suggestion), and the pelvic floor exercises at least 3 times a day, little and often to begin with.
  • Squeeze your pelvic floor before you cough, sneeze, laugh or lift, and keep the exercises going for life.
  • Lifting: the RCOG says light loads only, such as a 1-litre bottle of water, for the first 1 to 2 weeks, and nothing heavy, including children, until 3 to 4 weeks (4 to 6 after a pelvic floor repair). POGP's 2017 booklet says avoid heavy lifting for up to 6 weeks. Follow your own surgical team.
  • Leave out sit-ups, double leg raises and planks while your tummy heals. Ease back if your scar pulls or the middle of your tummy bulges.
  • Don't strain on the toilet: put your feet on a small stool, lean forward with your arms on your thighs and keep your tummy relaxed.
  • Get medical advice for bleeding that becomes heavy or smelly, a temperature, increasing tummy pain, a red, painful scar, burning when you pee, or a painful, swollen leg. Call 999 for chest pain, breathlessness or coughing up blood.
  • What comes next depends on whose timings you follow: the RCOG's trackers suggest low-impact sport from 2 to 4 weeks after keyhole or vaginal surgery, while POGP's booklet suggests low-impact exercise such as cycling or beginner Pilates from 6 to 12 weeks after any gynaecological surgery. Your surgical team's advice comes first.

The doses are suggested starting points, not a prescription. Choose a range you can control and stop for sharp or increasing pain, numbness or tingling. Get individual advice after an injury or surgery, or if you are pregnant or managing a health condition.

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Questions people ask

How long does the exercises after a hysterectomy: the first 6 weeks take?

About 15 minutes, including any warm-up and cool-down listed. Shorten it by doing fewer rounds; lengthen it by adding one.

What equipment do I need?

You need: Cardio machine. Each move links to its guide, where you can find an alternative if you are missing something.

Is it suitable for beginners?

It is written for beginners. 3 of its 11 moves have an easier option listed beside them if you need one.

How do I make it easier or harder?

Use the easier or harder option listed under each move, change the number of rounds, or adjust the rest. Progress one change at a time.