Pilates with an Ostomy and Hernia: Seeking Advice

Hi everyone,

Love the help I get here! Thanks to you, I can now irrigate, though I am not doing it every day... but I can when something is coming up that I want to be sure I have no output.

My question today is about Pilates. I don't mean just a Pilates class at your local gym. But rather going to a proper Pilates studio where they use the Reformer and Cadillac machines, and where the instructors are fully certified in the Pilates methods. Classes are pricey and often one-on-one, so you get individual attention. Does anyone here do this?

I have a large peristomal hernia. I am sick of being out of shape and not flexible like I used to be. Since 2008 and two year-long fights with colon cancer, surgeries, ileostomy, permanent colostomy, and untold doses of chemo, I mourn the loss of my health. I have checked with my doctor who says go ahead. I have also read in many places where it says exercising with a hernia will only make things worse.

Pilates uses isometric exercises and seems to me to be a reasoned approach to making changes carefully and slowly as your body can handle it. Anyway, I have signed up for a one-on-one evaluation with an instructor tomorrow who thinks she can help me.

Would appreciate any feedback from anyone doing this already!

I would talk to your doctor first before a consultation with the Pilates instructor. That person is likely trained in basic physical therapy only, and a hernia is a serious, very difficult, and often frustrating injury to overcome for anyone, and for someone with an ostomy, it's even more difficult having had their abdominal cavity opened up. From what I've read from those having them, exercise that involves a lot of bending at the waist and twisting is not recommended at all when you have a hernia, especially if you've had it repaired.

Thanks for your reply.....you must have missed the sentence where I wrote I had talked to my Doctor.....he has said ok to go ahead.  That's why I wanted to hear from anyone who is actually doing Pilates...to see if it has helped or not.  I was surprised he said ok, and I did explain the process.  He basically told me not to do anything that hurt, and to take it gently and carefully.  He's a big believer in trying to keep yourself motivated and healthy.

Ahhh yes, I did miss that part - didn't have my reading glasses on, sorry. I don't do Pilates, but I do go to the gym 4 to 5 nights a week and do weight training, and do cardio and core training in the morning every other day - so I do know a lot about fitness with an ostomy. Just please be ever so careful when tensing your lower abs, because I've had several friends get hernias and are always aggravating them just doing their basic daily routine around the house. You must have had good core strength before your operation - I did, so it was very easy for me to get back into my workout routine after surgery - and I had 4 in total.

Thanks, Jim, that is where I would like to get back to! I used to run, worked out with light weights, and was in good shape before cancer got me. The chemo gave me really bad neuropathy in my hands and feet, so I haven't moved around like I would like since the chemo finished. You are a walking billboard for staying healthy with an ostomy. I may never run again, but I really want strength and health back.

I will be VERY careful... I am printing out some stuff for the instructor who sounds very cautious... will let you know how it goes...

Living with Your Ostomy | Hollister

"A man's got to know his own limitations" ----Dirty Harry!!

Hey Juuust-Jim, I've started going back to the gym and have been cautious not to do sit-ups or anything that would pull on my abdomen. The surgeon has me on light duty at this time, as I'm sure everyone is. I can pick up only 25 lbs, he said. I lift a little more but watch myself, making sure not to feel my stoma area pull. Do you have sit-ups in your routine, and do you use any support? Thanks





TerryD, good questions for others like myself to think about. I'm not going to do Pilates, but you're attacking the problem the right way. Sometimes you just have to go around, over, or under the wall.





Frizbeekid

I do just ab crunches flat on my back (no incline) with my legs raised. Having had to recover from a long abdominal incision four times, I always wait until my abs are 100% recovered, meaning no pain, then I tense them up before doing any "core" training whatsoever.

Thanks Jim. I have been tensing my abs more and more, as time goes on. I'm taking it easy though.

Thanks again.

Hey Everyone, I think Jim has given some good advice and obviously sets a good example for us all. Having been physically active all my life before and now after three surgeries, my advice and caution to you would be to listen to your body, start a reasonable training regime based on YOUR personal fitness history, and if need be, under the supervision of a physiotherapist or exercise physiologist. There isn't anything we can't do so long as you work up to it in an intelligent and informed manner. I do CrossFit and other types of very intense physical training. Yoga, Pilates, and Tai Chi are also very good non-invasive workouts that can improve your fitness without over-stressing your body, especially when beginning.

