As your body begins to heal following surgery, you may wonder about a more active lifestyle - either to resume the sports and fitness activities you have already enjoyed, or whether you'll be able to take up a new sport that you want to try.
The thought of taking up a new sport or striving for ambitious goals in a sport previously enjoyed can seem overwhelming, but many have done just that. The following information will help answer your questions and encourage you to get the many pleasures and benefits that come from physical activity.
For many people, stoma surgery creates a renewed zest for life. Along with that new found enthusiasm comes the desire and determination to achieve goals they would never before have considered.
Stoma surgery is a major event that should not be underestimated. The first few weeks or even months following the operation may be difficult as you adjust gradually to having a stoma. However, once fully recovered and settled at home, returning to the lifestyle you enjoyed before the operation should be attainable.
As long as you have no complications and your healthcare professional has no objection, you can enjoy almost any kind of sporting activity. Contact sports, such as rugby or soccer, can be possible. Even sports that call for a lot of bending, such as bowling and aerobics, have been taken up after having stoma surgery.
Before looking at specific sports and fitness activities, it is important to have a clear understanding of how your body has responded to your surgery.
The stoma, stronger than you think
The stoma on your abdomen may look vulnerable, but in fact it is quite resilient. The surgical incision should be fully closed just about ten days after the operation, and over time, the scar tissue surrounding the stoma will reach its optimum strength.
Hernia prevention and care
Every person, with or without a stoma, should take care to protect his or her abdomen. Now that you have a stoma, you will want to be especially mindful of this area of your body.
With a stoma, the risk of developing a hernia from lifting or strenuous exercise may be higher than that of developing a common groin hernia. This is because the muscles supporting the stoma are not as strong as they were before surgery.
You can help prevent the development of a stomal hernia by taking precautions. Keep your weight in check and talk with your surgeon before resuming any abdominal exercises.
Contact your healthcare professional for further information or if you have questions.
Perineal wound healing
In some cases, a person may have a perineal (rectal) wound resulting from the removal of the anus and rectum. Although this area is likely to be tender for longer than an abdominal incision, it will heal and become equally resilient.
If you have a stoma, particularly an ileostomy, there are occasions where you may become dehydrated. Take care to drink plenty of water unless you have a fluid restriction.
There are several situations that make you especially susceptible to dehydration. In hot climates and/or when exercising, less urine is produced, so it is more concentrated. And when diarrhoea strikes, more fluid is being lost, so more should be taken in.
To help rehydrate your body, water is the best fluid, as it is the most readily available. You can also get special rehydrating solutions from most pharmacies, and sports drinks can be useful for severe cases of diarrhoea One good sign of being well hydrated is passing clear or straw-coloured urine throughout the day.
Diet for fitness
Once you recover from surgery, your diet and state of nutrition should be getting back to normal. How and what we eat is as much part of our individuality and lifestyle as our appearance and personality, and having a stoma should not have many restrictions to individual preferences.
It is vital to re-establish a healthy diet, but be cautious at first and chew thoroughly to avoid possible digestive problems. You may find that some foods upset your system, causing gas, diarrhoea or even pain.
Pay attention to your body to learn how your digestive system works best — when you are hungry, how long it takes to digest and what foods upset your system, if any.
We are working with Fern Freeman, a Chartered Physiotherapist who has been qualified 4 years and currently working in a major trauma centre. You can ask her a question and we will publish the most commonly asked questions.
As you recover from surgery, you will probably feel tired and may have little desire to exercise.
But you know it is important for your overall health and well-being to start moving around, even just a little at a time. Exercise can help you get better faster and also prevent potential complications from sitting or lying down. This does not mean aggressive or strenuous exercises by any means. Take it easy, start out slowly and enjoy the thought that you are getting back to your normal lifestyle and level of exercise.
Exercises 1: The corset squeeze:
Think of your ribs, tummy, back and pelvic floor like a corset. Knit your ribs together by squeezing them towards each other and back towards your spine. Aim to pull your belly button towards your spine, and engage your pelvic floor as if your were stopping urine mid flow. Work with the natural flow of your breathing to create the engagement of your muscles. Complete 10 squeezes with the in and out of your breaths. This exercise is also the base to which you should perform the other exercises in order to engage your core muscles and maintain good posture. Try to do this as you go about your daily life, out walking is a great place to fire up your core muscles while moving. Don't hold your breath whilst working on this exercise!
