Easing back into your workout
If you’re an exercise buff who needs surgery, it’s hard to back off while you recuperate. Being sedentary can make you feel restless, listless and out of sorts — but your body needs time to heal.
Fortunately, when options like minimally invasive surgery are appropriate, recovery times can be pretty short. Even with traditional surgery, prolonged immobility after surgery is rarely what the doctor orders.
You want to take care when you start working out post-op and understand how to ease in. For most types of surgeries, the advice is similar:
— Find out what to expect regarding physical activity limitations in advance.
— Follow your surgeon’s post-op recommendations.
— Give your incisions enough time to heal.
— Realize that doing too much, too soon, is counterproductive.
— Build up gradually and listen to your body.
— Consider using the early recovery time to explore gentle, mindfulness exercise.
— Consult with experts like exercise physiologists and physical therapists for education and support.
While this advice applies across the board, additional guidelines vary by the specific health condition and type of surgery. Instructions will differ for someone who’s having cataracts removed versus a patient undergoing a gastric bypass procedure for weight loss. Here are some examples of post-op precautions and strategies for resuming your fitness routine.
By improving your vision, eye surgery can improve your ability to exercise, once you give yourself a chance to heal.
“When can I play golf?” That’s the most common sports-related question Dr. Andrew Iwach hears from patients having eye surgery. “When they come to the surgery, it’s ‘I can’t see the golf ball,'” says Iwach, executive director of the Glaucoma Center of San Francisco and a clinical spokesperson for the American Academy of Ophthalmology. “Then it’s, ‘Now I can see the golf ball and I want to go play.'”
When you have eye surgery for conditions such as glaucoma, cataracts and retinal detachment, protecting your healing eye and preserving your vision are clearly top priorities. Avoiding eye trauma, infection and blood pressure spikes is imperative during the surgical aftermath. Minimally invasive procedures can reduce recovery time but they’re not indicated for everyone.
“With the traditional surgeries, incisions are larger and it takes longer to heal, so that the time patients need to restart activity is longer,” Iwach says. Surgical wounds from fresh eye incisions can be vulnerable to hemorrhage, or bleeding. Patients must take care to avoid straining or lifting, to avoid disturbing a series of extremely fine, fragile blood vessels in the back of the eye, he explains.
“What’s critical is to have that conversation with the eye surgeon — the ophthalmologist,” or a member of the ophthalmology practice in advance, Iwach says. “It’s important to map out what your experience is going to be as a patient after surgery.”
Avoiding heavy lifting can prevent sudden increases in blood pressure that may affect the eye itself. Keeping your head at heart level or higher also helps maintain a normal blood pressure. Staying away from activities that make your abdominal cavity tighten up and potentially raising that pressure — like situps — is recommended while your eye is still healing, he says.
Exercise after eye surgery
Direct impact to the eye obviously should be avoided, as well as losing your balance and falling. That means staying away from contact sports or other activities that could lead to eye trauma until cleared by your doctor.
Impact on the eye from a high-velocity projectile — like a golf ball — could pose a problem for recovering patients. Fortunately, Iwach says, someone playing “reasonable” golf isn’t likely to be hit in the eye. For most golfers after routine surgery, he says, “usually within a few weeks we’ve got them up and going.”
Infection is another postoperative consideration. Ophthalmologists may use antibiotics to prevent eye infections, and recovering patients can help by taking precautions like keeping dirty water away from their eyes. Swimming, for instance, could increase infection risk, along with irritating your eye from chlorine.
The AAO website offers these generalized tips on resuming exercise after an eye surgery:
— Cataract surgery. Your eye will be particularly sensitive to light. Wear wraparound sunglasses, which also prevent irritants from entering your eye. Walking and other light aerobics may be allowed soon after surgery.
— Laser surgery for glaucoma. While there are typically no physical activity restrictions, talk with your surgeon first.
