Post Surgery Workout Instructions

Getting Back To Training

There is a reason for most everything, but if you don't know why a particular recommendation is made, you may nor adhere to it. That is why you have received this instruction sheet. This will explain how you may return to training after your surgery, as well as why you should follow these suggestions, based on a few scientific principles. You may get away with a more rapid return to your routine, but on the other hand, you may be increasing the risk of unwanted complications. If you don't understand the reasoning behind any recommendation, just ask about it. In the past, it was often routine to restrict activities following surgery for up to six weeks. While some restriction is beneficial, both you and I know that six weeks of sitting around without exercise would be unbearable for someone who is accustomed to a high level of activity. By gradually returning to training after surgery, we can avoid cabin fever and still nurse our bodies in a way that we can minimize the risk of complications. In fact, certainly some benefits are likely with early exercise.

A few initial points:

  1. Always wear any protective or compression garment for the specific time period recommended. This will help both with comfort and healing. 
  2. Avoid exercises which directly stress the area of your surgery for a full four weeks unless otherwise instructed. You will still be initiating exercises in that area faster than has been traditionally suggested. 
  3. Whenever something hurts, avoid it. This is not a time for a "no pain, no gain" philosophy. 
  4. If it keeps hurting despite adherence to #3, call your surgeon. In fact, call with any concerns to avoid bigger problems. 
  5. Write down your questions so that you don't forget them. And ask your surgeon, not your training partner. Everyone has brilliant ideas for post-operative care and recovery, but only your surgeon knows what your specific case requires. Most of your friends' recommendations won't be harmful, but always ask first. 

First week post-op

During the first week after surgery, you want to avoid activities that raise your blood pressure. This could cause bleeding at the operative site, which could result in a hematoma (collection of blood). This can lead to other problems, so...

  1. Take it easy. 
  2. Read a book or watch TV. 
  3. Walking is an underrated, excellent form of exercise, especially during this week. 
  4. You may usually shower beginning two days after your surgery, unless otherwise instructed.
  5. Wear your garment all of the time, including at night. 

Second week post-op

You've been sort of lazy for a week, so get back into it gradually. Cardiovascular activities are best at this point, such as riding a stationary bicycle or brisk walking, either outside or on a treadmill or Stairmaster. Running at this point may be premature, depending on the type of surgery you've had. Stretching can be incorporated at this point to prepare you for the next week and to prevent injury. Be gentle.

After gynecomastia surgery: Toward the end of the week, lower extremity training can be introduced. Start with light weights.

The reason to avoid stressing the surgical area has to do with healing and scarring. During the early phase of healing, one must avoid irritation around the operative site, as this can worsen swelling and fluid accumulation. This could cause development of a seroma (fluid collection) or cause problems with the wound (dehiscence or opening of the suture line, or widening of the scar). Even though the skin is closed, there are many activities taking place beneath the skin.

Third week post-op

Some light weight lifting can be introduced at this point. Avoid your operative site and keep on your garment, even during workouts. Yes it may get a little smelly!!

After gynecomastia surgery: Increase the weights in the lower extremity and initiate light upper extremity exercise and abdominal exercises. Use machines rather than free weights, and absolutely NO chest!!

Fourth week post-op

By the end of the week, you'll be getting back to normal except at the operative site, where you'll just be reintroducing part-specific exercises. With that in mind, you're gradually increasing weights for unaffected body parts and increasing your cardiovascular training.

One month post-op

Now you can resume full-body training. Remember that you've been working at a reduced level, so that you should be gradually increasing weight and level of training over the next two weeks. By the time you are six weeks post-operatively, you will be nearing your pre-operative level. Think about the fact that in the past, you would have just been starting back into it at this point.

During your recovery, always remember that if something doesn't seem quite right, it probably isn't right. Back off for any pain or discomfort, and be attentive to signs of swelling, infection or other local problems around the operative site. Call your surgeon with questions to prevent little concerns from becoming big complications. A little patience and intelligence will get you back to your pre-operative level of training safely and in a timely fashion.

Richard Silverman, MD

Richard T. Silverman, M.D., F.A.C.S.
Cosmetic and Reconstructive Plastic Surgery
29 Crafts Street, Suite 370, Newton, MA 02458
617-965-9500 / 800-785-7860
Certified, American Board of Plastic Surgery
http://www.ricksilverman.com/

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