Movement is part of recovery from almost every operation. Getting out of bed and walking soon afterwards reduces the risk of blood clots and chest infections, and a gradual return to exercise restores strength. The timetable depends on the operation, and the instructions of the surgical team and physiotherapist take priority over any general guide.
Before the operation
People who are fitter before surgery recover faster and have fewer complications. Hospitals increasingly offer "prehabilitation": advice on activity, diet, stopping smoking and reducing alcohol in the weeks before a planned operation. Even a few weeks of regular walking helps.
The first days
- Patients are usually helped out of bed within a day of the operation.
- Deep breathing exercises clear the lungs.
- Circling the ankles and pumping the feet up and down keep blood moving in the legs.
- Short walks are taken several times a day, a little further each time.
The following weeks
- Walking is the basis of recovery, increased steadily in distance and pace.
- Tiredness is normal and lasts longer than most people expect. Rest is taken when needed, without staying in bed all day.
- Lifting, pushing and pulling are restricted after operations on the abdomen, chest, heart and spine, commonly for six weeks or more, to protect the wound and the tissues beneath it.
- Swimming waits until the wound has fully healed.
- Driving is resumed only when an emergency stop can be made without pain, and the insurer's conditions are checked.
After particular operations
- Hip and knee replacement: a programme of exercises set by the physiotherapist begins on the first day and continues for months. Doing them is the largest factor in the result.
- Abdominal and gynaecological surgery, including hysterectomy and caesarean section: pelvic floor exercises and gentle walking start early; heavy lifting, sit-ups and high-impact exercise wait until the surgeon or physiotherapist agrees.
- Heart surgery and heart attack: patients are offered cardiac rehabilitation, a supervised course of exercise and education.
- Breast surgery: arm and shoulder exercises prevent stiffness and are started as advised by the breast care team.
- Keyhole surgery: recovery is faster, but the internal healing still takes weeks.
Returning to sport and the gym
Exercise is resumed at a low level and built up in stages: walking, then gentle cardiovascular exercise, then light resistance, and finally the previous routine. Pain at the wound, swelling or exhaustion the next day means that the last step was too large. Contact sports and heavy weights come last.
Warning signs
Urgent medical advice is needed for:
- pain, swelling, warmth or redness in a calf, which can indicate a blood clot;
- sudden breathlessness or chest pain, which needs a 999 call;
- a wound that becomes red, hot, swollen or painful, opens, or leaks pus;
- a high temperature;
- heavy or increasing bleeding.
Help with recovery
The hospital's discharge leaflet states what may be done and when. Questions go to the ward, the surgical team, the GP or the physiotherapist. General advice on building up activity is given under avoiding exercise injuries.