Physical activity after removal of the gallbladder. When you can start to swim in open reservoirs after surgery

Date: 11.04.2019

Diseases of the gallbladder are quite common among the population. Part of the diseases of this organ can be cured by conservative methods: drugs, diet, physical therapy. However, there are pathologies in which surgical methods of treatment are priorities. One of these methods is cholecystectomy, an operation to remove the gallbladder.

For the past 100 years, cholecystectomy has been the main treatment. She is prescribed to the absolute majority of patients who have such a diagnosis. Although non-surgical methods of treatment are developing intensively, they still have a number of significant drawbacks. So, for example, with litholytic therapy, the course of treatment can reach 1-2 years, while even if successful, half of the patients may experience repeated stone formation. In addition, when prescribing conservative therapy, the size of the stones, their shape, volume occupied in the gall bladder are important. This factor can be decisive when choosing a method of treatment.

It is customary to distinguish two types of operations to remove the gallbladder:

traditional (standard, open) cholecystectomy;
laparoscopic (video laparoscopic) cholecystectomy.

Unconditional preference is given to the second method, as less traumatic, and, therefore, requiring less time for rehabilitation.

Fig. 1. Left - laparoscopy, right - open cholecystectomy

Ideally, the operation to remove the gallbladder should be planned so that the person has time to properly prepare for it. However, this is not always the case, and in acute cases the patient goes to the operating table without preparatory procedures. If everything goes according to plan, then the complex of therapeutic gymnastics is assigned to the patient (provided that the hospital stays long enough).

Therapeutic gymnastics in the preoperative period

Physical therapy is especially important when planning to remove the gallbladder in the classical way. Laparoscopy, which accounts for most of the planned operations, causes significantly less damage to the body, and, consequently, the importance of physical therapy during this procedure is reduced. However, it must be remembered that properly chosen physical activity in any case has a positive effect on the body. In addition, in 4-8% of cases, the already started laparoscopic operation is forcedly transferred to the classical one due to the circumstances discovered during the operation.

The need to assign adequate physical activity before a planned operation is due to the following reasons:

development in patients with neurotic conditions associated with the expectation and possible consequences of the operation;
a decrease in muscle tone, a decrease in lung capacity due to the limitation of physical activity in the hospital;
circulatory disturbance, decrease in circulating blood volume.

Properly chosen gymnastics by the attending physician will help level the psycho-emotional state of the patient, improve the functional state of the cardiovascular and respiratory systems, and gastrointestinal organs. In addition, the patient should master the chest type of breathing with an emphasis on exhalation and basic exercises of the early postoperative period.

The complex of therapeutic gymnastics may include breathing and general developing exercises, exercises for the abdominal and pelvic floor, turning to the side, coughing exercises with fixing the area of the future postoperative suture and lower sections of the chest. Exercises are performed in a variety of starting positions, 1-2 times a day. The load varies depending on the physical fitness of the patient.

Contraindications to physical therapy are severe general condition, persistent pain, body temperature above 38, the risk of bleeding, anemia.

Below is a sample set of exercises in the preoperative period.

Exercise in the postoperative period

The duration of the rehabilitation period after surgery depends on the method of surgical intervention. During laparoscopy, injuries of internal organs and tissues are minimized, therefore, the recovery time is less compared with the classical operation to remove the gall bladder (laparotomy). The table below shows the stages of rehabilitation depending on the type of operation chosen (dates are indicated in the absence of complications).

Fig. 2. Physical exercise after removal of the gallbladder

Gymnastics and physical activity after laparoscopy of the gallbladder

During laparoscopy, strictly bed rest is shown in the first 6 hours after surgery. Then the patient can already get out of bed (the first time with help) and move independently around the ward.

Starting from the 2nd day, therapeutic gymnastics is shown, which can be performed in various initial positions and for all muscle groups. Be sure to include in the complex exercise therapy exercises associated with body rotation, contraction and relaxation of the muscles of the perineum, with breathing. Exercises for the abdominals are used with caution to avoid postoperative hernia (lying or sitting). The duration of classes is 12-15 minutes, 2-3 times a day. Medical gymnastics should be performed after discharge (3-6 days), at least for 1-2 months.

Exercises after gallbladder removal

Below are the options for breathing exercises that can be practiced after removal of the gallbladder (with any method of type of surgery).

I.P. standing, arms along the body, legs together. Raise your hands up through the sides - inhale, return to the SP - exhale.
I.P. standing, hands on a belt, legs slightly wider than shoulders. Bend backwards, extending your arms to the sides and up. Inhale Slightly lean forward, putting his hands on his belt and moving his elbows forward. Long exhalation. Return to i.p. and a slight pause.
I.P. lying on his back, one hand on his chest, the other on his stomach. Deep inhalation (hands together with the movement of the front wall of the chest and abdomen are raised), deep breath (hands fall).

An exemplary set of exercises after removal of the gallbladder is presented below (for any type of surgery). The number of repetitions is selected by a specialist in exercise therapy, taking into account the physical condition of the patient and the stage of rehabilitation.

