Conditioning and rebuilding pelvic floor strength is critical after having a hysterectomy. Women who neglect this step may suffer from loss of bladder control, decrease in sexual satisfaction and poor abdominal strength. Pelvic floor exercises can typically be done beginning two to three days post-surgery; however, you should check with your physician for clearance in order to prevent any complications.
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The Kegel exercise is effective for starting to work on the pelvic floor, and is also the base for several other more progressive exercises. You can perform a Kegel anywhere once you understand how it feels, and many physicians will recommend doing Kegels every time you are at a stoplight in your car, waiting for an appointment, or watching TV. When you first attempt Kegels, it is easiest to sit on a stability ball, which is a large inflated ball. Start by sitting on the ball with good posture, your feet shoulder distance apart. Take an inhale breath, and as you exhale draw your pelvic floor upward, as if pulling away from the ball. This should feel the same as when you have to stop mid-stream when urinating, or when you have to hold your urine until you get to a toilet. You should not feel your buttocks contract, it should feel more "internal" versus "external". Initially hold your Kegel for as long as your exhale breath, and work toward holding each Kegel for 15 to 30 seconds.
For heel taps, you will need to lie on your back with your knees bent and your feet hip distance apart on the floor. You should have a small amount of space underneath your lower back, and you should try to relax your shoulders down away from your ears, your arms resting at your sides. Take an inhale breath, then as you exhale perform a Kegel as you draw your abdominals down toward your spine. With these two movements, let your lower back gently touch down into the floor, but do not contract your buttocks. Next, pick your legs up one at a time until both knees are bent and aligned over your hips. With another exhale breath, re-engage your Kegel as you tap your right heel down to the ground and lift it back up, then repeat with the left side. Do ten alternating heel taps, focusing on your lower back staying down on the floor and performing a Kegel each time you start to move your leg.
The ball squeeze exercise can be performed lying on your back with knees bent, or sitting upright in a chair. Whichever position your choose, the mechanics of the exercise are the same. Place a small playground ball between your thighs, just above your knees. Inhale to prepare, and as you exhale perform your Kegel as you squeeze your legs into the ball and pull your abdominals in. Try to make your exhale breath long, and hold the ball squeeze for the entire exhale phase. Squeezing into the ball helps the pelvic floor and the deep abdominal muscles contract, and they contract more strongly together than when you try to isolate just one. Repeat this exercise 15 to 20 times per set.