— LASIK surgery. Avoid swimming or exposing your eye to water for at least two weeks. Stay away from strenuous exercise and contact sport for up to one month. Wear sunglasses outdoors to protect your eyes from UV rays and debris as they heal.
— Retinal surgery. Avoid strenuous exercise and swimming for up to two weeks. For specific types of retinal surgery, you may need to avoid flying, high altitudes and scuba diving until cleared by your doctor.
When it comes to exercising after cancer surgery, there’s a fine balance between being active enough to start feeling better and overdoing it.
Walking is generally OK fairly soon unless it involves part of the body affected by surgery, says Nancy Campbell, an exercise physiologist at Dana Farber Cancer Institute in Boston. “There are always those people who, when you tell them to walk, are trying to power walk five miles the next day,” she says. In her role, “It’s trying to meet people where they are, knowing that some aren’t going to walk at all, but others are going to try to do way too much, too soon.”
Doing several shorter exercise bouts during the day can be a good strategy, Campbell says. “So, do five minutes in the morning, and then another five or 10 minutes in the middle of the day, and then again at the end of the day — as opposed to trying to do a continuous 30 minutes.”
Breaking activity up into smaller chunks gives people an idea of their endurance, she says. “Are you coming back wiped out, or, hopefully, is it giving you a little energy, helping you move things around and get the anesthesia out of your body? Does it help you feel better?”
Staying hydrated and eating a balanced diet with sufficient protein are important to help your body heal and recover, Campbell says.
Exercise after cancer surgery
Even when doing seemingly gentle forms of exercise like yoga, people recovering from cancer surgery may need to proceed with caution. With breast cancer surgery, for instance, patients will probably be fairly limited in terms of movements like lifting their arms, Campbell says. In her classes, people adapt according to their situations and needs.
“Yoga often involves arm movements so in that particular situation may not be great, but that doesn’t mean you couldn’t do lower-body stuff or stretch out your hamstrings or calves,” she says. “Or vice versa if you’ve had lower-body surgery. You could just sit and do a chair yoga class where you’re really just moving your arms and practicing breathing.”
Physical therapy can help patients optimize their movement and exercise routines. “Depending on how involved the surgery was, getting someone to come to the home can be another component of their recovery,” she says.
With cancer, resuming an exercise routine can reduce stress and help restore a sense of control, in a situation where people may feel they really don’t have much, Campbell says. For many patients, the early postoperative period can present an opportunity to concentrate more on breathwork, mindfulness and meditation, she says: “This is the time to focus on the more restorative side of things, versus go-go-go, do-do-do.”
Weight-loss surgery can turn your ability to exercise around. But first, you have to recover. It’s up to the surgeon’s discretion how long you should wait to exercise after an operation like gastric bypass, says Dr. Renza-Stingone, a bariatric surgeon with Temple University Hospital–Jeanes Campus and an associate professor of surgery at the Lewis Katz School of Medicine at Temple University in Philadelphia.
“In general, I allow my patients to engage in full activity without restriction one month after surgery,” Renza-Stingone says. “In the immediate post-op period, I ask people to avoid heavy lifting, more than 15 pounds. I also advise just walking on flat surfaces without elevation and (against) very physical activity for that first month after surgery.”
Lifting heavy items could strain the abdominal wall and put patients at risk of developing an incisional hernia, in which abdominal tissue protrudes through a surgical incision.
Oftentimes, patients haven’t been very physically active before they had their surgery. “This patient population has a variety of stages of different capacity to exercise,” she says. “So, some people are much more immobile than others, and it’s really up to them to gauge their own exercise tolerance after surgery within the parameters that I’ve set.”
Incorporating physical activity into their lives is important for patients as they successfully recover from weight-loss surgery. “I definitely stress to patients that these surgeries will not be as effective as they could be without routine exercise after the operation, and that they shouldn’t look at the operation as some kind of magic that’s going to solve all their issues,” Renza-Stingone says.