Exercise 2: Pelvic tilts:
Lay on your back on a bed. Engage your core muscles as we have done in exercise 1. Then aim to peel your lower back from the bed approximately 1 inch or so then stop and hold. Check you are still holding your core correct. Then lower back to the bed and tilt your pelvis the opposite way creating a deeper curve in the lower spine. Aim for 10 repetitions of this exercise.
Exercise 3: Bridge:
Engage your core as per exercise 1. Begin a pelvic tilt as per exercise number 2, then fully lift your bottom and lower back off the bed. Aim to press your hands and arms into the bed. The key is to engage your core, push your heels into the bed and feel as if you are pulling your heels towards you bottom. Aim for 10 repetitions of this exercise. You can adjust the height of your lift as you get stronger. It is better to only lift a little but maintain a strong and engaged core than lift higher.
Exercise 4: Knee rolls:
Laying on your back on a bed, bend your knees and place your feet on the bed, hip width apart. Then, engage your core as per exercise 1, then gently and slowly roll your knees from side to side as if they were a windscreen wiper on a car. You can start off by moving the knees a few inches side to side if you don’t feel confident, aim to get your legs fully flat on the bed as your confidence grows. This is also a lovely side stretch for your lateral core muscles. Aim for 10 repetitions and build up as you get stronger.
Exercise 5: Mini air squat:
Standing in front of a chair or a kitchen work top, place your feet hip with apart. Engage your core as per exercise 1. Place your arms extended out in the air in front of you, the higher they are the more difficult. Slowly bend at your knees and hips to perform a squat. Go as low as feels comfortable for you. Ensure your knees don’t go over your toes as this can damage them overtime. Aim for 10 mini squats. Progress repetitions, depth of squat and arm position to add difficulty as you get stronger.
The easiest and most effective form of exercise can be walking. It gets the blood flowing, helps with mental alertness, helps lift your spirits and generally increases your physical well-being.
Walking can be started soon after surgery and gradually increased to a brisk pace, adding minutes and distance over time.
You can even walk in the house. Online videos and DVDs, or even just some invigorating music, will help set the pace. Some people practice going up and down stairs to increase stamina and endurance. But if weather permits, a walk outside in the fresh air can do wonders both physically and mentally.
Riding a bike is also an excellent form of exercise that does not put too much strain on your abdomen or involve heavy impact. Like walking, biking can be introduced gradually and then increased over time to higher levels.
If you have a perineal wound, you may want try other activities for a while. This area can take a while to heal, and sitting on a bike seat may cause discomfort.
Try walking instead until the wound has fully healed.
Other favourite activities
You might enjoy aerobic activities such as skating, golfing, jogging or tennis. Training with light weights and frequent repetitions can be beneficial as well.
It is always wise to pay attention to how your body responds. You know it better than anyone else. If an activity makes you breathless or causes you pain anywhere, it might be wise to try another form of exercise, or take a break and return to it later if you feel you are up to it.
There is no motivation better than knowing a friend is waiting to join you for a walk around the block or a round of golf.
Gentle exercise can benefit your social life as well as your body.
Swimming is a popular and beneficial form of exercise. It can be enjoyed by everyone, regardless of ability. Many people who are recovering from surgery are encouraged to take up swimming as an easy and gentle exercise.
Swimming is not only one of the best forms of exercise for every part of the body, but it can also be taken up gradually and gently to build up stamina at a steady pace. It can be a highly sociable pastime, frequently enjoyed as a family outing. There is no reason why a person with a stoma cannot join in the fun.
Swimming can help in another way to overcome psychological hurdles. Do not fear being in changing rooms, pools, or in and around the water. The courage to take up this challenge will be rewarded by newly gained confidence, not only to enjoy more social sports but also activities such as clothes shopping and sunbathing.
People with a stoma may expect others will stare at their stoma. In truth, most people will not even notice the colour of your swimsuit, let alone what is underneath.
Pouch security while swimming
Another concern is that the pouch may come loose in the water. This is unlikely and easy to prove to yourself. Just sit in bath water for a while to test and ensure that the seal stays snug and leak-free. The chance of the pouch showing or coming off, even one that is two-piece, is quite unlikely.
