Hi, I had a stomach operation last Monday and now have a cut on my lower stomach, bikini line. Could you please give me some idea how to start exercising again? What kind of exercise I am allowed to do and how and when to start? Thank you in advance.
With any invasive stomach surgery or post C-section the deep core muscles are damaged and these need specific attention to resolve resultant scar tissue from the surgery and re-strengthen the muscles. This means working the inside (deep) muscles followed by the outside (more superficial) muscles. Often this important step can be missed with individuals focusing too much on the more superficial stomach, i.e. six pack, muscles.
You should get specific time guidance from those who supported you through your surgery and if you haven’t been given any I would recommend you contact them and ask about the required recovery period – as different surgeries require different recovery periods. Once they suggest you are safe to restart core activation (i.e. pelvic floor exercise) then you can follow the following advice:
So, the best way to tackle the deep core muscles is by doing a focused abdominal program done 2-4 times a week but NOT everyday! This is a common misconception that abs should be trained daily but all muscles require rest time to recover and adapt to the training. Often daily abdominals leads to lower back pain long-term due to the lower back muscles having to help out in movements to support the fatigued abdominals (tired from consecutive days training!).
Here is how to activate the deeper muscles:
- On a DAILY basis you need to be re-training your deepest abdominal muscles (transverse abdominals and pelvic floor) so practice the 'drawing-in manoeuvre' as often as you remember. You can do this anywhere (nobody will know!) and it is great to do when you are in a car or at a desk (i.e. any sedentary position), simply start by taking a breath in and as you do, draw your belly button in towards spine. You should feel a tension develop in your midriff (like you have put a belt on!), then as you breathe out, keep your belly button drawn towards your spine and breathe normally.
Hold the tension for as long as you remember, although it will not be long to start with. The more you practice this manoeuvre the more automatic it will become. By strengthening your TVA and retraining it to automatically activate and stay where it should, you can visibly reduce the size of your waist as well as protect your lumbar spine in the long-term (a common site of pain during and post-pregnancy and following any invasive stomach surgery).
- As well as the above, you do also need to be retraining the more superficial muscles of the abdominal area which will include the rectus abdominals ('six-pack' muscles). Due to surgery-related stress, the abdominals need specific training to ensure they recuperate. The core exercises you do need to be performed at a slow, controlled pace, with a full range of motion, with conscious attention given totally to the abdominal area you are trying to strengthen.
1) A well executed basic floor crunch with your knees in a bent position would be an excellent way to start, doing 2-3sets of 15 repetitions. At the top of each crunch movement, (which wouldn't be a big movement and would not involve your lower back leaving the floor) pause and hold for 1 second while trying to consciously squeeze your abdominal muscles. The most important thing about this exercise is not the repetitions but that you REALLY feel the muscles waking up, working and tiring out!
2) An exercise called "the plank" is a fantastic exercise designed for core strength and incorporates shoulder stability and upper body strength. For the starting position, lie on your front and have your elbows underneath your shoulders and feet tucked under your ankles, then lift your body off the floor so only your forearms and knees and shins are on contact with the floor.
Concentrate on drawing your tummy in towards your spine against the pull of gravity. If you can do this and hold for 30seconds and prevent your lower back from activating and getting involved then your core strength is strong enough to try a full plank where you progress the hold by lifting the knees up so only your forearms and toes will be in contact with the floor. Aim to hold for as long as possible and do it 2-3 sets.
- You really want to do 1-3 core exercises that could be incorporated into a whole body approach training program, with an emphasis on targeting your core muscles through the entire workout, at the same time as working the other parts of the body. This structure would be ideal and would significantly enhance the strength and tone of your stomach!
- It is difficult for me to provide detailed programs/exercises for specifics in written format, especially without even a visual aid, i.e. photos, however, check out my "core exercises" article and the "lower body workout" on the resources page of the website as this contains details of the 'drawing in manoeuvre' and another exercise for you to work up to.
- What you could also do if it is an option for you, (i.e. you are a member of a gym), is to get a 1-2-1 with a fitness professional where you have visual, verbal cues and feedback on your technique, if they are a level 3 with the register of Exercise Professionals (REPs) they are qualified in special populations including pre/post natal/surgery.
Good luck and hope this helps,
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