Physio for Hysterectomy
A hysterectomy, a surgical procedure to remove the uterus, is a major surgery, from a physical and often an emotional perspective. Whether it’s for treating conditions like fibroids, endometriosis, or cancer, understanding the importance of comprehensive post-operative care can make all the difference in your recovery and overall well-being. One critical component of this care is consulting with a women's health physiotherapist both before and after the surgery. Here’s why.
What is a Hysterectomy?
A hysterectomy involves the removal of the uterus and sometimes additional reproductive organs. There are several types of hysterectomies, each varying in scope:
Total Hysterectomy: Removal of the uterus and cervix.
Partial (or Subtotal) Hysterectomy: Removal of the uterus, but the cervix is left intact.
Radical Hysterectomy: Removal of the uterus, cervix, and the surrounding tissues, including the top part of the vagina and often the ovaries.
Impact on the Pelvic Floor and Hormones
After a hysterectomy, the body undergoes significant changes, especially in the pelvic region and hormonal balance:
Pelvic Floor Health: The pelvic floor muscles, which support the pelvic organs and help control bladder and bowel functions, can sometimes be impacted after this surgical procedure. Knowing how to contract and relax your pelvic floor prior to the procedure and help with early pelvic floor rehab following surgery.
Hormonal Changes: If the ovaries are removed during the hysterectomy, it results in an abrupt change in hormone levels, which can lead to symptoms of menopause like hot flashes, mood swings, and vaginal dryness. Even if the ovaries are left intact, hormonal fluctuations can still occur due to changes in the pelvic anatomy and blood supply. Estrogen is found in almost every cell in the human body. The estrogen receptors in the vagina help to lubricant the vagina, it also allows our bladder to expand smoothly and helps vascularise the external urethral sphincter (a muscle which helps us hold onto wee). Depending on the cause for hysterectomy we would recommend discussing local vaginal HRT to help mitigate this abrupt change in hormones and prevent the onset of pelvic floor symptoms.
The Role of a Women’s Health Physiotherapist
A women’s health physiotherapist specializes in managing the physical aspects of women’s health, particularly the pelvic floor. Here's why seeing one before and after your hysterectomy is beneficial:
Pre-Surgery Preparation:
Education: Learn about the impact of the surgery on your pelvic floor and overall body mechanics. We also want to optimise any bladder or bowel concerns you have prior to surgery. Especially if you are someone who suffers constipation! Our pelvic floor can be vulnerable after surgery and we want to minimise any additional pressure downwards. Addressing constipation prior to surgery can help to prevent pelvic floor changes post-surgery.
Strengthening Exercises: Pre-surgery exercises can help strengthen your pelvic floor and core muscles, which may aid in a smoother recovery.
Post-Surgery Rehabilitation:
Pelvic Floor Assessment: A physiotherapist can evaluate the condition of your pelvic floor muscles, helping identify any weaknesses or issues that need addressing.
Personalised Exercise Program: We can work together to develop a graduated return-to-exercise plan depending on your goals. This program will focus on gradually reintroducing physical activity in a safe manner, minimising strain on your healing tissues and supporting your recovery.
Pain Management: Techniques such as manual therapy, soft tissue massage, and tailored exercises can help manage pain and improve mobility.
Long-Term Health Maintenance:
Ongoing Support: Regular check-ins with a physiotherapist can ensure that any new or ongoing issues are addressed promptly.
Education on Self-Care: Learn about pelvic floor exercises, posture, and body mechanics that support long-term health and prevent future issues.
The Need for a Graduated Return to Exercise
Returning to exercise after a hysterectomy requires careful consideration. Here’s why a graduated approach is essential:
Healing Process: Post-surgery, your body needs time to heal. Gradually increasing your activity level helps prevent complications and supports tissue recovery.
Avoiding Strain: Sudden or intense exercise can put undue stress on the healing pelvic floor and abdominal muscles. A physiotherapist is trained to provide gradual return to exercise.
Customized Approach: Every woman’s recovery journey is unique. A physiotherapist can tailor your exercise plan to your specific needs, ensuring that you progress at a safe and effective pace.
A hysterectomy is a significant surgery with profound effects on your body. We believe checking in with a pelvic health physiotherapist before and after surgery can be invaluable in healing after following hysterectomy.
