The Anatomy of Rehab – Recovering from Surgery With Pilates

In June of this year, I had two abdominal surgeries. The irony of that does not escape me. After all, I’ve been teaching Pilates for well over a decade, and I’ve always been proud (and maybe a little vain) about my core and its ability to do amazing feats of strength.

My favorite feat of strength in my pre-surgery days. I'm happy to report I have successfully completed this exercise post-surgery, too. Read on to find out how.

But, after the surgeries, I was left with an 8-inch scar from my sternum to below my navel. My ribs had been opened. Part of my liver and all of my gall bladder were removed. My intestines were cut, pulled out, squeezed, and replaced. I have no idea how many stitches and staples are/were inside of me, but I can tell you, there’s a lot. I can still feel them when I push on my skin. I lost 15 pounds in two weeks.

I didn’t really research the surgery in advance (certainly not the second one, which was from complications from the first). In fact, I actually planned on taking off just two weeks of work. (Evidently, most people take off between 2-3 months from the same surgery).

However, before I even went into surgery, I was already thinking about my rehab. What core work would I be able to do first? What other exercises would I be able to add to the mix and when? Did I really have to wait 6-8 weeks to resume exercise? I decided to do what I could. I found out that sometimes I could do more, sometimes less, but that I could almost always do something. And yes, strength does come back.

Here’s where I’ve been:

In the hospital, I was the only person walking up and down the halls (in my awesome hospital socks) without being prodded by the nurses to do so. I started walking the day after the first surgery (and then again, after the second). I actually would have preferred not to, but since I have MS and I know the less walking I do, the more my leg acts up, I wanted to stay ahead of the game. And I was sufficiently (highly) medicated, so it didn’t feel too awful. I wasn’t walking fast, of course. I had my IV pole to hold onto. I took lots of breaks and memorized the bulletin boards. (I know way more about ileostomies than I hope to ever need.)

Post-Op Weeks 1-4

When I got home from the hospital, I slept A LOT. I was unbelievably tired, and my ribs hurt every time I breathed. I couldn’t sit up without support, and I literally had a rope tied to the door to help pull myself out of bed, even though I was always propped up on multiple wedges. I was warned that inflammation of the intercostal muscles between the ribs was pretty much a guarantee with the surgery. Everything hurt.

So, I just walked on the treadmill at 1 mph. I would watch one episode of a TV show, and then walk for five minutes. Maybe I’d nap for an hour or two. I progressed over time to 8 minutes, 10, 15, and then 20 minutes.

(There was a LOT of TV binging, so if you need recommendations for shows, let me know.)

A forced vacation from fitness is much less pleasant than it might seem.

Post-Op Weeks 4-6

Feeling a bit stronger, I started to add in some standing exercises and arm weights to the walking regimen. I sped up to a blisteringly fast 1.5 mph. I did some squats and plies, some bicep curls and tricep extensions with 2 pound weights.

I avoided ab work completely.

I started laying flat on the floor at night for about 10 minutes at a time. That felt like an incredibly difficult stretch since so much scar tissue on the front of my body was pulling me forward. I tried to just relax there. It was not relaxing.

Post-Op Weeks 6-8

Technically, you can start working out again after six weeks, but since I had two surgeries, I decided to be extra cautious and hold out for eight weeks. Still, I upped the walking intensity, added some inclines on the treadmill, and did some standing leg presses on the Wunda chair on a relatively light weight. I also did some Theraband rows and more standing squats and lunges.

Rehab with Pilates at Fuse Pilates Wunda Chair

Rehabbing from surgery or an injury? The Wunda Chair can work wonders.

Post-Op Week 8

Back to it! I took my first Pilates private session post-surgery and managed to do more than I thought I’d be able to do. I also decided that to stretch and work on the fact that it still hurt to breathe, I should hit the pool. After all, swimming is all about the reach (stretch).

Life lessons courtesy of Disney.

I started with ¼ mile and thought my ribs were going to explode. But the stretch that happens with backstroke and freestyle was incredible, and I felt like my posture was better afterwards. I swam a ½ mile just three days later. Using the kickboard and breaststroke were absolute hell-nos as the back extension they put you into made me feel like my abs were ripping. So, I skipped it.

Post-Op Weeks 9-12

Laying on the floor progressed to laying lengthwise on a foam roller with my arms to the side, and then overhead.

New rehab milestone: lifting my arms above my head.

I kept swimming 2-3 times a week, and worked up to at least a ¾ mile for each swim (sometimes a full mile!).

Walking pace progressed to 2.5 mph.

I kept with Pilates exercises in private settings. By week 12, I was doing the intermediate repertoire on the reformer with modifications for back extension, which still felt like way too much stretch.

I took a Pilates reformer class at Fuse, and I did about 90 percent of it. What hurt, I didn’t do. But I didn’t sit still. I did something that didn’t hurt. If you come to one of my classes and are broken in some way, you aren’t sitting still either. I’ll give you something else to do.


Now, I’m back to feeling almost normal. I get the occasional twinge in my ribs, and mat work still feels like too much. My endurance still isn’t back. And back extension – well, that’s probably going to take a full year to fully recover.

But I took a Pilates private today, and I did advanced work. I even did some of the classical (smaller) back extension exercises. I walked at 3 mph on the treadmill.

Next week? Who knows… But I know it keeps getting better (when you work on it, that is.)

This week: Feeling happy, hopeful, and amazed at everything our bodies are capable of accomplishing.

Stay hard core,


If you are looking to rehab from an injury, a chronic medical condition, or perfect your form, try a private with one of our teachers. Many of us have specialized training in everything from cancer recovery and neurological conditions to orthopedic problems, scoliosis, back injuries, and even amputations.

Or, if you just want to be worked out like you’ve never been worked out before, we can handle that, too – sign up for a group class and get ready to work your body from head to toe in a whole new way.

Share and Enjoy

Posted in Fuse Pilates and tagged , ,

All Comments (3)

  1. WOW, Mariska, I’m about 8 weeks behind you and my story is very similar (right down to my being a Pilates instructor)… thanks for reminding me what I have to look forward to. And be well!


  2. Mariska says:

    Ainka – Be well – it does get better, and if you’re in good shape going in, it’s surprisingly fast how quickly you’ll be able to do things week by week. I still can’t do many things, but I am constantly surprised at what I can do when I try. If it hurts, I stop. No point in risking anything. 🙂

  3. This is an excellent blog – wishing you both well, going to forward to one of my clients who has had the same surgery. Many thanks for sharing x