Good luck and take care.

Remember, six packs aren't made in the gym... they're made in the kitchen!!

That's so true!!! I watch and shake my head at guys at the gym doing a 30-minute routine just on the abs—using a high inclined bench and added weight resistance—only boxers/fighters need to work their abs that hard. So, like you said, having cut abs is from dieting and having an extremely low body fat percentage.

I told a number of Ostomy friends—who have asked if and how they could strengthen their stomach muscles without injury, being they were not physically active prior to surgery—and I have always suggested they use the old 1950s Charles Atlas techniques of dynamic tension. When watching TV in your most comfortable chair or even sitting at your computer: just take a deep breath, lean slightly forward, tense your stomach muscles, and hold for a count of 20, then breathe out and relax, and repeat.

Bodyrocker, I get my six pack at the beer store. LOL

Hi Terry,

Everyone gave you some really good answers, but I'm going to add my own personal experience. I was "never" in good physical shape...since I got sick at 12, had surgery at 15, and had to deal with 2 very resistant incisional hernias at the base of the scar, that refused to heal. They left me with a very weak abdominal wall. I did marry and have two children, but that increased abdominal weakness, and so little by little, I just gave up doing what I could do...walk, (need orthotics) swim, (chronic sinus and ear trouble) play tennis (shin splints) bike ride (sciatica and degenerative disc disease). The years passed, I developed diabetes, was grossly overweight...and had developed leg pains, that turned out to be "Peripheral artery disease" ? we think. That along with neuropathy in my feet, and with arthritis everywhere...and a new "huge hernia on one side of my upper belly... I could barely hobble. Asthma...also made it difficult to breathe.

Three years ago, I decided to pull myself out of bed, off the couch, and "out of the grave," joined a gym, and hired a trainer for the first time. This isn't a regular gym...it's a "wellness center, attached to the local hospital, and they work hand in hand with a registered nurse, and support from the certified trainers and physical therapy department.

I met with the head of the trainers...and explained my "issues" and he recommended someone for me. It was a 20-something "scrawny" little girl, who barely weighed 100 pounds. I was so skeptical. But I have to say, she really knew her stuff. She got me moving, without any high impact on my bad feet, legs, or back. We met with a physical therapist, and found out that I barely had movement in my lower abs, and so they recommended exercises for me.

I began taking 5-10 classes a week, and thought of the gym as my "get well playground," often spending more than 3 hours a day there. I wasn't working at the time. I did weight training and some machines under guidance. I did balance and movement classes (low impact exercises) some arthritic chair classes, to concentrate on lower abs. I took water ex classes, and I did tai chi, and Feldenkrais to improve mind and body. I also started a beginner Pilates class with a fabulous instructor/trainer.

When the gym started the "reformer" program, I tried that too, but found it too difficult, and cumbersome for me. I needed to relearn how to move my own body. I got back to swimming, but because my arthritic neck wouldn't turn enough for me to breathe regularly, I started to use a snorkel. I went from 3 strokes to 10 laps. From walking 5 minutes, (for form and motion not cardio speed) I can now do a mile in 30 minutes. That's great for me.

I lost about 30 pounds, that have been difficult to keep off, but I'm still working on it.

I had mixed messages from my various doctors. One said, fine, go ahead, while the other was concerned about the abdominal hernia, and wanted me to wear an elastic support band. I haven't, and it hasn't been a problem so far.

It's been three years now, and I am so much more improved that I can't believe that I "regained" so much mobility...more than I had in my 40's, 50's, and now I'm in my sixties.

My best advice to you, is to not be in a rush. Work on your whole body... as well as "your mind". Research "Feldenkrais" classes in your area. It's been fabulous for me. It's a neuromuscular, slow and gentle stretching class...started by an Israeli physicist years ago. It's relaxing, healing, and restores mobility through relearning movement patterns, much the way a baby develops.

I hope this has been of some help to you, and to any others who've had the patience to read it. :)) Working on editing my writing.

Best wishes.

Marsha

Thanks so much, everyone, for your comments! I think this is a great discussion, and just as we all have different ostomy problems, we all will have slightly different solutions, so reading these replies is so very helpful!

