Gynaecology Enhanced Recovery After Surgery (GERAS) is a UK wide patient-centred care pathway. The aim of GERAS is to improve patient recovery while ensuring a high standard of patient care.
This exercise is helpful if you have mucus to clear from your chest after surgery. It may also help you relax, relieve nausea and move any trapped wind.
This breathing technique will also help to clear any mucus.
You will not harm your stitches or scar when you cough. You will feel much more comfortable and able to cough if you support your stitches with your hands, a folded up towel or a pillow. If your surgery is through the vagina place your hand firmly over your sanitary pad.
When in hospital, we will probably ask you to wear TED stockings. These stockings are special support stockings to reduce the risk of blood clots. However, you should also do the following exercises to help maintain blood flow in your veins and help prevent blood clots developing.
As part of the ERAS pathway, we encourage early mobilisation. However, depending on the type of surgery you've had and your Consultant's post-operative recommendations, the time in which you mobilise from your bed may vary person to person.
Benefits of Early Mobilisation
To turn onto your side from lying on your back
To get out of bed
To get into bed
Stand with the back of the knees against the bed
Good posture will help prevent backache. You will feel better if you stand tall.
The ideal position for emptying your bowels is shown in the diagram.
It is important to exercise your abdominal muscles following your surgery. They form a natural corset and help to support your back and internal organs. The following exercise can also help to relieve wind and backache both of which are often felt after abdominal surgery.
As you feel more comfortable increase the amount of walking you do about the ward and take the opportunity to get as much rest as you can. Remember recovery from surgery varies with every individual. Listen to your body.
Your stay in hospital will vary depending on the type of surgery you have had. Even when your wound heals, healing continues in the deeper tissues. Take advantage of any help offered.
You may be more comfortable if a towel, folded into a pad is placed across your abdomen.
When getting into the car
Returning to driving will depend on the type of surgery you have had, advice from your surgeon, your recovery and your comfort. It can take as long as six weeks following major abdominal surgery before you feel able to drive.
Make sure that you:
For the first six weeks after major abdominal surgery you should only lift light loads such as one litre bottle of water (1.1 kg). You can gradually increase this to three litres by 12 weeks after your surgery.
Always remember to bend your knees, pull in your deep abdominal muscles and draw in your pelvic floor muscles as you lift, this can help protect your back.
Try common daily activities in sitting instead of standing, such as preparing vegetables.
For the first six weeks try to take a rest every afternoon lying on your bed for a least an hour.
You will probably have had a six week postoperative check. You may feel able to return gradually to both work and previous activities. We advise you to check with your surgeon if you are unsure.
Returning to Work
You may feel ready to return if your job is not physically demanding or is part time. If your job involves heavy lifting, returning to work will take longer, 10-12 weeks depending on how physically demanding it is. Your employer may offer you a phased return to work.
Whatever your workplace, good posture is important at all times and correct lifting habits must be remembered for life in order to protect your back.
The time when you resume sexual activity will depend upon the type and extent of your surgery and how you feel but it is usually around six weeks. Before you leave hospital you will need to ask your surgeon when you can resume full intercourse.
You may be able to start swimming after your six week postoperative check as long as your scar has healed and any vaginal bleeding or discharge has stopped.
You may be able to start low impact exercise and controlled stretches after your six week postoperative check as long as your scar has healed. You should gradually resume your preferred exercise. However, you should avoid competitive sports and high impact exercise for 12 weeks. Please contact our physiotherapy department for individual advice.
For further advice please refer to
Reproduced with permission of Pelvic Obstetric and Gynaecological Physiotherapy (pogp.csp.org.uk)