Diaphragmatic breathing. We breathe in through the nose while puffing up the belly. Slowly exhale through the mouth, simultaneously drawing in the stomach (6 times).
Lie on your back, arms along the body, legs together. Bend the right leg, straighten it, then do the same with the other leg. Exercise should mimic walking. Perform 1 min.
Lie on your back, arms along the body, legs together. Raise your leg up, return to the starting position. Change leg (4 times for each leg).
Lie on your back, elbows rest on the floor, legs bent, feet slightly apart. After inhaling as you exhale, raise the pelvis. Return to the original position (4 times).
Lie on your back, legs bent, feet on the floor. After inhaling as you exhale, raise the bent legs. Return to the original position (4 times).
Exercise "Bicycle". Lying on your back, raise your legs above the floor, bend your knees slightly and make circular movements, as if riding a bicycle. Perform 1 min.
Lying on your back, one hand on the chest, the other on the stomach. Deep inhalation (hands together with the movement of the front wall of the chest and abdomen are raised), deep breath (hands fall).
Sit on the floor, lean back, leaning on his arms slightly bent. Raise your legs up. Return to the original position (4 times).
Sit on the floor, lean back, leaning on straight arms. Raise the pelvis upward so that the body forms a straight line. Return to the original position (4 times).
Get up on all fours. Raise your leg up. Return to the original position. Do the same with the other leg (4 times for each leg).
Get up on all fours. Lean on arms bent at the elbows. Straighten the legs, lifting the pelvis up. Return to the original position. Feet and hands should stay in one place. Do exercise 4 times.
Sitting on a chair, arms to the side, legs together. Turn left and right 4 times.
Sitting on a chair, arms along the body, legs together. Lean forward, trying to get the tips of the legs (4 times).
Put one foot on the chair. Climb the chair, leaning on the leg. To be fixed in the top position, keeping the second leg on weight. Return to the original position. Repeat 4 times, then change the supporting leg.
Standing, arms along the body, legs together. Raise your hands up through the sides - inhale, return to the SP - exhale (6 times).
Standing, hands on the belt, legs shoulder-width apart. We do 4 squats.
Standing, hands on the belt, legs shoulder-width apart. Tilt the body to the right and left (4 times in each direction).
Standing, hands on the belt, legs shoulder-width apart. Perform circular movements of the body, first in one direction, then in the other. Taz is still. 4re turning in each direction.
Standing, hands on a belt, legs slightly wider than shoulders. Bend backwards, extending your arms to the sides and up. Inhale Slightly lean forward, putting his hands on his belt and moving his elbows forward. Long exhalation. Return to the ip and a short pause.
Standing, one hand on the chest, the other on the stomach. Deep inhalation (hands together with the movement of the front wall of the chest and abdomen are raised), deep breath (hands fall).

Sports, sex, gravity and water treatments (pool, bath) after removal of the gallbladder

Daily walks are desirable in the first 15 days after laparoscopy. After consultation with your doctor, you can enter such types of physical activity as skiing, cycling, roller skating, dancing (not very active), swimming in the pool. Also possible cardio in the gym, easy running. It is better to start swimming in open water (sea) no earlier than one month after the operation.

Within 30 days after the operation, hard physical labor, tension of the abdominal muscles (not applicable to special exercises in the complex of medical gymnastics), weight lifting over 3 kg should be avoided.

Download press can begin one month after the removal of the gallbladder.

Fans can take a steam bath and sauna 1.5 months after laparoscopy.

Doing professional sports, game types, such as football, hockey, can be no earlier than 3 months. The same goes for strength training in the gym.

Resumption of intimate life is possible 2 weeks after surgery.

Exercise therapy and gymnastics after traditional cholecystectomy

AT early postoperative period in bed rest the main physical activity is medical gymnastics. LH objectives in the early period:

blood circulation improvement;
restoration of the respiratory system;
prevention of the most frequent complications (intestinal atony, lung atelectasis, congestive pneumonia, thrombosis);
increase of a psychoemotional tonus of the patient;
prevention of adhesions;
formation of elastic, rolling scar.

Major contraindications: severe condition, acute cardiovascular insufficiency, intoxication of the body, peritonitis.

Physical therapy classes can be scheduled as early as the day after surgery. In the 1-2 day, the regime is strictly bed rest, so the focus is on breathing exercises and exercises for the distal extremities (ip lying on your back).

At the 2-6th day bed mode, exercises are performed from the prone and sitting positions. Also practiced breathing exercises. The complex exercise therapy includes general developmental exercises for all muscle groups and joints, diffragmatic breathing (4 times every 20 minutes), body rotation to the sides, exercises for the small pelvis. Every day, 3 classes are held for 7 minutes.

From the 6th day a ward mode is appointed, allowing independent movement of the patient within the department ( late postoperative period). The main tasks of physiotherapy are:

restoration of the cardiovascular, respiratory and digestive systems;
stimulation of regeneration processes in the field of surgical intervention;
strengthening the abdominal muscles;
prevention of posture disorders;
adaptation of the organism to increasing physical exertion.

The complex of exercises is complemented by exercises for the muscles of the body (including the abdominals). Starting position - lying, sitting, standing. Every day there are 3 classes lasting 12 minutes.

In addition to therapeutic exercises in the ward conditions, walking and sedentary games are recommended.

From the 12th day free mode can be assigned. The duration of training increases to 20 minutes. Patients can already perform exercises with gymnastic equipment, with weights and resistance, at the gymnastic wall. Relevant are walking and sedentary games.