Exercise after bariatric surgery
Cardio exercise is important after bariatric surgery, Renza-Stingone says, but so is resistance work to begin building muscle, reshape the body and help maintain weight loss. “By increasing your muscle mass, you’re making your body more metabolically active,” she explains. “You’re burning more calories to support the muscles even when you’re sitting still, so it will bump the basal metabolic rate.”
It’s good for patients to mix it up with a variety of activities. “Swimming’s a great exercise,” she says. “Obviously, we tell people to hold off on the pool-based stuff until their incisions are fully healed, so that would probably be something to engage in after that one month, because there’s also a lot of core involved in swimming.” Another pool-based benefit: “Swimming is also a good choice for people with joint issues who can’t have impact on the joints.”
Not having enough time to exercise is a “classic” complaint that Renza-Stingone hears from patients. High-intensity interval training is one solution. HIIT alternates quick bursts of vigorous exercise with brief recovery periods to deliver streamlined but effective workouts. You can even find targeted HIIT workouts that take less than 10 or 15 minutes online.
In general, for people who don’t have time to head out to a fitness club — no problem. “You don’t have to go to the gym,” Renza-Stingone says. “Gym does not equal exercise. Exercise can be any kind of movement that you enjoy, whether it’s going for a walk, playing tennis, jumping around in your living room or doing squats while you’re having a telephone meeting with people. You can incorporate exercise and movement throughout your day.”
Open-heart surgery is a grueling procedure that requires a careful approach to recovery. During this type of surgery, the sternum is divided from top to bottom, called a median sternotomy, to give surgeons access to the heart.
Activity restrictions known as sternal precautions are typically advised for open-heart surgery patients for several weeks postoperatively to promote healing and prevent complications. Standard sternal precautions may include:
— Avoid heavy lifting over 5 to 10 pounds.
— Not pulling or pushing with your arms.
— Not reaching behind your back.
While necessary, these restrictions can limit your ability to perform activities of daily living and hamper your ability to exercise. However, it’s important to avoid being too sedentary, in order to promote circulation and respiratory function to help prevent complications such as blood clots or pneumonia.
Soon after open-heart surgery, while you’re still in the hospital, you may begin walking short distances and do gentle seated and standing movements, with initial instruction and assistance. However, you also need a physical activity plan to improve your health and fitness at home.
Exercise after heart surgery
If you’re recovering from bypass surgery, heart valve replacement, a stent procedure or even a heart transplant, cardiac rehab offers a medically supervised path to safely increasing your physical activity and improving your heart recovery outcomes.
You’ll have access to specialized exercise facilities, often within a hospital. Wearing a heart monitor as you work out helps rehab team members, including doctors, nurses and exercise physiologists, track how well you’re tolerating sessions on exercise equipment like treadmills or rowing machines.
Cardiac rehab is typically covered by insurance, often for three visits a week for up to 36 cardiac rehab sessions, and it’s recommended by the American Heart Association.
If you’re not able to take advantage of cardiac rehab in your area, ask your doctor about when and how to build a physical activity routine after heart surgery or a heart attack, the AHA advises. That can mean anything from raking leaves, climbing stairs, walking or playing sports. Jogging, swimming, biking, and strength and stretching exercises can increase your overall stamina and flexibility. Your doctor may recommend an exercise stress test before you become physically active.
Exercising after surgery
Follow these general guidelines for resuming physical activity after an operation:
— Ask your surgeon when and what to expect about returning to physical activity.
— Find out about specific activity guidelines for your type of surgery.
— Walking is often recommended as a good way to start.
— Protect unhealed incisions by avoiding exposure to water (swimming) or debris.
— Eventually incorporate a variety of aerobic, resistance, flexibility and mindfulness activities.
— Consider taking a targeted exercise class for patients in your situation, in-person or virtually.
— Consult with a physical therapist or exercise physiologist for guidance with major surgery.
— Be kind to your body and ease in gradually.
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Update 07/06/22: This story was published at an earlier date and has been updated with new information.