How can I exercise with my ostomy?

May 10, 2021

Exercising with an Ostomy Experts weigh in on benefits, techniques and precautions 

By Kelly Sagert 

Originally published in The Phoenix Ostomy Magazine, 

Bertina likes to walk her dogs and do yoga. Nicola enjoys aerobic DVDs at home, while Heidi prefers to hike, rock climb and snowboard. Still other ostomates swim, do archery and dance. What’s important is to focus on physical activity that you enjoy and the benefits will follow.  

“Exercise helps you avoid post-operative weight gain, keeps your muscles strong and helps to prevent a peristomal hernia. People say they feel better about themselves when they exercise and it gives them a sense of control. Post-ostomy, returning to exercise can be very empowering, illustrating that you can indeed lead a normal life,” says the chief science officer of the American Council on Exercise (ACE), Cedric Bryant. 

It’s recommended to consult your surgeon and family physician before returning to exercise after ostomy surgery. If you have a hernia (and perhaps as many as 50% of people with ostomies develop a peristomal hernia), ask what limitations that places on your physical activities and what modifications you should make in your routines. 

Trusting Your Body -

After undergoing whatever medical issue(s) led to your ostomy and then surgery, it’s natural to feel anxiety when returning to your former workout routines – or perhaps adding exercise for the first time.  

Part of it is the fear of the unknown and learning to trust your body again. If you feel anxious, try deep breathing. Slowly take in a deep breath, imagining that it’s traveling to the top of your head, then release. Take another deep breath, this one traveling to the base of your spine. Release. Repeat this cycle ten times. If you practice it enough, you may find yourself starting to relax as soon as you start this breathing routine.  

What else helps you to relax? Sitting outside in sunshine? Listening to calming music? Burning incense or scented candles? Come up with a list of anxiety-fighting techniques and talk to your doctor if you need more help.  

To find out more about exercising with an ostomy, we talked to physical therapists, an ostomate coach and everyday patients who are reaping the benefits of physical activity after surgery. 

Magic Formula -

Manhattan-based physical therapist Marianne Ryan, PT, BS, OSC, believes that you should be able to return to pre-surgery exercising abilities by following a logical process. “But,” she cautions, “there’s no magic formula of needing six weeks or twelve weeks to heal. Different surgeons use different techniques and people heal at different rates.” 

Marianne emphasizes that, before you begin to strengthen your core muscles, you must activate your deep-muscle system. “You need to wake up muscles that forgot how to work,” she explains, “because of your pain and inflammation and because muscles were cut.” 

These core muscles, she explains, lie deep within your belly. They are not used for movement but to hold you together. “Inside muscles,” Marianne says, “are holders. Outsiders are movers. You don’t want your insides to be jelly.”  

The bottom of the core muscle group, she explains, is the pelvic floor and the top is the diaphragm. If there is too much pressure from your diaphragm because you’re holding your breath, then too much pressure is pushing on your abdomen.  

Reactivating your core muscles doesn’t take long. “It’s like flicking a switch. The ultimate goal is to coordinate the inner and outer abdominal muscles so they’re humming like a well-oiled machine. If you were active before the surgery, muscle memory may make this a quicker process,” says Marianne. 

To activate your core muscles, she recommends the following: 

  • Start by walking and perform gentle body movements such as those taught in tai chi. 
  • Be sure to use proper form and breathing, gently exhaling on exertion and matching the level of exhale to the level of exertion.
  • If you’re exercising to the point that you hold your breath, then slow down, lighten up and decrease reps. 
  • Add to your exercise routine incrementally, perhaps going from two 10-minute sessions daily to a 30-minute session to an hourly one.
  • Be careful lifting weights. If you can do 12-15 effortless reps without holding your breath, then you’ve got the right weight to start. Then build up. 

“I’m not a big fan of sit ups,” she says. “If you’re doing 100 crunches, then you’re probably increasing internal abdominal pressure – which adds pressure to your pelvic floor, which is the support system for your organs.” 

Absolute Beliefs -

Kim Levenhagen, PT, DPT, WCC, is an assistant professor at St. Louis University in the department of physical therapy and athletic training. Kim doesn’t believe in absolutes. Instead, she prefers to work with individuals to see what works for each of them. Nevertheless, she offers the following caution to all ostomates. “For the first few weeks,” Kim says, “even avoid vacuuming and laundry, including hamper emptying.” 

She recommends swimming as a great overall activity, adding that there are discreet swimsuits made to support your abdomen and hide your pouching system. If you’re worried about your skin barrier loosening in the water, add extra adhesive tape or try Sure Seal™ Rings by Active Lifestyle Products. Then, when your pouch is empty, fill up your bathtub with water and get in to test your seal. Avoid lake swimming because of the added risk of infection due to bacteria.  

She also offers these general tips for ostomates: 

  • Whatever caused you gas pre-surgery will cause it post-surgery, so avoid those foods before exercising. 
  • During summer, heat and exposure shorten the life of adhesives because of perspiration, so take that into consideration. 
  • Always take extra supplies when exercising away from home. 
  • Be careful with clothing, such as bike shorts, that are so tight that they constrict flow. 
  • People with ostomies are at higher risk of dehydration, so drink plenty of water when exercising. 

Luxury of Nature -

We talked to Bertina Donahue, who is one year post-surgery – and who prefers exercising in the “luxury of nature” rather than in pricey gyms. Bertina walks her two dogs three or four days a week and her horse along a riding trail two or three times a week. “Yoga is a really big thing for me,” she adds, “and it really builds your strength, balance and flexibility.” She uses YouTube videos to guide her yoga workouts and recommends the POPSUGAR Fitness Channel.  

When asked if she faced any special ostomy-related challenges when exercising, she says, “When bending or during certain yoga poses when I’m compressing the midsection of my body, I find that I’m sometimes squishing my ostomy. And, a squished ostomy is a sad ostomy. Otherwise, I don’t have any challenges at all.” 

Bertina has the following advice for people who are nervous about exercising with an ostomy. “Get creative! Have fun! Check with your doctors before doing strenuous types of exercise and always know your own limits. Never push yourself if you feel like your body can’t do it. There is no shame in needing to tweak something or take a rest. Don’t be afraid to get out and get dirty, though, so to speak. Try new things, start small if you need to – and, if it helps, get a workout buddy. It’s always more fun to have someone else around while you exercise.” 

Summary -

Although it’s wise to be cautious, especially during the immediate post-surgery period, people with ostomies enjoy a wide range of exercise activities. Overall, exercise can help you become healthier, physically, emotionally and psychologically. For more advice from active ostomates, visit where individual ostomates share how they’ve incorporated exercise into their lives, post-surgery. 

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