How Physical Therapy Helps With Post-Hysterectomy Pain


Have you had a hysterectomy or booked in to have one?

Are you wondering what to expect and how to heal well afterward?

A hysterectomy is the second most common medical procedure for women in the US after the C-Section. Studies reveal that more than 600,000 women undergo this procedure annually across the US. It involves the removal of the cervix and the uterus via surgery.

Most women that opt for hysterectomies are women of the age group of 60 and above. However, lots of younger women also undergo this procedure for many reasons – including endometriosis, cancerous or pre-cancerous cells in or around the womb, or when there is a medical risk of developing cancer in the womb.

After a hysterectomy, doctors recommend that you do not undertake anything strenuous (such as no lifting weights above 10 lbs) and abstain from physical intimacy for a minimum of 6 weeks. These guidelines give the tissues time to heal while ensuring you don’t strain your pelvic floor muscles and rupture the stitches.

A hysterectomy is a big deal – from a physical and a psychological perspective. Significant hormone changes send you off on an emotional rollercoaster and cause a whole host of uncomfortable symptoms, such as vaginal dryness and painful sex, incontinence, and pelvic pain. It’s major abdominal surgery.

You need adequate (almost total) rest directly after the surgery, too, followed by a gradual increase in activity after the period of recuperation recommended by your surgeon.

But don’t worry. There are many helpful things you can do to prevent or minimize the physical symptoms and make sure you have the proper emotional support.

Pelvic Floor Physical Therapy For Your Post-Hysterectomy Pain

How Physical Therapy Helps With Post-Hysterectomy Pain


Pelvic floor physical therapy is beneficial pre- and post-hysterectomy to prevent and treat side effects that may occur because of the surgery, such as lower abdominal pressure, pain, incontinence, or prolapse.

For this type of physical therapy, doctors recommend a specialist Pelvic Floor PT who can help you address all these complaints. And in the case of pre-hysterectomy physical therapy – it potentially allows you to prevent them from happening at all.

After undergoing a hysterectomy, there generally is inflammation and irritation throughout the pelvic region. This inflammation directly impacts the all-important PFM (pelvic floor muscles). They cannot contract or relax properly. They can also become taught as a protective mechanism to protect the inflamed tissues.

Even after the healing process has been completed and the tissues return to their pre-inflammatory state. It’s not unusual for the pelvic floor muscles to remain dysfunctional, leading to chronic issues with urinary stress incontinence or consistent pain in the pelvic region.

But even if it’s decades since you had your hysterectomy, you can resolve these issues with physical therapy.

If you haven’t had your hysterectomy yet. You can prevent these complications from arising and recover quicker with early intervention physical therapy.

Either in preparation before your surgery or as soon as possible after your immediate rest period. We can diagnose issues with your pelvic floor muscles and work with you to correct them before they start causing problems.

The recovery process after a hysterectomy can take a long time. But physical therapy can help you recover your fitness and get back to doing all the things you love quickly.

Knowing you have a specialist Pelvic Floor PT in your corner to support you through the healing process can make everything feel less daunting.

So, if planning a hysterectomy, we recommend consulting a professional physical therapist to create a customized program for you before and after the procedure.

What Is A Hysterectomy?

How Physical Therapy Helps With Post-Hysterectomy Pain


The word “hysterectomy” describes the medical removal of the uterus or “womb.” In some cases, the operation removes the uterus in isolation, but in other cases, the surgeon may suggest removing additional parts of the female reproductive system at the same time.

The exact procedure depends on your specific situation and medical symptoms, as dictated by healthcare professionals.

But you are likely to undergo one of these types of hysterectomy:

Subtotal hysterectomy: In this procedure, only the uterus is removed. Your cervix remains in situ.

Laparoscopic hysterectomy: During this procedure, the surgeon makes tiny cuts or incisions to insert a miniature camera into your abdomen to view the inside of your pelvic region. They then remove your uterus via the vagina. This type of hysterectomy is minimally invasive, thanks to keyhole surgery. Also, recovery is usually quicker than an abdominal hysterectomy.

Radical or Wertheim’s hysterectomy: This radical procedure involves removing a part of the vagina, the cervix, fallopian tubes, and uterus. This type of hysterectomy is usually only performed in the event of cancerous cells being present to prevent the disease from spreading to other parts of the body.

