This information describes exercises you can do when you have a new ostomy to help your body recover. This is part 2 of a 2-part ostomy exercise program.
Your care team will tell you when it’s safe to start doing these exercises. Do not start them within 6 weeks of your surgery. Follow the instructions in Exercises After Ostomy Surgery: Level 1 until your care team tells you it’s safe to start these.
An exercise program focused on activating your core will create a mind-body connection and strengthen your muscles. It will also help you move better.
What to do before starting this exercise program
Talk with your healthcare provider before starting this program. Your healthcare provider or rehabilitation (rehab) therapist may change the exercises to meet your needs.
Your care team will talk with you about movements to avoid while your incisions (surgical cuts) are healing. Follow their instructions. Contact them if you have any questions.
In general:
- Do not lift or carry anything heavier than 10 pounds (4.5 kilograms) for 6 weeks after surgery. For example, a full laundry basket or a large trash bag usually weighs more than 10 pounds. After 6 weeks, you can slowly start lifting and carrying heavier objects. Talk with your care team if you have any questions.
- Avoid pushing or pulling moderate to heavy objects as much as you can for 6 weeks after surgery. A full grocery cart or large garbage pail with trash in it are examples of moderate to heavy items. After 6 weeks, you can slowly start pushing and pulling heavier objects. Talk with your care team if you have any questions.
- Do not do sit-ups, pushups, or any strenuous exercise (exercise that takes lots of energy or effort) for 2 to 3 months after surgery. This will help prevent a hernia (bulging of an organ or tissue) through your incision or around your ostomy.
Speak with your Wound, Ostomy, and Continence (WOC) nurse after your surgery and during your post-op visit to learn more about how to prevent a hernia around your stoma.
Exercise tips
- Make sure to wear your abdominal support binder when doing these exercises. Lie down to put it on.
- Dress comfortably. Wear clothing that will not limit your movements.
- For exercises you do lying down, support your head and shoulders with pillows, if needed. You can also bend your knees, put a pillow under your knees, or both. Make sure you’re comfortable.
- For exercises you do while standing, keep your back straight and pull your belly button to your spine. This helps activate your abdominal muscles.
- Avoid holding your breath while doing any of these exercises. Breathe in through your nose and out through your mouth. Do the exercise movements when you breathe out. Count out loud during the exercises to keep your breaths evenly paced.
- Stop any exercise that causes pain or discomfort and tell your healthcare provider. You can still do the other exercises.
Exercises
Your healthcare provider or rehab therapist will tell you how many times per day to do these exercises. Follow their instructions.
These exercises will get easier as you do them regularly over time. When they get easier, tell your healthcare provider or rehab therapist. They will give you instructions for adjusting them so you can keep building your strength.
Diaphragmatic breathing
This exercise can help relax your chest wall and abdominal muscles.
- Lie on your back. Place one or both of your hands over your belly.
- Breathe in slowly and deeply through your nose. Your belly should rise, but your upper chest should stay still and relaxed.
- Breathe out slowly through pursed lips, like you’re blowing out candles. As you breathe out, slowly and gently pull your belly towards your spine.
Repeat this movement 5 times. If your care team gives you different instructions, follow those instead.
Overhead chest stretch and 4-8-8 breathing
This stretch is a good way to loosen the muscles in your chest and help air move in and out of your lungs. This helps to increase the amount of oxygen in your whole body.
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Lie on your back, sit in a supportive chair, or stand with your feet shoulder-width apart. Relax your arms at your sides.
- If you’re lying on your back, make sure you have enough room to raise your arms over your head.
- If you’re sitting or standing, make sure your back is straight and shoulders are back.
- Breathe in for 4 seconds. As you do, slowly raise your arms out to the sides until they’re over your head. Keep your elbows straight.
- Hold your breath and keep your arms up for 8 seconds, if you can.
- Breathe out through pursed lips (like you’re blowing out candles) for 8 seconds. As you do, slowly lower your arms back to your sides. Keep your elbows straight.
- Relax for 1 to 2 seconds.
Repeat this movement 5 times. If your care team gives you different instructions, follow those instead.
Knee lifts with core (abdominal) activation
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You can do this exercise while sitting or standing.
- If you’re sitting: Sit in a supportive chair. Move your feet so they’re flat on the ground, under your knees. Your shins should be straight up and down, not at an angle.
- If you’re standing: Stand with your feet shoulder-width apart, shoulders back, and back straight. If you want extra support, place 1 hand on a nearby surface or wall. For even more stability and balance, you can stand with your back against a wall.
- Place 1 hand on your upper belly. If you are not using your other hand for balance, place it on your lower belly. Take a few slow, deep breaths. Feel your belly rise and fall under your hands.
- With your next breath out, gently pull your belly button towards your spine. You should feel your abdominal muscles contract (squeeze). Hold the contraction while you keep breathing.
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Keeping your abdominal muscles contracted and your back straight, raise one knee.