On the 12-14th day, as a rule, an extract occurs ( remote postoperative period). Classes of therapeutic gymnastics after discharge will contribute to the speedy recovery of the patient’s ability to work. Special attention in the late postoperative period is paid to strengthening the abdominal muscles in order to prevent postoperative hernias.

Daily walks are still important. A month after the operation, in coordination with your doctor, you can enter such types of physical activity as skiing, cycling. A month later, you can start to swim.

For 2-3 months after the operation, hard physical work, tension of the abdominal muscles (not applicable to special exercises in the LH complex), weight lifting over 3 kg should be avoided.

Doing professional sports, playing games such as football, hockey, can be no earlier than 6 months. The same goes for the gym.

Bibliography

Dubrovsky V.I. Therapeutic physical culture (kinesitherapy): Proc. for stud. higher studies, institutions. - 2nd ed., Sr. - M .: Humanit. ed. Center VLADOS, 2001. - 608 pp., ill.
Epifanov V.A. Medical physical culture: study guide / V.A. Epifanov. - M .: GEOTAR-Media, 2006. - 568 p.
Ilchenko A.A. Diseases of the gallbladder and biliary tract: a guide for physicians. - 2nd ed., Pererab. and add. - M .: LLC Publishing House Medical Information Agency, 2011. - 880 p.
Physical rehabilitation: a textbook for university students enrolled in the State educational standard 022500 "Physical culture for persons with disabilities in the state of health" (Adaptive physical culture) / Under the general ed. prof. S.N. Popova. Ed. 3rd - Rostov-on-Don: Phoenix, 2005. - 608 p.

Sport and Exercise After Gallbladder Removal

Surgery to remove the gallbladder is called cholecystectomy. According to statistics, it is one of the most frequently prescribed in the world, since if the gallbladder is impaired due to the flow of bile into the duodenum, it becomes useless and must be removed. As with any operation, it has consequences in the form of some restrictions, such as eating and exercise after removal of the gallbladder.

Load or exercise

After cholecystectomy, mandatory restrictions are imposed on physical activity. Many do not see a big difference between normal physical activities and special therapeutic exercises. But the difference between them is huge. With a sharp concentration of force in one place, as it happens when lifting weights, due to an incorrectly distributed load, the joints may suffer, there may be irregularities in the work of the cardiovascular system, there is a probability of stretching the muscles. Then further rehabilitation will be more difficult and lengthy, and drug treatment may also be needed. Therefore, it is forbidden to lift weights (more than 4 kilograms), to go in for sports (professional, for example, weightlifting) after the operation for 2-3 months. But special physical exercises, on the contrary, are only welcomed by doctors. Such gymnastics gradually works out all the necessary muscle groups, in combination with breathing exercises, helps to reduce the recovery time of the body.

It includes three periods:

early - until the suture is removed (7–8 days after the operation);
late - until discharge from a medical facility (up to 2-3 weeks after surgery);
distant - until the return of working capacity (up to 2-3 months).

Physical exercise at high temperature, peritonitis, sudden pain in a wound, heart failure are contraindicated.

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Early period

In the early period, therapeutic exercises help:

Avoid some postoperative complications (pneumonia, thrombosis, embolism, intestinal atony, atelectasis).
To improve the respiratory and cardiovascular systems.
Improve the emotional state.
Form an elastic scar.

Often the question arises whether it is possible to start the exercises immediately after the end of the anesthesia, and which ones are recommended. Despite possible doubts that it is possible to harm oneself, if there are no contraindications, medical gymnastics can be practiced immediately after surgery (after the patient has withdrawn from anesthesia). But you can not get up - the mode should be bed. Exercises can be performed lying, sitting or half-sitting.

The very first exercise should be breathing: a deep breath should occur through the nose, and on the exhale it is necessary to “push” the air out of yourself. At the same time, it is necessary to hold the wound formed after the operation with your hands. It is necessary to do these breathing exercises for 3-5 minutes with a frequency of 4-5 times a day. They help improve the ventilation capacity of the lungs and speed up the process of sputum discharge.

It also recommends exercises involving the small and medium joints (fingers, wrist, elbow, ankle joints, neck) - alone or with breathing exercises. Their example can be flexion - extensor exercises for fingers, feet, elbows. You can still perform imitation walking, lifting the heels of the support from the starting position while sitting. However, such movements should be done only at the end of this period, since after cholecystectomy, it is allowed to sit starting only from 6–7 days.

A massage to the chest area is very useful; it can be performed simultaneously with breathing exercises: for example, after exhaling, vibrating tapping on the back can be performed.

Additional exercises can serve as diaphragmatic breathing exercises and body turns, lying in bed.

Diaphragmatic breathing can be learned quite easily and quickly. The diaphragm (the muscle that separates the upper and lower internal organs) is involved in the process of such breathing. During inhalation the tension of this muscle occurs, the stomach becomes round. And during expiration, the "dome" of the diaphragm rises and pushes air out of the lungs. With the help of such a breath, it is also called the lower one, the blood is enriched with oxygen, the lungs are massaged, the digestive functions of the gastrointestinal tract are restored.

Turns are performed as follows: from the starting position (lying on the bed, knees bent) you need to move to the edge of the bed, lifting your arms with the help of muscles located in the pelvic area, then turn your knees to the right and, raising your left hand, roll onto your right side. The same procedure and turn to the left side.

