What I’ve Learned About Fitness After Hysterectomy (and Other Major Surgeries)

It’s been about 2 years since my hysterectomy. And in a lot of ways, I’m “back to my old self.” Most of the time, in most ways, I’m now able to do pretty much whatever I want to do in the gym. However, I’ve learned a lot from the ups and downs along the way, and since there is still an unacceptable dearth of information for folks looking to reinstate their fitness pursuits after such a major life change, I feel responsible to share my experiences in hopes of giving other folks some context as they figure out what is best for themselves. That is why I shared my posts from earlier in my recovery (6 weeks, on returning to lifting at 10 weeks, and later returning to running). Now, two years later, in this final post on the subject (at least for a long while!) I want to share my take-aways from the full process of recovery.

Lesson one: Medicine is as much art as science, and we are each a case study of one. I’ve learned and relearned this lesson over and over again. The most evidence-based practitioners are still working from averages and likelihoods, and we all must do our best to evaluate in the moment what seems to be the best for each individual and their unique circumstances. Unfortunately, this puts the onus on ourselves collecting and interpreting the information our bodies are giving us to know where our boundaries are. We can get advice from health practitioners on what is likely, but they will not know what is exactly right for us until we try things out.

My doctor didn’t want me doing anything for the first 2 weeks of healing other than light activities around the house. During this time, I don’t think that advice would be different for anyone. However, once healing was properly underway, things get murkier, and what one person would find too challenging might be just fine for another. This is where our personal data collection starts to be relevant. We also need to make reasonable guesses based on the lives we lived before our hysterectomies. For example, if you are generally strong and athletic, what activities are a strain for you will be different than if you have limited strength.

Lesson two: Pain is information our body is sending us, but it doesn’t always mean we’re doing something wrong or bad. Current pain science, as I understand it, has decoupled pain from injury. We can experience pain without being injured and we can have physical changes that do not result in pain.

About six weeks into healing from my hysterectomy, I experienced severe pain in the right side of my abdomen–a tearing sensation that became extreme with each inhaled breath. When I asked my doctor about it, she chalked it up to “scar tissue disease” and suggested that what I needed was more movement to prevent future scar tissue from holding me back. This required me to reframe my experience of the pain from something that required rest and protection to something that told me I needed more diverse movement experiences (more twisting and bending, in particular). If you have learned that pain means you are hurting yourself and it must always be avoided, this is a pretty big shift in perspective! However, I was grateful that my doctor empowered me to keep moving, as I now experience very little discomfort that I associate with the surgery.

Lesson three: It costs energy to heal; feed yourself. If you have been pursuing physique goals for a long time and now have been prescribed a period of reduced activity, it is very tempting to eat less. However, repairing tissues after surgery takes energy. It is common to be exhausted when all you’ve done is sit around healing all day!

I chose to keep my energy intake about the same in the months after my surgery, and it did not result in any significant change in my body size. It is reasonable to expect some changes, and some of those changes may be temporary and some may not be. The solution to this is not to cut back on food while we’re healing but to reframe our experiences of our bodies. To help me feel like I was taking care of myself, I made sure to keep my protein levels high, eating at least 30g (a palm-sized portion) at each of my 4 meals a day. I also emphasized fresh produce high in Vitamin C, as Vitamin C may be helpful with tissue healing and repair–berries, citrus, and bell peppers were my go-tos. By focusing on my self-care in the moment, I was able to be patient with the process and put myself in the best possible position to recover and get back quickly to the life I wanted to live.

Lesson four: Speaking of practicing patience, respect your energetic boundaries. I’m usually pretty good about this, but there were days when I felt really impatient with the recovery process and just wanted to be back. But anytime I went too far on a walk or a jog or pushed too hard with my lifts, I got the immediate feedback from my body that I was being overly aggressive. In general, I like to workout just under my threshold. I imagine my energetic and physical limitations like a rubber band that I’m gently pressing against, feeling it get tighter but not risking the breaking point. It takes practice to determine what “just enough” feels like, and while we’re healing, it can vary from day to day and week to week.

Lesson five: As long as we practice having a flexible mindset and avoid dichotomous (all-or-nothing) thinking, there are always ways to train around an injury. This one is huge for me. In addition to my hysterectomy, I’ve had six other surgeries that have required general anesthesia. Each surgery involved changes to my physiology, long periods of healing and recovery, and learning new ways to train. At this point, I’ve become a master in working around my personal limitations. Can’t squat? How about single leg work! Need to keep training to 30 minutes or less? Program circuits or use mobility fillers to maximize progress! As I commented on this post about returning to running, I think those of us who lift are lucky that we have so many options! But it does require us to believe it is still worth training even when we need to hold back, switch things out, or cut it short.

If you are healing after a hysterectomy(or another major surgery for that matter) and want to return to your fitness pursuits, I want to offer you the reassurance that there are ways to do it safely and with limited setbacks. Find a way to consistently do something, listen to your body, if you’re lucky enough to have access to a physiotherapist or trainer who can guide your recovery, set an appointment and make a plan together. I get really frustrated when I think about how common hysterectomies are and how little evidence-based information is available for us to healthfully live our lives afterwards. I am grateful we no longer live in a world where it is recommended that we never push our bodies hard again, but there is still so much work to be done to give us equitable access to information so that we can live our best lives.

Hey, you made it this far, how about taking a moment to find and follow Progressive Strength on Facebook! Or better yet, skip the evil middleman and follow me directly by entering your email here. (No spam, I promise!)

Are you working to return to fitness activities after having a hysterectomy or another major surgery? What have you learned about yourself as you heal? I’d love to hear from you! (Here is our comment policy.)

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