Exercise
Exercise is very important for everyone. Exercise has lots of benefits for physical and mental well-being including:
Improving heart and lung health
Improving strength
Improving balance
Improved recovery from illness and injury
Improving mood
Improving sleep
You should aim to be physically active every day. Adults should aim to be moderately physically active for at least 150 minutes a week, this means getting out of breath but still being able to speak in short sentences (this is called aerobic exercise). You should also aim to do strengthening exercises for your major muscle groups (hips, knees, shoulders, abdomen) at least twice a week.
When you exercise it is normal for your heart to beat faster, to breathe faster and to feel warm.
Exercise looks different for different people. Not everyone enjoys going to the gym, running or swimming. It is important that you enjoy the exercise that you do. Lots of everyday activities count as exercise, as long as your heart rate increases and you get out of breath doing it. Examples of activities that you may want to try include walking, gardening, cycling, climbing stairs and dancing.
If you are uncertain about where to start consider joining a local sports group. Many UK towns and cities have community based exercise groups and joining one can be a great way to improve your fitness level and meet like-minded people in your community who will support your journey. For example, weekly park run events (where you can walk/job/run at your own pace, free of charge) https://www.parkrun.org.uk. If you have or have had cancer have a look at '5K your way' (https://5kyourway.org). A community-based initiative to 'encourage those living with and beyond cancer, families, friends and those working in cancer services to walk, jog, run, cheer or volunteer at a local 5k Your Way parkrun event on the last Saturday of every month'.
Exercise before surgery
It is helpful to be as active as you can before your surgery. There is clear evidence that better fitness levels before an operation results in reduced complications, shorter stay's in hospital, a quicker recovery and return to normal quality of life. I see this benefit countless times in the patients I care for. This is because the fitter you are the the better your body can cope with the stress of the operation. We call this prehabilitation.
If you are normally an active person, it is important to keep that up before your operation as fitness level can drop quickly if you stop exercising.
If you normally struggle to maintain a more active lifestyle it is helpful to consider ways in the run up to your operation to improve this. People who have low activity levels can improve their fitness within as little as four weeks by taking regular exercise. This gives you an opportunity to get fitter before your operation and improve your chances of a better and quicker recovery after surgery with fewer complications.
Keeping a track of your activity levels can be very helpful in understanding where you are, monitor changes if you are making them and provide you with a baseline to aim to when recovering from your surgery. The next section includes an example of an activity diary which you may find helpful. Many people find using a fitness tracker very helpful too - using this to set goals (for example 10,000 steps a day) and get a better measure of activity levels.
Exercise diary example.
Many people find using fitness trackers such as MyFitnessPal and Strava very helpful.
Exercise after surgery
It is important that you build up your activity levels following surgery. Exercise helps to speed up recovery from surgery. Unless your surgeon has told you specifically not to complete a certain activity there are no restrictions to what you can do. However, your body and common sense should guide how quickly you resume and build up activities.
On the following page I include a table giving some general guidance on how quickly you should build up activity levels in the weeks following your surgery. There is also a section to set your own goals, for example “I want to be able to walk for 15 minutes independently in an area I am comfortable within a week of getting home.” It can be useful to consider your activity levels before your operation , consult your activity diary to guide your goal setting and complete a post-surgery activity diary.
If you can, when you are in hospital and first discharged you should go for regular short walks, gradually increasing the distance that you cover. Aim to start walking for 10-15 minutes a day then increase this by 2-3 minutes each day until you are regularly managing to walk for 30 minutes or more, twice a day. If possible, walk with someone until you feel confident to walk alone. Recording your activity in a diary can help monitor your activity levels and see how it is building day by day.
You may also want to try general strengthening exercises twice a day, with or without weights. A suggested routine which works your core muscle groups is included later in this section. All exercises can be made easier by doing fewer repetitions or using no or lighter weights. If you find them easy then try and increase the number of repetitions or use heavier weights. It is okay to rest between each exercise or to break them into smaller sets during the day.
The key is to stay active, gradually build up your activity levels as you recover and combine aerobic exercise (such as walking) with some core strength exercises.
Post-surgery activity diary example
Where can I get help?
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Speak to your healthcare provider - most regions of the UK support an exercise 'on-prescription' service, a supported introduction to exercise under the guidance of specialist fitness instructors in local leisure centres. This is open to anyone with a health condition that would benefit from exercise. Please ask the ward physiotherapist, your GP or practice nurse to refer you if you are interested.
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Consider working with a local physiotherapist, either by referral from your GP, hospital team or privately. If you are based in the North-West I can personally recommend Mark Boundy, Rebound Physiotherapy https://rebound-physio.co.uk
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Speak to your local gym - most gyms offer personal training/coaching to help you work to your goals.
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Look for a local personal trainer/coach.
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Enlist the help of friends and family.
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Join a community exercise group. Having a support network around you can be a powerful way to support your exercise/recovery journey.
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Generation Games - https://www.generationgames.org.uk/ This website offers a wealth of information about exercise and includes videos by physiotherapists guiding you through home exercises.
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Park run, weekly events run in most UK cities: https://www.parkrun.org.uk
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5K your way: https://5kyourway.org