Late period

In the late period exercise therapy helps:

Improve the functioning of the respiratory, digestive and circulatory systems.
To launch regenerative processes in the wound area formed after the operation (to avoid the occurrence of adhesions, to form an elastic scar).
To tighten the abdominal muscles. This will reduce the likelihood of hernia after cholecystectomy.
Adapt all organs to beginner growth in physical activity.
Reduce poor posture (if any).

In the late operating period adhere to the ward mode. Breathing exercises are performed different: both dynamic and static. In addition to the joints, large muscles are also affected. The duration of gymnastics increases to 7–12 minutes, the frequency decreases slightly and is 2-3 times a day. Also, individual classes can be replaced by classes in small groups, if for some reason it is necessary.

Later, the mode of ward becomes free, exercises are conducted in groups (large or small) in the gym. The focus is on strengthening the large muscles as much as possible, and especially the abdominal muscles. It is possible to use weighting, special devices for performing exercises (for example, balls). Lesson time is extended to 15–20 minutes. And in their free time, a very useful exercise would be to walk up and down a few floors at a quiet pace.

Far period

In the long term gymnastics helps:

restore performance;
adapt the respiratory and cardiovascular systems to the load that is placed on them in a normal life mode.

It is recommended to continue classes of special therapeutic gymnastics and after discharge from the medical institution. The exercises themselves will be the same as in the later period, and the difference will be in the increase in the number of repetitions, the weight of the weighting (if they were used earlier), the use of other additional devices to better work out the muscles.

In addition to doing exercises in the gym, it will be helpful to take part in the terrenkurs, sports games, and skiing.

The general rules uniting gymnastics throughout all recovery periods will be as follows:

Exercises should alternate in time: begin with the upper limbs, gradually moving to the lower. The same applies to the joints: first they work on small ones, then on medium ones.
The larger the joint size and the amplitude of the exercise, the less the speed and number of repetitions of the exercises should become.
Before you do exercises for muscles or joints, you should perform a breathing exercise (mainly using lower breathing). It is necessary to breathe deeply.
After completing 3-4 exercises on muscles or joints, breathing exercises should be repeated.
When prescribing a set of exercises, exercise therapy 2 times a day, the first time must be done in the morning before breakfast, the second time in the evening, shortly before sleep.
Exercises should be performed as far as possible, depending on the state of health (for example, you can reduce the number of repetitions or even reduce the complex).
You should always follow the breath. It should be calm and deep. If this cannot be achieved, then it is necessary to temporarily stop the exercises and restore breathing. Then you can return to the complex exercise therapy.

And about 4–8 weeks after the operation, you can forget that there was such a question about the period after the removal of the gallbladder: how much kg can you raise? If rehabilitation was successful, you can return to everyday life.

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Many believe that physical activity after removal of the gallbladder will be contraindicated. Yes, sometimes excessive physical activity can provoke the need for an urgent operation to remove the gallbladder, since too active exercises can cause the movement of small and large stones. However, not everything is so simple.

The most common causes of gallstones are disturbances in the metabolism and dyskinesia of the bile ducts, which develops due to an unbalanced diet and sedentary lifestyle.

To avoid stagnation of bile, movement is necessary. After removing gallstones, you may no longer fear liver colic. That is why, if the operation went without complications, you will be recommended physical exercises in addition to the diet.

What are the stages of rehabilitation?

There are two methods for removing the gallbladder, the timing of rehabilitation depends entirely on the choice of one of them. A classical laparotomy is the performance of a significant incision of the abdominal wall, the isolation and removal of the gallbladder.

Most often laparotal cholecystectomy is used for urgent intervention, if necessary, or when a laparoscopic procedure is not possible. Laparotomy, like other abdominal operations, is not easily tolerated, and the recovery period is quite long.

Laparoscopy itself has several advantages compared with the classical method. It is produced by several small incisions in the abdominal wall, minimizing injuries to internal organs and tissues. As a result, the recovery period is significantly reduced.

Mainly distinguish the following stages of rehabilitation:

Early stationary stage. Takes the first couple of days. During this period, the changes that occurred as a result of the operation and anesthesia are most clearly manifested.
Late stationary stage. It refers to 3-6 days with laparoscopy and 14 days with laparotomy. This stage of rehabilitation is characterized by the revitalization of the respiratory system, the adaptation of the digestive system to functioning in the absence of the gallbladder. The recovery processes in the area of operation are also activated.
Outpatient rehabilitation. Flows for 1-3 months in accordance with the type of operation. During this period, the functioning of the systems of digestion and respiration, the general physical condition of a person, is activated.
It is recommended to carry out and treatment in a sanatorium after 6-8 months from the day of surgery. After 1-2 months after surgery, depending on the patient's well-being, exercises in the pool will already be useful. Swimming is an alternative to a soft abdominal massage.

Do not neglect daily walks on foot for 40-50 minutes outdoors. They include both muscular activity, which will help reduce the stagnation of bile, and improve the enrichment of body tissues with necessary oxygen. After all, as you know, in the absence of oxygen deficiency, the intensity of metabolism increases, the functioning of the liver and the process of bile secretion return to normal.

