Your natural corset

The word that runs through this whole subject is “corset”, and it needs defining so it is not misread. A corset is “a tight-fitting bodice to shape and support the body”. Nobody is talking about a garment. It means your own natural anatomical corset: the relationship of your abdomen to your spine. The exercise programme below was produced with physiotherapist input and with Per Herlufsen of the gastrointestinal unit at Hvidovre Hospital, Copenhagen.

Why the stoma changes the picture

The abdominal wall extends from the base of the chest to the top of the hip-bone. Under the skin there is fatty tissue, connective tissue and the superficial abdominal muscles, which form its framework. There are three places that framework is weakest: the umbilicus, surgical scars, and where the stoma is formed.

Everyone has a muscular corset around the spine — a functional working unit that shapes and supports the body, and one that can and should be exercised. Every movement you make affects the abdominal and back muscles; even the small movement of an arm can be measured in them.

Start before surgery if you can

The strongest piece of scheduling advice is the one easiest to miss: the earlier you start the exercises the better, and you should make yourself familiar with them prior to surgery. Doing so helps you gain control of your body core post-operatively, promoting healing and quicker recovery.

And it sets the bar for “exercise” low enough to actually clear. Walking is a good place to start — and even walking to the end of the hall or around the house is enough in the beginning. When you return home after surgery you will feel exhausted, and the thought of climbing the stairs can feel like conquering Mount Everest.

• Think about whether you prefer to exercise alone or with others, inside or outside, and at what time of day.
• If you feel like quitting, remind yourself of the reasons you started.
• Do not push too hard — you should be able to talk during exercise.

The core is not only muscle

One idea in all this does something the rest does not. The abdominal area together with the spine is “the core of the body” — a place related to feelings, strength, power, security and self-confidence. And the abdominal muscles, which the stoma penetrates, are part of that core.

It is the closest anyone comes to saying why abdominal work after stoma surgery feels like more than physiotherapy — and it is not overclaimed from there: exercise and training lead to better posture and increased body awareness.

What is still open to you

The expectation is set early and broadly: living with a stoma should not prevent you from exercising or being physically active. Other than extremely rough contact sports or very heavy lifting, you should be able to enjoy the same type of physical activities you enjoyed before — swimming, skiing, golf, tennis, aerobics, pilates, rowing, whichever is your favourite. Recovery can take up to six to eight weeks, and once past it, whatever you enjoyed before you should be able to do again.