After a hysterectomy, it is important to understand how inappropriate abdominal or abdominal strength training exercises can be identified. Many women unwittingly perform abdominal exercises that can cause serious pelvic injury when they return to their workouts and fitness classes after hysterectomy surgery. Unfortunately, many well-meaning fitness trainers are also unaware of this problem, so women who have had pelvic surgery are uninformed, vulnerable, and confused about proper exercise. These guidelines for physiotherapists are designed to help you identify dangerous abdominal exercises after a hysterectomy.

Exercises with the upper abdominal muscles (or “six pack”) pose the greatest risk to your pelvic floor. Ultrasounds show that basic abdominal flexion exercises push the pelvic floor down in women with poorly functioning pelvic floor muscles. The more intense the abdominal or abdominal exercise, the greater the pressure on the pelvic floor and the greater the risk of pelvic floor overload and reduced pelvic support.

Decreased pelvic support can lead to a number of serious pelvic floor problems, including: vaginal prolapse, incontinence, pelvic pain, and anorectal disorders. With a hysterectomy, the upper vagina is sutured into the woman’s pelvis to support the vagina and prevent vaginal prolapse (that is, the vagina moves down and sometimes out of the woman’s body). Research suggests that the risk of vaginal prolapse after hysterectomy is increased.

This means that you absolutely must understand how to avoid overloading your pelvic floor after a hysterectomy with improper abdominal exercises. The following abdominal exercises can overload the pelvic floor and therefore should be avoided after a hysterectomy.

Abdominal curl exercises involve lifting the head and shoulders from a lying position and are also known as seated exercises. Variations include; Do sit-ups, sloping sit-ups (elbows to opposite shoulder), and ball sit-ups.
With the double leg lifts, both legs are lifted off the ground at the same time. Variations include; Bicycle legs, double leg raises, Pilates table top exercise and fitball between the legs.

Intensive abdominal exercises such as “plank” or “hover”, which are regularly performed in fitness, yoga and Pilates classes. Never assume that an exercise just because it is “Pilates” is safe and strengthens your pelvic support. Some Pilates exercises can put a lot of pressure on the pelvic floor.

Abdominal weight machines that train the upper abdominal and / or external oblique muscles against resistance. These machines increase the pressure in your stomach, which is transferred directly to your pelvis. In fact, these exercises will make your abs even more effective at increasing pressure on your lower pelvis.
How do you recognize dangerous abdominal exercises after a hysterectomy?

Exercises in which the head and shoulders and / or both legs are lowered and raised off the floor at the same time increase the pressure on the pelvic floor. These exercises can all lead to pelvic floor damage after pelvic surgery and when the pelvic floor muscles are not working properly.

Exercises that are performed while lying down (lying on the floor) and weight load on the hands / forearms and feet (with the body lifted off the floor) are intensive abdominal exercises. These can be altered by kneeling rather than carrying weights across the feet. Again, never assume that using a fitball makes the exercise safe for your pelvic floor.

Abdominal muscle systems that train the abdominal muscles to stand or lie down can overload the pelvic floor. These types of machines are generally used to “smooth the stomach”. It is not possible to reduce abdominal fat with abdominal exercises, but this myth still permeates Western society. To smooth your tummy, you need to lose fat from your whole body. It is not possible to lose it in one place while training.
It is desirable that women return to sport after a hysterectomy and ensure their long-term pelvic health through a

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