I feel almost like I have to start all over again! Before cancer, I was a runner, did weights, a little yoga, a little core training when I felt like it, some Tae Bo and boxing stuff for fun, and swam. Yes, I ate well, my nutrition was pretty good, no smoking, hardly a drink but for a nice Corona one or so on the weekend. I loved running...but now, after five years of cancer, five more years of age, a replaced knee (too much overuse in the running), arthritis creeping in, and probably some osteo issues, never mind the killer neuropathy, I feel like I have to start all over again.

Anyway - here's the scoop on my first Pilates visit! Proper Pilates studio, not a group class in the gym. This studio is run by a woman who is in her 50's, all kinds of qualifications, been an athlete and dancer all her life, taken many classes herself, studies the Stotts method, and has her act together. Plus, she is only 5ft high, not one ounce of body fat, and in awesome shape herself. You have to schedule one-on-one sessions with her weeks ahead; she is so in demand.
Anyway, in I go for my alignment evaluation! We discussed my entire health history and had a long discussion about my limitations, but I was so encouraged by her. She told me there would be many things I could NOT do, but having said that, there were also many things she could teach me to help myself. She set me up with a body alignment, both laying down, standing, and sitting, I could feel the difference in my posture when she got me in the right positions. She taught me how to breathe, to lengthen my trunk, to straighten my spine, and isometric exercises like Jim talked about for my internal muscles.

We did some exercises in the machines, the reformer...loved it...and the Cadillac, and we found ways to keep the stress off my hernia. I honestly felt terrific after the one-hour session, and I did not hurt the next day, but yet knew I had done some new things with my body. She gave me exercises to do at home with the stretchy bands, some I had done before, but the big difference for me was her emphasis on correct form and the mental connection with the muscles we were using. I feel very encouraged! It has helped me to set some new goals for myself...like you, Marsha! We have to take control of getting our own lives back!

Upped my daily walk to three miles today, and stuck with the Atkins diet for yet another day...things are going good!

TerryD, it sounds like you have a good coach, watching out for you and your health.
Just remember, do what you can and know that the Pilates coach's job is to push you a little more than you want. Do that little extra, being mindful of abdominal muscles. Then have an ice-cold Corona and reward yourself. Post how you're doing, okay?

To TerryD - so happy that everything turned out so awesome for you!


And to Marsha - great post of your experiences in getting active again - great example of "When there's a will - there's a way"
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Jim, Marsha, Vulcan, frizbkid, and bodyrocker, thank you so much for your encouraging comments, and thanks also to anyone else just reading who is even thinking of giving input about starting over.

I have been practicing dynamic tension and the other moves at home. I got myself back on my elliptical the last few days and am finally following a diet. Just making a start and a plan and having that first session seems to have kick-started things for me. Honestly, what Marsha says is so true...you have to work on all of you to get healthy again. I have spent the last six months since my chemo ended just feeling really depressed. I can't go back to the job I loved; the neuropathy is so bad, so I miss the challenges of the job and my friends. I have really done nothing except a daily slow walk of two miles...

It has really just clicked for me that the hernia is only ONE place on my body! No reason at all that my arms and legs and aerobic fitness are out of shape! Heck...I had no problem on the elliptical - my numb and painful feet don't have to even lift like walking! My legs and butt were doing the work! Not to mention my heart! So the last two days I have not taken the Lyrica, which makes me feel like crap, and am just weaning myself off Ativan (Lyrica is supposed to help neuropathy but it makes me feel weird, the Ativan is for anxiety and depression), and I have another Pilates appointment Monday. Today I completed a very gentle yoga session (DVD) and lifted some light weights for my arms, plus the elliptical.

Here's hoping muscle memory will kick in too!
Hernia is sticking out like a baby belly on the stoma side, but that's no different than usual. I am wearing my belt all day and have no pain there...so - deep breath and keep moving! I told my Pilates instructor she should make a case study out of me...

Stay safe, everyone.

So true about having mind and spirit along for the ride, Terry. You have to want to get better!
I learned from an old man who lived to be 94, to never give up. I watched him keep pushing as long as I knew him, which was about 25 years. He would get up early in the morning and stay on the move. If he fell, he would get up, dust himself off, and away he'd go. He had his mind and spirit along for the ride, even if his body sometimes preferred the parking lot. He used to say you can always sleep when you're dead. Well, now his body is in its final resting place, but that spirit is in my mind. Never give up.

Frizbeekid