The so-called Nordic (Scandinavian) walking at a moderate pace, where ski sticks are used when moving, is also popular. It will also be useful when conducting health walks.

Basically, the possibility of the beginning of these loads should be clarified with the doctor. We are not talking about participation in any competition or cross-country competitions (by the way, it is not recommended to move to a fast run), since this can give painful sensations at the initial stage of recovery after surgery.

Respiratory therapy

While walking you should pay close attention to breathing.

With rapid expiration, the diaphragm exerts a slight pressure on the liver, facilitating its release from bile and blood. The duration of this natural massage should be 20-40 minutes. During this period, the liver improves its functionality.

It is recommended to practice breathing exercises and in isolation from walking. For example, you need to press your hands tightly open hands to the stomach, so that your thumbs touch the lower ribs. Slowly and deeply inhale, control while that the chest cell does not rise, and the stomach, on the contrary, is filled with air as much as possible. Then you need to hold your breath for 2-3 seconds, and make a strong exhale, while drawing in the stomach at the same time.

This exercise should be performed 2-3 times a day on an empty stomach. It is necessary to perform 2-4 series of 3-4 cycles, where one cycle is inhale-exhale. Rest between the series 30-40 seconds.

Morning exercises can be included in the program a couple of weeks after the patient has started daily walks. Gymnastics will have an activating function on the internal organs, including the liver, normalizing the passage of bile.

For 6 to 12 months after the operation, a heavy load on the muscles is strictly prohibited, especially if it is associated with increased use of the abdominal pressure. These exercises often lead to the formation of postoperative hernia.

Exercise complexes

The following set of exercises developed by rehabilitation specialists will not require a lot of effort from you. He, no doubt, will have a beneficial effect on the state of the body. It is recommended to supplement this list and make approaches for enhanced contraction of the abdominal muscles, such as lifting the body or legs lying on the floor, as well as different inclinations not earlier than 6 months after the operation. And then only if it allows the patient to feel.

Exercise always begins with walking at a moderate pace of 1.5-2 minutes, at the same time you can practice breathing exercises. Then go to the starting position for training (standing, then lying down).

Starting position - stand up, legs apart shoulder-width apart. Turn the torso to the right and left, at the same moment, inhaling, spread arms apart. Exhale, give up. Total 4-5 approaches.
Starting position - stand up, legs remain in the starting position. Hands are placed on the hips. Inhaling, move the arms bent at the elbows back. Then return, exhaling, to the starting position. Total 6-8 approaches.
Starting position - lie on the floor, back down, legs stretch out. Arms placed along the body. Bend the leg, pulling it up to the stomach as much as possible, exhaling, straighten the leg. Then repeat with the second leg. Total 4-6 approaches.
Starting position - lay back down, bending the legs. The left arm is on the abdomen, the right arm is extended along the body. Inhaling, you need to push out the stomach, exhaling, with the effort to draw it in. Total 4-6 approaches.
Lie back down, straight legs. Put your hands on the belt. When exhaling, it is necessary to raise and extend the leg in a straight position to the side, lower the leg, inhaling. Then repeat with the second leg. Total 4-6 approaches.
Lie back down, bending the legs. Arms extended along the body. Inhaling, stretch your legs, sliding your heels on the floor. Exhaling, slowly bend them. Total 4-6 times.
Lie on the side, then you need to straighten the legs. The left hand is placed on the belt, the right hand is worn on the back of the head. Exhaling, the leg that lies on top, you need to bend and inhale, bend. Repeat with the second leg, turning on the other side. Total 4-6 times.
Lie on your side, bending your knees. Breathing in, sticking out the belly and forcefully inhale it, exhaling. Total 6-8 approaches.
Starting position - stand up, legs apart shoulder-width apart, hands pressed to shoulders. Circular rotation of the elbows for 8-10 approaches forward and in the opposite direction.

Inna Lavrenko

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With stones in the gall bladder enough doctors have to resort to surgery, called cholecystectomy, the essence of which is to remove this organ.

Many patients who have either been shown or have already undergone such an operation are interested in the question: “Is it possible to play sports after an operation to remove the gall bladder, and what physical activities are allowed after such an intervention?”. It should be understood that the presence of stones in this important organ limits physical activity, since its high level can cause the movement of the resulting calculi and provoke complications (for example, a stone in the gallbladder can block the bile duct), after which cholecystectomy becomes inevitable. However, even after the removal of this important organ, active physical activity should not be completely ruled out. But what should be their intensity and whether sport will be available after the removal of the gallbladder - we'll see in this article.

The main reasons for the appearance of stones in the gallbladder and its ducts are disturbances in the normal flow of metabolic processes in the body, in which the chemical composition of bile changes due to inflammation of the walls of the gallbladder and bile stasis in it.

In these cases, some components of this hepatic secretion (for example, cholesterol and bilirubin) precipitate (this is called a biliary sludge), which is the basis for the formation of stones. Such pathologies are usually associated with dyskinesia of the bile ducts, which is caused by poor diet, alcohol abuse and insufficient physical activity.

Stagnation of bile can be prevented by leading an active lifestyle, since movement does not allow such processes to occur.

This is especially important after this important organ is removed and bile begins to accumulate in the biliary tract. Since the absence of the gallbladder allows no more to fear the appearance of so-called hepatic colic, besides a special diet, certain physical activities are recommended for patients (of course, if the operation did not cause any complications).

