Abdominal with Core 4

1. Tummy Tightening Breathing 2. Pelvic Tilt

When to start When to start This exercise can be started within days of surgery. Provided all This exercise can also be done just days after surgery. Just start is well, you can even start while you are still in hospital, and your very gently and work within a small pain free range. recovery is progressing normally. How to do it How to do it Lie on your back, with your head supported by a pillow and Lie on your back, with your head supported by a pillow and your knees bent as far as is comfortable. Very gently rock your your knees bent as far as is comfortable. Simply take a deep pelvis upwards and flatten your back into the bed or floor. You breath in and slowly exhale through your mouth. should feel your tummy and bottom muscles tighten a little. As you exhale, gently tighten up the deep muscles in your lower Rock back to your starting position and repeat. Initially just tummy. You should feel a very gentle ‘tightening’. Don not try aim for a 5 repetitions, and go very gently. to lift your bottom or press your back into the bed. Just hold this ‘brace’ feeling for a count of 3-5 seconds, and then release. As you progress, allow your back to arch up a little more, and Breathe and relax and then repeat 3-5 times. tighten your tummy more strongly as you push your back into the floor. Build up towards 20 reps. As you progress, you can do the exercise on the floor without a pillow and aim for a ‘stronger’ tightening feeling. Hold the ‘brace’ Try to do this 2 or 3 times per day. for a count of 10-15 and breathe deeply in and out 2 or 3 times. Repeat up to 5 times. Place your hands on your tummy so you can check and feel the muscles tightening.

Try1 to do this 2 or 3 times per day. 1 2 2

Tummy Tightening This exercise can be started within days of surgery, even if Tummy TighteningPelvic Tilt This exercise can beThis started exercise within can days also of be surgery, done just even days if after surgery. Just start Pelvic Tilt This exercise can also be done just days after surgery. Just start you’re still in hospital, provided all is well and your recovery is very gently and work within a small pain free range. Breathing Breathing you’re still in hospital, provided all is well and your recovery is very gently and work within a small pain free range. progressing normally. progressing normally. Lie on your back, with your head supported by a pillow and Lie on your back, with your head supported by a pillow and Lie on your back, with your head supported by a pillow and your Lie on your back, withyour your knees head bent supported as far as by is acomfortable. pillow and your Very gently rock your your knees bent as far as is comfortable. Very gently rock your knees bent as far as is comfortable. Simply take a deep breath in knees bent as far aspelvis is comfortable. upwards and Simply flatten take your a deep back breath into the in bed or floor. pelvis upwards and flatten your back into the bed or floor. and slowly exhale through your mouth and slowly exhale throughYou should your feelmouth your tummy and bottom muscles tighten a little. You should feel your tummy and bottom muscles tighten a little. Rock back to your starting position and repeat. Initially just aim Rock back to your starting position and repeat. Initially just aim As you exhale, gently tighten up the deep muscles in your lower As you exhale, gently tighten up the deep muscles in your lower for a 5 repetitions, and go very gently. for a 5 repetitions, and go very gently. tummy. You should feel a very gentle ‘tightening’. Don’t try to tummy. You should feel a very gentle ‘tightening’. Don’t try to lift your bottom or press your back into the bed. Just hold this lift your bottom or pressAs you your progress, back into allow the yourbed. back Just tohold arch this up a little more, As you progress, allow your back to arch up a little more, 3. Lift/‘brace’ feeling for a count of 3-5 seconds, and then release. ‘brace’ feeling for a andcount tighten of 3-5 your seconds, tummy and more then strongly release. as you push your back 4. Kneeand Rolls tighten your tummy more strongly as you push your back Breathe and relax and then repeat 3-5 times. Breathe and relax andinto then the floor.repeat 3-5 times. into the floor.

As you progress, you can do the exercise on the floor without a As you progress, youBuild can up do towards the exercise 20 reps. on the floor without a Build up towards 20 reps. pillow and aim for a ‘stronger’ tightening feeling. Hold the ‘brace’ pillow and aim for a ‘stronger’ tightening feeling. Hold the ‘brace’ for a count of 10-15 and breathe deeply in and out 2 or 3 times. for a count of 10-15 and breathe deeply in and out 2 or 3 times. When to startRepeat up to 5 times. Place your hands on your tummy so you Repeat up to 5 times. Place your hands on your tummy so you When to start Introduce thiscan check exercise and feel the muscles 7-10 tightening. days after surgery andcan checkinitially and feel the muscles tightening. Introduce this exercise 7-10 days after surgery. Always work make sure you do it very gently and with a small movement, within a pain free range and keep the movement very small Try to do this 2 or 3 times per day. Try to do this 2 or 3 times per day. only going as high as feels comfortable. Try to do this 2 or 3 times per day. to begin with. Try to do this 2 or 3 times per day.

How to do it How to do it Lie on your back, with your head supported by a pillow Lie on your back, with your head supported by a pillow and and your knees bent as far as is comfortable. your knees bent as far as is comfortable. Arms out to the sides. Keep your knees and ankles together and gently let your knees Very gently tilt your pelvis backwards and tighten your begin to drop over to one side. Only go as far as is comfortable, pelvic floor muscles. Lift your bottom off the bed/floor and then carefully tighten your tummy muscles and roll your knees slowly lift up vertebrae by vertebrae until your bottom is over to the other side. Try to keep your shoulders down and off the bed. Lift your bottom as high as you comfortably your head relaxed, looking up with your eyes. Aim for 5 rolls. can. Hold this for a moment, then slowly lower your spine and pelvis back down. Imagine you’re lifting a string of As time goes on, you can increase the range so your pearls off the floor and back down again. knees drop lower and build up to 20 repetitions.

Repeat 3-5 times initially building up to 10-15 repetitions Do this 2-3 times per day. in time and lifting higher as you feel more comfortable. 3 3 4 4 Note! If you have any concerns about whether or not you should do the , talk to your ostomy care nurse or surgeon before you start. Try to do this 2 or 3 times per day.

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