Recovery - Importance of Gentle Core Exercises

Hi,

I'm posting on behalf of my brother who had a complete and irreversible ostomy for Crohn's almost three weeks ago now. I'm currently looking after him while he recovers and I just wanted some advice on something that's concerning me.

He's not really doing his (gentle) core exercises that the hospital gave him to do. Whenever his post-op symptoms get worse (bleeding, pain, etc.) he just stops doing them altogether. My thinking is though that he's going to have these symptoms, and if he doesn't exercise through them then they're only going to be more frequent and worse. Am I wrong about this? It's obviously going to be uncomfortable for him at first, but is it worth him pushing through this initial discomfort (within reason)? And at what point is it sensible to listen to the discomfort and take a break for a while?

If anyone has any insight they could offer then I'd be very grateful to hear it. If he's doing the right thing already by taking it easy: great. But if he's causing himself more harm by avoiding an essential part of his recovery then I'd rather help him to be equipped with that information, even if he chooses not to act on it.

Looking forward to hearing your responses, and thanks in advance x

We all heal at different speeds.  I wouldn't push him at this point, just three weeks out.  But I'd think that, at minimum, he ought to be moving about, walking to and fro, getting used to his new reality.  Whatever the "core exercises" are that you mention, stay on him without pushing it.  As the young boy said to the coyote, 'be gentle with me.'  

I'd say get up and get walking to get everything moving again first. Discomfort usually means something isn't right. Doing core exercises might be too soon since the wounds are so fresh. The body has been sliced and diced and gone through some pretty traumatic stuff recently, it won't heal nearly as fast as anyone would like.

Like others say, getting up, moving, and walking is the key at this stage. Any stretching and very light exercise that creates additional pain is not where you want to be.

Thanks for your feedback, guys! He's been doing daily walks around the block and gets up and around the house when he needs to, so encouraging to hear that that's what he needs right now :)

I'll do my best to be gentle with him!

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Do you know if he had open or laparoscopic surgery? I'm curious what type of program they sent him home with because as others have mentioned, the early weeks he is in really comes down to walking, sitting down/standing up. I got in trouble for movements like leaning to get utensils out of the dishwasher. Couldn't lift anything heavier than a gallon of milk. It was only in the past couple weeks I got cleared to walk one of my dogs at a time (I have multiple dogs) and my most recent surgery was mid-November.

First things first, speak to his surgeon/doctor about this. What are the core exercises? Walking and generally moving the body a few times a day is good but I would avoid anything more until I was ready. You have to listen to your body because no one else can :) So he is probably doing the right thing stopping because of pain/bleeding. I remember being told to do breathing and coughing exercises a few times a day too. It took me a long time to heal and was told by the surgeon to not even lift a kettle for the first few weeks. Also, the risk of hernias is high at this stage. Everyone is different though so be gentle.

It's great you are helping him so well done. You are a great brother. I went through my 3 major surgeries and 4 smaller ones alone lol.

He had open surgery, and they gave him some exercises in a pamphlet to go home with but not really much info as to how much and when he should be doing them. Sounds like from what you're saying though we shouldn't be in any rush. Good to hear you're back out with your doggos and hope things continue to improve!

The exercises are (all lying on the back):

1) Deep breathing with gentle tensing of the tummy 2) Pelvic tilt exercises 3) Hip lift/bridge pose 4) Knee rolls

It looks like all the instructions advise staying within what's comfortable so definitely sounds like "listen to your body".

Thanks for saying so, that's really nice to hear. I'm trying my best

Yeah IMO he should start those exercises much further along his recovery. It's early days. For now stick with the walking and the breathing. But don't overdo the walking either. Body needs rest, time and patience to heal (something I lack!) and gentle movement helps with blood flow. Doing too much too soon hinders recovery and could cause harm. Likewise, doing nothing isn't good.

I had my surgeries in private healthcare in the UK and comparing to people I know who had theirs on NHS, I was given more aftercare info, follow-ups etc. So I guess the info received depends on who, where the surgeries are done and the extent of them.

You're welcome, keep it up :) And keep us all posted on his recovery.

Hi White,

What everyone is saying makes sense. But what caught my eye was you saying "Whenever his post-op symptoms get worse (bleeding, pain, etc.)........" At 3 weeks out he should have had any non-dissolving stitches removed and should be able to move around fairly well. Getting into and out of a car will still hurt a bit, and cartwheels are out of the question, but his pain should be overall moderate at the incision site, and there should be no bleeding. Pain should be a bit increased if the abdomen is stressed....i.e., twisting, sitting up in bed, coughing, sneezing, etc. But other than that he should be mobile and not in much pain. The exercises are to increase flexibility and prevent the scar tissue at the incision from forming and restricting movement. Rubbing Vitamin E on the scarring will help too.

We all sort of know what we can do physically and what not, as our brains recognize the pain signals. So let him do what he's comfortable with.........but if there's acute pain (and he's not doing anything stupid) or bleeding........it's time to call the Doc and see what's what. It's great he has someone watching out for him..........you rock! Don't hesitate to ask anything else on here!!

;O)

When I got my colostomy (laparoscopic), I was told not to start any type of abdominal or core exercises until five to six weeks out, and then only the gentle ones that you referred to, with the addition of a couple of others. Walking is great, as long as your brother is feeling up to it. As others have said, he should listen to his body. Being careful about lifting is another really big one, because it's easy to lift too much without realizing it. When he does start the exercises, just build up very slowly, in small increments, and don't neglect the abdominals, as increasing the core gradually will strengthen the muscles to help prevent hernia in the future.

Especially if your brother had open surgery, he needs more time to heal. Take it slowly.

Terry

P.S. Yes, you are a peach and your brother is lucky to have you!

If your brother is anything like me....he may listen better to doctors/nurses at the hospital and be a pain as a patient once home. But hopefully he's not :) I was so mad when I had my NG tube. I only cooperated when we negotiated popsicles into the deal.