The main stages of the rehabilitation period after cholecystectomy

First of all, it should be said that such a surgical intervention is performed in two ways: classical abdominal surgery and laparoscopic surgery. The term of the postoperative recovery period directly depends on what method was applied.

The traditional technique, called laparotomy, involves the removal of this internal organ through a rather large incision in the right abdomen, and is much more traumatic than laparoscopy. Basically, such operations are performed when urgent intervention is necessary or when a laparoscopic operation is contraindicated in a patient. As with any abdominal intervention, laparotomy of the gallbladder implies a fairly long period of rehabilitation and severe restrictions on physical activity.

The main method of removal of this organ at the moment is laparoscopy, since it is much less traumatic, and allows to minimize the risk of postoperative complications characteristic of abdominal intervention.

The essence of this technique is to remove the organ through small (less than 1 centimeter) punctures in the abdominal cavity using a special laparoscopic instrument. Thus, trauma to the surrounding organs and tissues practically does not occur, and hence, the recovery period is significantly reduced (compared to traditional abdominal intervention).

The main stages of rehabilitation

Stages of the rehabilitation period:

early stage of hospital stay. Continues the first two days after surgery. At this stage, all the consequences of the intervention and general anesthesia are maximally manifested;
late stage of the hospital. After laparoscopy of the gallbladder, this stage lasts from three to six days, and after its laparotomy reaches two weeks. At this stage, there is a revitalization of the respiratory system, the digestive system begins to adapt to the new functioning conditions for itself, as well as the activation of recovery processes in the operated part of the body;
stage of rehabilitation in outpatient settings. As a rule, it lasts from one to three months (depending on the method of intervention). During this time, the digestive and respiratory systems become significantly more active, and overall health is gradually returning to normal;
stage of sanatorium treatment. Doctors recommend after six months (eight months after laparotomy) to improve their health in specialized sanatoriums.

Exercise after cholecystectomy

Already a month after laparoscopy and two days after laparotomy, if the patient feels fine, it is recommended to begin a visit to the pool.

Swimming (without increased sports loads) is a great alternative to gentle massage of the abdominal cavity.

Such physical activity minimizes the risk of stagnation of bile and makes it possible to better enrich the tissues of the body with the much-needed oxygen. Normal tissue saturation with oxygen helps to increase the intensity of metabolic processes, normalizes the liver and the entire biliary system. One of the ways of such walking is the so-called Scandinavian walking, which takes place at a moderate pace using ski poles.

In any case, the level of current physical activity is determined only by the attending physician, and one should not experiment here.

At the initial stage of rehabilitation after cholecystectomy, active sports will have to be abandoned (even a quick run is not recommended), since at that time there is a high risk of severe pain. Also at this time it is impossible to lift weights, because it adversely affects the normal formation of the postoperative scar.

Breathing exercises

In the process of walking you need to pay close attention to your breathing.

Rapid exhalation leads to the fact that the diaphragm presses a little on the liver, and this contributes to the release of bile and blood from it. Such a natural breathing massage of this organ for twenty to forty minutes a day can significantly improve the functionality of the liver.

Such breathing exercises (deep breath / fast full breath) can be practiced not only while walking. For example, it is recommended to perform daily the following breathing exercise:

press your open palms firmly against your stomach so that your thumbs touch the lower ribs;
take a slow deep breath; at the same time the chest should not rise, and the stomach, on the contrary, should be filled with air as much as possible;
hold your breath for two to three seconds;
exhale deeply while simultaneously pulling in the belly.

Perform such exercises should be two - three times a day on an empty stomach. Each procedure should consist of two to four series, each of which should have three to four cycles. One cycle - one deep breath and one strong exhalation. Between the series you need to rest from 3 to 4 seconds.

Morning exercises are allowed two weeks after the daily walks were started.

Such exercises contribute to enhancing the functioning of the internal organs of the digestive system and the normalization of bile flow.

When can I play sports after gallbladder removal? Heavy physical activity on the muscles of the body is prohibited for a period of six months to a year after the surgery.

This is especially true of loads affecting the abdominal muscles (it cannot be pumped), since such loads often cause the formation of postoperative hernias. In any case, permission for full exercise should be given by the attending physician.

This reduces the load on the press and prevents the occurrence of postoperative hernia. Wearing such a support belt should continue throughout the day, and at night it should be removed. The duration of wearing a bandage is determined by the doctor, based on the patient's state of health.

Morning exercises, as a guarantee of health

Fitness after removal of the gall is in physical therapy. Performing such a therapeutic gymnastics, which was developed by specialists in the rehabilitation of patients with a removed gallbladder, does not take much effort and time. Moreover, such exercises have a beneficial effect on the general state of the body and accelerate its recovery.

If you can feel well, this complex can be supplemented by training the abdominal muscles (for example, by lifting the body or legs from a prone position), as well as various kinds of bends, but not less than six months after cholecystectomy and only with the doctor's permission.

