EXERCISE AFTER PROSTATECTOMY
These simple instructions were designed to help answer some common questions about your postoperative recovery as well as guide you back to your previous level of activity. Check with your physician prior to beginning this program. The US TOO (www.ustoo.com) support group is also a good resource for your questions or call the American Foundation of Urologic Disease patient information line at (800) 242-2383 for further information.
WHAT DO I NEED TO AVOID?
It is very important that you avoid anything that will stress or strain your incision. Every day activities like lifting tools or groceries and toileting can cause problems. These activities can put undue stress on your surgical site. Try not to strain (hold your breath and bear down) while having a bowel movement and avoid constipation. If you need to cough or sneeze, you should place a pillow or your hands over your lower abdomen or incision area and support it as best you can to counteract the intra-abdominal pressure.
WHAT CAN I LIFT?
It is recommended that you do not lift anything over 10 pounds in the first 6 weeks after surgery. However, your Physician may have his/her own guidelines so check with him/her first and follow their protocol. After 6 weeks, you may gradually increase the weight of objects you lift. Never lift anything you feel you cannot easily handle. Technique is important. Do your pelvic brace by contracting your pelvic floor and lower abdominal muscles together as you begin to lift heavier objects (making sure you do NOT hold your breath—always exhale as you lift to decrease intra-abdominal pressure). It is extremely important to use proper body mechanics when lifting. Be sure your back is straight and your knees are bent. When you lift even a light object, keep it close to your center of gravity (near your belly button) and lift with your legs not your back.
WHEN CAN I EXERCISE?
Once you get home, you should climb stairs only as necessary to get to your bedroom or bathroom. A gentle-walking program will gradually build up your endurance and can be initiated for short distances (around the house) in the first week. Remain at low level, gentle walking until your recheck appointment when your doctor can see if you are healed and ready for more physical activity. Consult with your physician about when it is OK to begin an exercise program.
Pelvic floor muscle exercises, also known as Kegel exercises, help strengthen and support your internal organs after surgery. If you have difficulty learning how to contract these muscles you may need extra help to relearn how to use these muscles and to start strengthening them. At this time, you should consult your therapist to instruct you in proper abdominal muscle training, lifting and postural exercises. This will ensure that the correct muscles are functioning.
WHEN CAN I BE SEXUALLY ACTIVE?
It is not recommended to resume sexual activity for 4-6 weeks after surgery (However consult with your Physician before you have intercourse). Your erection ability can depend on the amount of surgery that was required to remove all the prostate cancer. The nerves that control erection run very close to the prostate. If the nerves are intact then erection should be possible once the tissues are healed. Give yourself time for the operation to heal. If an erection is not possible, medications or mechanical devices can assist you. Please discuss these options with your physician.
POSTURAL CONSIDERATIONS
It is common to maintain a more bent or flexed posture after any kind of abdominal surgery. It is important to do some gentle exercises and to stand up straight to avoid poor posture becoming a habit.
General postural exercise
- Stand against a wall with your knees slightly bent.
- Place your arms in a “hold up” position or in the shape of a goal post.
- Perform a pelvic brace by contracting your pelvic floor and lower abdominal muscles together.
- In this position, slide your hands up toward the ceiling being careful not to let arms come away from the wall.
- Repeat this exercise 3-5 times at least 2-3 times a day.
WHEN CAN I EXERCISE MORE VIGOROUSLY?
If you participated in running or jumping sports, avoid returning to those sports until at least 12 weeks after surgery. This may be difficult to do because you feel ready to return to your previous level of exercise however your bladder may not be as ready as you are. Return gradually doing 30%-50% of what you did prior to surgery. For example, if you ran 3 miles per day before surgery, start out with no more than 1 mile. If you feel any discomfort, pain or pressure in the lower abdomen, stop exercising immediately! Your therapist can help you gradually and safely return to your previous level of exercise. If you have any questions about your postoperative recovery please call your physician or therapist.