by Sue Croft Physiotherapist
Adapted from author’s blog first published Feb 11, 2014 at SueCroftPhysiotherapy.com.au
Physiotherapists who specialise in women’s health often collaborate to share knowledge and support each other’s clinical practice. Online communities such as the #pelvicmafia network provide an avenue for these professionals to exchange advice, particularly regarding complex pelvic floor conditions and post-surgical rehabilitation.
One common area of discussion relates to the safe return to daily activities, exercise, and sport following vaginal reconstruction or gynaecological repair surgery. To address this need, experienced physiotherapist Sue Croft authored Pelvic Floor Recovery: A Physiotherapy Guide for Gynaecological Repair Surgery. The guide offers practical, evidence-informed advice for both clinicians and patients, helping to optimise recovery and long-term outcomes after surgery.
Understanding the Importance of Post-Surgical Rehabilitation
Vaginal repair surgery is a significant procedure, and the body requires time to heal effectively. A helpful analogy compares the process to rehabilitation following a sports injury. For instance, when an athlete undergoes an anterior cruciate ligament (ACL) reconstruction, extensive rehabilitation is essential before returning to full activity. Similarly, for women who have undergone major gynaecological repair surgery, gradual and structured recovery is vital to protect surgical outcomes and reduce the risk of recurrence.
Daily activities—such as lifting, bending, or housework—can place substantial pressure on the pelvic floor. Scar tissue that supports the surgical repair continues to strengthen for up to 12 weeks post-operation. For this reason, a slow and steady approach to recovery is recommended.
General Post-Surgery Guidelines
The following general guidelines are consistent with physiotherapy recommendations for post-operative pelvic floor recovery. Individual advice should always be sought from the treating surgeon and physiotherapist:
- Pelvic floor muscle training: Begin around six weeks post-operation, unless otherwise advised by the surgeon.
- Early protection: From immediately post-operation, gently engage the lower abdominal (transversus abdominis) and pelvic floor muscles before any increase in abdominal pressure—such as when coughing, sneezing, or bending.
- Movement technique: Use the log-roll method when getting in and out of bed and continue this long-term to minimise strain.
- Lifting and bending: Avoid repetitive bending and heavy lifting. In the early stages, limit loads to no more than two litres of milk per hand, and avoid lifting more than 15 kilograms permanently.
- Walking: Begin with short, comfortable walks once soreness has eased. Gradually increase distance only if there is no heaviness or dragging sensation the following day.
- Household chores: Delay tasks such as vacuuming or cleaning bathrooms until at least six weeks post-operation. If possible, organise assistance for up to 12 weeks.
- Bowel care: Maintain healthy bowel habits and avoid straining, as this can compromise surgical repairs.
Promoting Confident Recovery
Sue Croft’s book provides clear information about bladder, bowel, and prolapse management, as well as strategies for safe physical activity and effective post-operative care. It is designed to empower women with the knowledge needed to understand their surgery, protect their pelvic floor, and rebuild confidence in their recovery.
Pelvic Floor Recovery: A Physiotherapy Guide for Gynaecological Repair Surgery is available for purchase from www.pelvicfloorrecovery.com and selected bookstores.