Therapeutic exercises after removal of the gallbladder:

Any lesson should begin with walking. Pace - moderate, duration - from one and a half to two minutes. It is useful to combine this walk with breathing exercises.
Next you need to take the starting position: stand up and spread your legs shoulder-width apart. Then turn the torso to the right / left, while taking a deep breath and spreading his arms to the sides. When exhaling, hands should be lowered. It is necessary to make from four to five approaches.
Next, legs - shoulder width, hands - on the hips. Taking back the arms bent in the elbows, we take a deep breath, and returning them to the starting position - a strong exhalation. And so - from six to eight approaches.
Change the starting position. Lie on the floor with your back down and stretch your legs. Hands put parallel torso. Bend the leg and as close as possible tighten it to the stomach, while taking a deep breath. On the exhale, we return the leg to the initial position, and then we repeat the same for the other leg. This exercise should be done six to eight times on each leg.
Starting position - lie on your back; legs - bend at the knees; we put the left hand on a stomach, and we stretch the right hand parallel to the body. While inhaling, we stick out the belly, and when we exhale, we pull it in as much as possible. You need four to six repetitions.
Starting position - lying on his back, legs extended, arms - on the belt. Taking a breath, we lift a straight leg and we take it aside (without bending). On the exhale, lower the leg and repeat the exercise with the other leg. Repeat four to six times.
Lying on your back, legs bend at the knees. The arms are extended parallel to the body. While inhaling, slowly extend your legs so that your heels slide along the floor surface. On the exhale, return the legs to their original position. Four to six repetitions.
Lying on your right side, straighten your legs. Put your left hand on the belt and put your right hand on the back of the head. On the exhale, the leg above, bend, inhale - straighten. Further, the exercise is repeated on the other side with the second leg (four to six approaches).
Lying on the side, legs bent at the knees. While inhaling, bulge the belly, and as you exhale, force it in. Repeat six to eight times.
The initial position is to stand, feet set shoulder-width apart and hands pressed against shoulders. Then elbows make circular rotations eight or ten times forward and the same amount backward.
At the end of the gym you need to do breathing exercises and calm your breathing.

Summarizing the above, I would like to say that cholecystectomy, although it imposes certain physical limitations, does not imply a complete rejection of an active lifestyle.

Walking

Playing sports (especially professional) may be unavailable to you, however, active exercise, swimming and walking completely compensate for the lack of physical activity. If you want to increase the level of physical activity over time, be sure to consult your doctor. The sports component of your life should always be under medical supervision.

Not always, alas, in diseases of the gastrointestinal tract, including the biliary system, it is possible to avoid surgery. Launched forms of disease sometimes end in organ removal. Cholecystectomy is one of the types of surgical intervention in which the pathologically changed gallbladder is removed and the anastomosis is applied between the bile ducts. The period of rehabilitation and restoration of a normal lifestyle depend on the conditions that led to the operation, the way it is carried out and the individual characteristics of the patient’s body. Important in this process physicians assign physiotherapy exercises.

Operations on the method of removing the gallbladder are divided into the following types:

laparoscopic cholecystectomy;
laparoscopic transvaginal cholecystectomy using the NOTES method;
minilaparoscopic cholecystectomy;
laparoscopic cholecystectomy using a single port and SILS technology.
open cholecystectomy (performed with the development of complications, for example, the development of biliary peritonitis) and cholecystotomy separately.

Laparoscopic cholecystectomy is that using special equipment, you can make minimal tissue incisions. The patient is immersed in anesthesia, two or three incisions are made to access the organ, each about a centimeter in size. They immerse the devices with which the surgeon performs the operation.

Then the gallbladder is immersed in a special bag and is removed through the port in the navel. Cuts are sewn up, drainage systems are left, and bandages are applied. Next, the patient is observed. The rehabilitation process is much easier than after abdominal surgery.

With open cholecystectomy, a significant incision is made for access - up to 20 cm, if necessary, it can be extended. This type of surgery is considered invasive, therefore the indications for it are limited by the development of complications (peritonitis, gangrene). The recovery period after it is long.

Any surgical intervention is strictly according to indications.

For cholecystectomy, they are as follows:

Complications of chronic cholecystitis and ineffective drug treatment.
Ineffective conservative treatment in case of acute cholecystitis.
When gallstone disease (when conservative treatment does not help, in the case of jaundice, if a duct stone is blocked, the following symptoms often occur - abdominal distension, nausea, vomiting, bitter mouth, frequent aching pain in the right half of the stomach and in the gall bladder) .
With the development of tumor neoplasms (especially if jaundice and obstruction of the bile ducts develop).
With congenital abnormalities and anomalies of the hepatobiliary system.

The postoperative period is conventionally divided into the following stages:

1-2 days - early stationary.
3–6 days - late stationary.
1–3 month - outpatient.
The 7th and subsequent months - spa.

The most difficult, of course, the first days after surgery. With a classical operation in the intervention zone, edema is possible, there is a significant risk of adhesions formation, the motor function of the gastrointestinal tract is disturbed. After laparoscopy, such complications are less pronounced. In addition to problems in the digestive system, breathing is often difficult with external respiration after artificial ventilation of the lungs and because of the pain of the abdominal wall, which the postoperative patient begins to spare. Sometimes pneumonia occurs on this basis. That is why rehabilitation measures should be started in the hospital.

The first exercises should be breathing: up to 15 deep breaths with the nose and sharp exhalations through the mouth. During the day, this breathing exercises should be done 5–8 times.