Vaginal hysterectomy: If you have a vaginal hysterectomy, your surgeon will remove your cervix and uterus via the vagina.

Total abdominal hysterectomy: Although this procedure is described as “Total.” Unlike a radical hysterectomy, when all the female reproductive system organs are removed, a total hysterectomy is limited to the uterus and the cervix.

Hysterectomy: The Benefits of Pre-and Post-Surgical PT

How Physical Therapy Helps With Post-Hysterectomy Pain


If you value your health, it’s a great idea to have physical therapy before your hysterectomy. This proactive approach allows you to start working on strengthening your pelvic muscles before the surgery and on staying active and mobile, too, to make sure you’re as fit and healthy.

So, before surgery, we recommend a combination of the following:

  • Specialized Pelvic Floor PT and exercises to strengthen the pelvic floor
  • Resistance exercises to strengthen the upper and lower body
  • Cardiovascular activities like cycling and walking
  • Hydrotherapy
  • Exercises for the transverse abdominals

After your hysterectomy surgery and the immediate rest period, you may experience the following symptoms:

  • Inflammation and swelling in the pelvic region
  • Diminished cardiovascular fitness and strength
  • Pelvic pain
  • Desensitization of the surgical area due to nerve involvement (temporary)
  • Bruising
  • Scar tissue

Everyone is different, however, so you may have completely different symptoms to the ones listed above. Still, these are the most common complaints women report after hysterectomy surgery.

Physical Therapy After Hysterectomy

How Physical Therapy Helps With Post-Hysterectomy Pain

After your surgery, you may remain in the hospital for 4-7 days, subject to the type of procedure you opt for and the recommended recovery period. Once discharged, however, it is beneficial to contact a specialized Pelvic Floor PT to begin therapy at the earliest possible point, as advised by your doctor.

Week 1 after your hysterectomy

Every woman is different – and your specific set of symptoms after surgery is likely to be different. But the following might be part of your physical therapy treatment in the first week after your immediate recovery period:

  • Gentle strengthening exercises for the transverse abdominals
  • Pain control treatment
  • Pelvic Floor exercises to strengthen the muscles
  • A range of movement exercises to strengthen the legs
  • Elevation exercises
  • Recommendations about the most appropriate sitting and standing positions to minimize pain and symptoms
  • Advice on scar management
  • Basic mobility exercises to prevent muscle stiffness

Weeks 2-6 after your hysterectomy

By this point, there should be a noticeable decrease in your symptoms. You should also notice that you can slowly return to your daily routine – with some thoughtful modifications.

During this time, your physical therapy treatment schedule might look something like this:

  • Increasing the strengthening exercises
  • An increase in traverse abdominal exercise movements
  • Steadily increasing pelvic floor exercises in different positions
  • Expanding the range of movement to strengthen the upper body
  • Adding functional activities over time

Approximately six weeks after your hysterectomy – with effective physical therapy – you should be able to resume all your regular activities with no or minimal pain.

By the seventh week, it should be easier to carry moderate weights without any pain. However, it is recommended that you don’t lift heavy weights or indulge in strenuous activity for six months after the surgery.

We also give you exercises to do at home to further aid the healing process and speed up your recovery.

At LEVEL4 PT & Wellness, we specialize in women’s health and post-hysterectomy physical therapy. We’re here to support you pre- and post-surgery and to help you heal well naturally.

We help you regain strength in your pelvic floor muscles and reduce pelvic and abdominal pain. We also help you with the things nobody talks about. Like – regaining bowel and bladder control, prolapse, urinary stress incontinence, lack of libido, and feeling confident again during intimacy.

We help you get your life (your relationship and your sex life) back.

We don’t just tell you to do 100 Kegels!

To book a free consult about your post-hysterectomy pain or in preparation for your hysterectomy surgery, please complete the form to request an appointment with our women’s health specialist. We answer all your questions and put your mind at ease, ready for your surgery.

We also help you put a supportive plan in place for after your surgery and the lengthy recovery period to follow. And don’t forget, this situation is nothing to feel embarrassed about. We are here to help you, and understand the condition you are currently going through.

Reach out to us at any time. We’ll help get you back to health.

Dawn Andalon, DPT, MTC, CPI

You Might Also Like...