Hysterectomy is an operation to remove a woman’s uterus, the muscular organ where the fetus resides during pregnancy. It may be performed laparoscopically, vaginally or abdominally. In any event, the surgeon will probably have to cut through the stomach muscles and fibrous bands in the abdominal wall.
Unfortunately, this can cause weakness in the abdominal wall, resulting in a loss of muscle tone that causes the stomach to pooch out. However, once your doctor gives you the green light to start working out again, it’s possible to get that abdominal tone back with exercise. It’s not just a matter of looks, either. Toning your stomach muscles after hysterectomy also lowers your risk of hernia.
It's important not to stress your stomach muscle too soon after surgery. The Ohio State University Medical Center recommends these exercises to restore abdominal strength and improve posture.
1. Chin Tuck
In a seated position, drop your arms to your sides. Face straight forward and tuck your chin back into your neck as if you’re trying to make a double chin. Hold the position for 5 to 10 seconds. Let go and repeat.
The following exercises are done lying prone. Begin the exercises with your knees extended up and your feet flat on the floor or bed.
2. Pelvic Tilt
Rest hands on your stomach or rest one hand on your stomach and slide the other under your lower back. Gently tighten stomach and buttock muscles, contracting your lower back so that you feel your pelvis tilt backwards. Hold for five seconds. Relax and repeat.
3. Head Sit-Up
Cross your arms over your stomach. Use your hands as a reminder to keep your abdominals engaged. You can even give your midsection a slight squeeze with your hands. Inhale deeply. As you breathe out, raise your head and try to touch your chin to your chest. Hold for three to five seconds and then gradually lower your head to floor. Relax and repeat.
4. Pelvic Floor or Kegel Exercise
Inhale deeply and squeeze the muscles around your vagina as if you’re stopping urine flow. Hold for five seconds. Relax and repeat. Do this exercise four of five times a day for optimal results.
Easy Does It
Depending on how the surgery was done, it may take two to six weeks of recovery before you're ready for more strenuous exercise. When your doctor approves you for it, "toning your abs after a hysterectomy is the same as toning them under normal circumstances, except that you’re working around scar tissue,” says David Knox, author of Body School: A New Guide to Improved Movement in Daily Life.
“The important thing is not to get over-anxious,” Knox says. That means sit-ups, crunches and especially leg-lefts to tighten up the lower belly, says Knox. “You can get tone back, and also regain sensitivity in the places where you might be experiencing some neural numbness from the incision.”
Knox recommends emphasizing form and checking posture when exercising. “Is your spine long? Is the area being supported? Is it properly aligned? Think carefully about each part of the movement and assess to make sure it’s okay. As you continue to train, you’ll have more insight.”
It's also important not to get too obsessed with your abs to the exclusion of the rest of your core. Strengthening the muscles that stabilize the spin, pelvis, rib cage and hips is essential for your overall form, including ab support. It will also help provide definition for superficial core muscles. Planks, cat-cow and supine pelvic tilts all assist in strengthening the core.
Diet and Weight Loss
Of course, part of acquiring a flat stomach is getting rid of excess belly fat. Exercise will only take you so far. There are seemingly as many diets as there are people who want lose weight.
Choose a diet that suits your preferences and lifestyle, preferably with the help of a qualified nutritionist. However, there is evidence that lowering carbohydrates does help reduce belly fat. In a study in the January, 2015 Journal of Nutrition, people who moderately lowered their carbs saw significant reductions in belly fat.