If the surgical intervention was laparoscopic, then the resolution to rise will follow in a few hours. These instructions must be followed.

Diet therapy and medication will gradually do their job. But the next stage of rehabilitation, very important for the patient, will be physical therapy.

After cholecystectomy, exercise therapy begins with walks.

Physical therapy (physical therapy) - is one of the methods of treatment, rehabilitation and prevention of various diseases, which is based on the use of specially selected complexes of physical exercises and proper breathing. After removal of the gallbladder, physical activity (in the form of various special gymnastic exercises) is allowed in a month or two, depending on the state of health of the postoperative patient. To begin with, doctors recommend ordinary walks. If the patient is in good health, they can be taken the very next day after laparoscopic cholecystectomy. Their duration can be several minutes at first, gradually it is necessary to increase the time, eventually devoting to such useful leisure at least half an hour.

Hiking in the fresh air has the following tasks:

inclusion in the work of almost all muscle groups;
activation of metabolism, prevention of stagnation of bile, restoration of its discharge;
improvement of blood flow, tissue nutrition, oxygenation;
normalization of the liver (including bile formation);
normalization of the ducts;
weight loss (in the presence of extra pounds);
struggle with depression, mood improvement.

Walking is designed to strengthen a little the body and prepare it for further physical exertion.

Gymnastic therapeutic exercises can be started a week after you started walking for half an hour a day at least. It is recommended to perform a medical complex in the morning, after sleep, when the body rested and gained strength overnight.

Begin exercise should be a small, three-minute workout, for example, walking on the spot, while breathing should be smooth and calm. Then you can do the following exercises:

Starting position - lying on the back, with the legs bent at the knees and feet are near the buttocks:

In the initial position, the arms are extended along the body. At the same time, we lift the abdomen, inhale, then slowly as we exhale, lower the abdomen and relax the muscles as much as possible. You must repeat the exercise four times.
The next exercise - the hands slowly slide up to the chest, inhale, then during the exhalation of the arm we return along the body to its original position. Repeat also four times.
Slow dilution to the sides of the knees. Repeat at least five times. You need to make sure that there is no pain. If they occur, stop doing this exercise.
Hands should be placed on the shoulders. When the elbows move up, they inhale, on the exhale they lower the elbows. You need to repeat at least four times.
Bend your elbows, focus on them. On the inhale we lift the heels, on the exhale we omit. Repeat four times.
In front of the chest, you need to raise straight arms extended, take a breath. On the exhale, return to the starting position. Repeat five to six times.
Slowly bend the right knee to the stomach, inhale. On the exhale, we return to the starting position (legs bent on the floor). Repeat on the next breath exercise with your left foot. Repeat at least three times with each leg. Make sure that there is no pain. If they occur, stop performing this exercise, it is advisable to notify the doctor. You may need an adjustment exercise.
Hands must be kept in the “lock” position. Then lift above your head, take a breath. On the exhale, lower. As you exhale, the muscles relax. Repeat five times.
Restore breathing. Slowly calmly inhale, exhale, four times. On the last respiratory movement, you need to achieve maximum relaxation of all muscles.
Bend arms in elbow joints. We rely on them and on the head. We inhale and slowly raise the chest. On the exhale as slowly lower. Repeat three times.
Slowly at the same time you need to raise the hands and feet. Inhale, as you exhale, slowly lower it. Carefully perform. Ensure that the abdominal muscles are not overstrained and there is no pain. You need to repeat it five or six times.
When inhaling, raise straight arms up, shake hands. On the exhale, lower. Repeat the exercise six times.
Perform the exercise "bike", while trying to pull the sock when the leg straightens. Breathing is arbitrary, even.

You also need to be careful and remember that you should not overload the abdominal muscles, especially in the early postoperative period. This can lead to the development of postoperative hernia.

You may need to wear a special bandage (especially if you have extra weight). Properly dressing him should be lying in bed, immediately after waking up, without getting out of bed. And take off just before bedtime, also lying down. Tilting, lifting the body or legs lying on your back should be performed only six months after surgery.

Starting position - standing, back straight, arms along the body or on the belt, legs apart shoulder-width apart:

We spread straight arms to the sides, performed body turns to the sides. In this case, we inhale simultaneously with the turn, and exhale - in the initial position. You can also perform torso torso sideways. It is necessary to remember that it is necessary to take care of the press.
Leaning on the back of the chair with your hands, take turns moving your leg back and to the side. Then repeat with the other leg. Breathing smooth, calm. Repeat five times.
Extend your arms straight to the side, parallel to the floor surface. Describe circular movements with such straight arms.
We put our hands on our shoulders, make circular rotations in the shoulder joint. Rotation on four accounts in each direction - forward and backward. Breathing free, even. Repeat ten times.
Hands bend at the elbow joints, positioned at the waist. Then take a deep inhale elbows back, and when we return to the starting position, we exhale. Repeat ten times.

We do a couple of exercises while sitting:

Starting position - sitting on a chair, lean back on your back, grasp the seat with your hands. We take a deep breath, then during exhalation, leaning on the hands and feet, slowly lift the pelvis up. Drop down, relax. Repeat five times.
Sitting on the floor, legs should be spread to the sides, with free hands along the body. After taking a deep breath, take turns to lean towards the legs.