I had a hysterectomy with major repair work to the pelvic region (my doctor called it A&P repairs). My doctor has now told me that I have a lifetime weight restriction of 20 pounds. In other words, he says I can't lift anything more the 20 pounds for the rest of my life. I am also told I need to avoid exercise that would stress the pelvic floor. I don't want to become a "little old lady" and have my upper and lower body strength dwindle, especially since I've worked so hard to achieve it. My personal isn't sure what I can and can't do. Can you give me some ideas? I think my doctor said I can lift light weights if I'm sitting. Can I do lunges and squats? He said I should avoid walking lunges (which I've really come to enjoy because of the strength and toning results). Any advice would be greatly appreciated!
Here are some things to think about with regard to your hysterectomy repair and the process of restoring optimal function post surgically:
A weight restriction of 20 pounds is a typical restriction. It protects the doctor if someone tries to go mud wrestling after a hysterectomy and blames the doctor when they hemorrhage or have a vaginal wall prolapse. This is designed to protect you from finding out what the limit of the surgical repair is! I realize that is a very low level of resistance, but there are some things you can do such as consulting a female physician/surgeon that works with athletes. You could find such a physician by contacting any woman's professional sports team in your area and they can tell you who they recommend. You can also contact the local newspaper and see if they have ever run a story on an athletic female (or male) gynecologist. Once you find a good physician that can give you a second opinion, you will need to take to them a copy of your operative report along with any other records you can get. Usually it's just a matter of requesting a chart transfer or to get a copy of your medical records. Once the surgeon sees the operative report and performs an examination, they can establish new guidelines for you based on your overall condition at that time. I know this is possible because there are women out there power lifting after similar surgical procedures. That doesn't mean what they are doing is a good idea, but I do know that in a healthy woman, given time to heal and rehabilitate correctly, the body can return to pretty impressive levels of function.
Working within the confines of 20 pounds, you can use very slow movements. By increasing the time under tension for each set, you will experience the full effect of gravity, creating a "real 20 pound lift" so to speak. For example, if you do a split squat (static lunge) with a 10 pound dumbbell in each hand, and perform the exercise at a 1-2 down, 1-2 up count, you will be moving fast enough that you will actually only be lifting the full 20 pounds for about .3 of a second per repetition due to the aid of inertia. By performing the same exercise on a 1-2-3-4-5-6 count down-pause 1-2-3-4-5-6 count up, you will not get nearly the benefit of inertia (momentum) as you did on the 1-2 tempo, and you will see quite quickly that there is a BIG difference! Using a 15 pound Body bar, I can pretty much exhaust even a top athlete by manipulating the movement and the tempo. You can also effectively double the weight by doing exercises on one leg as you get more fit and assure optimal core stability (see my course Scientific Core Conditioning for the necessary tests and rehabilitative exercises). By performing exercises while standing on wobble boards, rocker boards or from a Swiss Ball, you can dramatically increase the challenge, and 20 pounds will seem like 100 pounds until your core recruitment, reflex righting and equilibrium actions and strength are fine tuned to function synergistically.
YOU ARE WHAT YOU EAT! What you must also work to do is restore optimal hormonal balance to your body. If you had optimal health and normal (not normal from the modern sugar eating societal globula perspective, but normal for a native woman untouched by white man's food) hormonal physiology, you probably wouldn't have ever had to have your uterus removed. This sort of problem is literally unheard of in native cultures that live naturally and eat a whole food diet in accordance with their racial and genetic requirements. There is no doubt in my mind that your estrogen levels are likely to be imbalanced, which means ALL your female hormones are imbalanced because they all work together, like a big spider web of hormones. You can't pull on any part of it without all parts reacting. The ligaments of the body are very sensitive to estrogen and other hormones as well. This is why many women's pelvis and knees feel loose when they are premenstrual. Even though you've had a hysterectomy, you could very well still have high levels of xenoestrogens in your tissues from such activities as eating and drinking out of plastic wrappers, from pesticide residues on commercially farmed foods (very likely) and other medical drug or industrial, environmental sources.
The goal is to get you eating the right proportions of animal versus vegetable foods, eating clean, organic produce and organic free range meats to aid in hormonal restoration. This happens by providing the correct building blocks to make your steroid and peptide hormones, while getting adequate nutrition on board to run your pathways of detoxification so you can begin eliminating from your system unwanted estrogenic and other endocrine disrupting toxins. I have seen many cases where this process improves joint stability in females and also improves their hormonal profile and menstrual cycle – not an issue for you now, but you still have a body!
Body Weight Exercise: You don't need weights to be strong. Most gymnasts don't lift weights, yet they are some of the strongest people I've ever worked with! I've worked with many women who train to compete in horse jumping and barrel racing, who were very fit, well balanced and strong from riding horses, yet again, no weights! If you work your way through my Swiss Ball Training DVD, you will find that you get a good workout, develop great muscle tone, core control, balance, good reflexes and still will not have exceeded your physicians recommendation of 20 pounds! Also check out Pavel Tsatsouline's book The Naked Warrior, which is all about how to become strong with only body weight exercises!
I would suggest strongly that you find a C.H.E.K Practitioner (Level II at least) who is also at least an NLC II and have them perform a full assessment of structure, core control, motor skills, diet and lifestyle factors. They can then work directly with you or can work with you and your trainer to safely restore your health. They can also interface with your physician to become familiar with the details of your surgical procedure and your body. At that time, the discussion of your walking lunges should be brought up. While it is likely that you will be fine doing them, you may also increase the risk of something unpleasant such as stretched ligaments, a vaginal prolapse or an evulsion of a surgical repair.
I hope I've given you enough good advice to do some thinking and restore your fitness, and your health, constructively! Please don't rush or make quick emotionally based judgments. Get professional assistance. You can become very strong, graceful and beautiful through intelligent application of the suggestions here. Good luck.