- If you’re sitting, raise your knee to slightly above your hip level.
- If you’re standing, raise your knee to hip level.
- Gently lower your foot back to the ground, then repeat the movement with your other knee. Remember to breathe.
Repeat this movement 10 times for each knee. If your care team gives you different instructions, follow those instead.
Sitting, standing, or lying rotations with abdominal (core) activation
Sitting or standing rotations
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Sit in a supportive chair or stand with your feet shoulder-width apart.
- If you’re standing and want extra stability and balance, place a chair on either side of you. When you turn to one side, lightly place both hands on the chair on that side for support.
- Cross your arms and comfortably rest each hand on the opposite elbow.
- Take a few slow, deep breaths. Feel your belly rise and fall. With your next breath out, gently pull your belly button towards your spine. You should feel your abdominal muscles contract. Hold the contraction while you keep breathing.
- Keeping your abdominal muscles contracted and back straight, turn your arms, torso (trunk), and head to the left. Turn as far as you can without feeling discomfort. It’s normal if this is only a few inches.
- Hold this position for 5 seconds. Remember to keep breathing. After 5 seconds, turn back to facing forward.
- Turn your arms, torso, and head to the right as far as you can without feeling discomfort. Keep your abdominal muscles contracted and back straight.
- Hold this position for 5 seconds. Remember to keep breathing. After 5 seconds, turn back to facing forward.
Repeat this movement 10 times toward each side. If your care team gives you different instructions, follow those instead.
Lying rotation
- Lie on your back with your arms at your sides. Bend your knees and place your feet flat on the bed or ground, hip width apart.
- Gently tuck your tailbone and flatten your lower back to the ground. To tuck your tailbone, imagine you’re scooping your pelvis forward so your lower back is flat.
- Take a few slow, deep breaths. Feel your belly rise and fall. With your next breath out, gently pull your belly button towards your spine. You should feel your abdominal muscles contract. Hold the contraction while you keep breathing. Keep your tailbone tucked.
- Breathe gently and rotate your knees and legs to the left as far as you can without feeling discomfort. It’s normal for this to only be a few inches. Make sure to keep your upper body stable against the ground as you move your lower body.
- Hold this position for 5 seconds. Remember to keep breathing. After 5 seconds, move your lower body back to the starting position.
- Breathe gently and rotate your knees and legs to the right as far as you can without feeling discomfort. Keep your upper body stable against the ground.
- Hold this position for 5 seconds. Remember to keep breathing. After 5 seconds, move your lower body back to the starting position.
Repeat this movement 10 times toward each side. If your care team gives you different instructions, follow those instead.
Deadbug
- Lie on your back with your knees bent and feet flat on the bed or ground. Place your arms at your sides.
- Gently tuck your tailbone and flatten your lower back to the ground. To tuck your tailbone, imagine you’re scooping your pelvis forward so your lower back is flat.
- Take a few slow, deep breaths. Feel your belly rise and fall. With your next breath out, gently pull your belly button towards your spine. You should feel your abdominal muscles contract. Hold the contraction while you keep breathing. Keep your tailbone tucked.
- Extend your left leg. As you do, lift your right arm over your head. Remember to breathe.
- Gently move your leg and arm back the starting position. Then, repeat the movement with your other leg and arm. Remember to breathe.
Repeat this movement 10 times on each side. If your care team gives you different instructions, follow those instead.
Woodchopping
- Sit in a supportive chair or stand with your feet shoulder-width apart. Clasp your hands together over your left hip.
- Lift your arms up and twist your torso to the right, ending with your arms overhead over your right shoulder. Watch your hands as you move. Keep your hips stable and keep breathing.
- Gently move your arms back to the starting position.
- Clasp your hands over your right hip. Repeat the movement in the opposite direction, moving your hands up over your left shoulder. Remember to keep breathing and watch your hands as you move.
Repeat this movement 10 times toward each side. If your care team gives you different instructions, follow those instead.
Quadruped with alternating hand and leg extension
- Start on your hands and knees on the ground. Keep your back straight.
- Take a few slow, deep breaths. Feel your belly rise and fall. With your next breath out, gently pull your belly button towards your spine. You should feel your abdominal muscles contract. Hold the contraction while you keep breathing.
- Lift and straighten your right leg behind you. At the same, time, lift and straighten your left arm in front of you. Hold this position for 2 to 3 seconds. Remember to breathe.
- Lower your leg and arm back to the starting position.
- Repeat the movement, lifting your left leg and right arm.
Repeat this movement 10 times toward each side. If your care team gives you different instructions, follow those instead.
Daily activities
Follow the instructions in follow the instructions in Safe Movements and Posture With an Ostomy: Instructions for People Who Can Sit as you do your daily activities. Most people can do all their normal activities, such as:
- Vacuuming
- Sweeping
- Cooking
- Sitting at a computer
Ask your healthcare provider if there are any daily activities that you should not do.