If you are embarrassed changing in front of other people, try wearing a long shirt to cover most of your body. Even just draping a towel over your shoulder will keep your stoma from view. Or you can change at home and wear clothes over your swimsuit.
There are special suppliers who make swimsuits to fit particular needs, such as high-waisted swim trunks or swim bottoms. You may want to check with local suppliers in your area.
You might think impact from diving will pull on the stoma and the pouch. For added security, a snug bathing suit can help keep it in place. A man can wear drawstring trunks, tightly fitted around the waist.
Before going to a public swimming area, try your swimsuit at home. Wear it in the bath or shower to see how you look when it is wet and clinging to your body.
Contact and team sports
If you prefer the action of a team or contact sport, do not let minor concerns keep you from returning to it. Having a stoma will mean planning ahead, but you can still continue to participate. You may be concerned about your stoma, wondering whether it can be damaged. Remember that it may take several weeks or months for the stoma to shrink to its permanent size.
Damage to your stoma is unlikely, but you should still take precautions to protect it.
Another concern is that the pouch could be punctured or ripped off during contact sports. To avoid a damaged pouch, precautions can be taken. For added security, many people use firmly-fitted waistbands or girdles to keep the pouch securely in place. Everyone has individual needs and preferences, so it is up to you to see what suits you best. Try different sportswear to see what works best for you.
Competitive sports call for both skill and fitness. So it is essential to build up to the proper level of fitness gradually, before returning to or taking up a strenuous sport after the operation.
If you have a colostomy and you wish to minimise the "flow" from the stoma, stick to a low-fibre diet. Be sure to watch out for dehydration. Drink plenty of fluids before and after activities.
Empty your pouch before activities
People with a stoma often feel determined to become healthier than they were before the operation. This can lead to ambitious goals they might not have set before their surgery.
On the other hand, many athletes who were superachievers before their illness fear they may not be able to continue with their sport once they have a stoma.
In any endurance sport, the body needs to be in peak condition regardless of whether or not you have a stoma.
If a lot of running is involved, rubbing or chafing around the stoma may occur. Little red marks similar to mouth ulcers might appear on the stoma. They should heal quickly and disappear with rest. Double-check the pouching system is not too tight or cuts into the stoma.
If the pouch fits properly and is not too long, it should not touch or rub against the skin. If the red marks don’t resolve, contact your healthcare professional.
Take it easy to start, and gradually build up your strength and fitness before setting more ambitious goals. Your surgery means that initially you will be less fit than you were before.
Dehydration can be a major concern when taking part in sporting activities. Drink plenty of fluids at every opportunity to avoid problems with your stoma, and ensure you understand the signs of dehydration.
"A few years ago, when I was at the beach, I even wore a bikini and the fact I have a colostomy went entirely unnoticed."
"When I first learned I had to undergo a urostomy operation, my first reaction was - will I still be able to ride? If the answer had been no, I'm not sure I would have gone ahead with it. I live for sport and within 3 months of my operation I was back on my horse."
Hydration Keeping as hydrated as possible has been clearly demonstrated in clinical research as being the most effective lifestyle change you can make to decrease ostomy related problems.
Signs of dehydration
Sources of hydration
Water & well diluted squash or cordial
Diluted Fruit Juices & smoothies
Milky Drinks, decaffeinated tea and coffee, coconut water
It is important to be able to recognise when you are dehydrated, to prevent the symptoms and health problems associated with urinary tract infections and constipation.
Drinking plenty of fluids regularly throughout the day (at least 6 - 8 cups a day, 1.8 - 2.4 litres, or 3 – 4 pints) is the key to staying hydrated.
If you are active and/or the weather is particularly hot you should increase your fluid intake.
A parastomal hernia (a hernia around your stoma) is a common complication which can affect some people following stoma formation. Research has shown that as many as 10-50% of patients may go on to develop a hernia.
We understand it is likely your stoma nurse has already spoken to you about hernia prevention, but by clicking the link opposite, you will have access to a great resource written by stoma care nurses in the UK, which will serve as a reminder to you.
If you are worried you may have a parastomal hernia, you should contact your stoma nurse for advice, or click the "Ask a stoma nurse" link within this website, and we will be able to guide you.
The booklet will cover elements such as:
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