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Movement & recovery

Exercises for ostomates, in two groups

A programme designed for people who have had ileostomy, colostomy, urostomy or pouch surgery — with one exercise pouch patients are told to skip.

3 min read1 source

This programme opens with a warning rather than an exercise: do not follow it without first consulting your doctor. If you are in any doubt, seek the advice of a state-registered physiotherapist, your GP or consultant — and if you cannot reach any of them, your stoma care nurse can refer you.

How to progress

  • Add more movements every few days — start with about 4, but do not go beyond 10.
  • Start by doing the exercises twice a day, then increase the number of sessions.
  • Build the “holding” part of each exercise up to a maximum of 7 seconds.

Group 1 — lying down

On the bed or floor, a pillow under your head if needed, knees bent up. Flatten your lower back onto the bed, hold for a slow count of 3, relax — then progress by raising your head and shoulders, holding, relaxing. From there, take one hand across to touch the opposite knee, hold, relax, and repeat to the other side.

Then: with one knee bent, shorten the straight leg by hitching the hip up towards your shoulder, then slide it towards the foot of the bed, keeping the weight of the leg on the bed throughout. Repeat 5 more times, then change legs. Lift your bottom as high as you can, hold for a count of 3, lower. And on hands and knees, keep your back flat while you pull your tummy up towards your spine, count 3, then let go slowly — progressing by gently rocking forward and backward, back still flat.

Group 2 — standing

These are for the busy person, as a progression after you get home, or for anyone with a low back problem. Stand leaning against a wall with your heels at least 12 inches (30.5cm) away and your hands tucked behind your lower back; press that part of your back against your hands onto the wall. Hold at least 5 seconds, relax, and do this 1 to 5 times. With no wall handy, simply tuck your bottom in and hold for 3 to 5 seconds — you will feel the bottom of your tummy move up towards your ribs.

The general advice that goes with it

  • Sit with your lumbar spine supported — a small cushion or rolled towel will do.
  • Develop a “roll out of bed” habit. It protects your back as well as your tummy muscles.
  • Walking is the best exercise for maintenance of general fitness.
  • When you can, swim or do exercises in water.
  • For lower back ache: arch your back above your hands 7 times, after sitting a long time, gardening, heavy housework or long car journeys.
  • Lifting heavy objects should not be attempted for three months after surgery.

Where this came from

  • Consult your doctor first; progression by 4 to 10 movements, twice a day, holding up to 7 seconds; the Group 1 lying exercises; the pelvic floor exercise from 3 days after surgery and the instruction that internal pouch patients avoid it unless their consultant recommends it; the Group 2 standing exercises; lumbar support, roll out of bed, walking, swimming, the back arch, and no heavy lifting for three months.

    IA (Ileostomy & Internal Pouch Association), “Exercises for Ostomates”, 2018

Before you change anything

These posts are readings of published patient information, and every one links to the sources it came from. They are general information, not medical advice, and they cannot account for your own diagnosis, surgery or treatment. Anything you plan to change — what you eat, how you manage your bowel, your medication, your activity, your stoma or pouch care — is a conversation to have with your IBD team or stoma care nurse.