Rehab from Abdominal Surgery

[Dcramsey]

I had abdominal surgery April of 2007. I have been cleared for all activity. During physical therapy the therapist made a statement that my abs were folding over during an attempt to do a crunch. He then had me doing reverse crunches. Can someone explain what he meat by folding over?

[UConnJulie]

I have absolutely no idea ... never heard that terminology before!

What surgery did you have? Where is your incision and in what direction does it run?
Do you still have pain, or just weakness? Do you have a rehab plan in place?

[Dcramsey]

I still have weakness. I couldn't do a sit up to save my soul. I don't have real pain, the scar tissue doesn't contract and release at the same rate as the muscle tissue, sot there's more pressure than pain. Maybe fear more than anything. I can do push ups, which cause the abs to contract, planks, and a sort of crunch, but I don't have a rehab plan in place. Any suggestions?

[UConnJulie]

I can't give a properly informed opinion until you answer my other questions, sorry!!

What surgery did you have? (you don't have to give major details if that makes you uncomfortable ... so did you have something removed, something replaced, something repaired? And why? Is there cancer or some other nasty thing? Or was it just "broken"?)

Where exactly is your incision? How long is it? Which direction does it run?

And one other one.
If you lie on your back with your knees bent, and you raise your head and shoulders like you are going to do a crunch. Feel along the linea alba above and below your belly button. How wide does it feel like it is? Can you sink your fingers in along the linea? Does anything bulge out?

[Dcramsey]

Perforated colon August 2004, reversal November 2004. Rectus Abdominis seperated after surgery. Hernia repaired April 11, 2207. No hernia, scar tissue down midline of abdomen.

[UConnJulie]

Well, I would start at the very beginning ...

Starting plan = getting everything firing properly again.

1. Prone TA activation: lie on your stomach and pull your belly button in toward your spine like you are trying to zip up tight pants. Work your way up to 30 second holds (make sure you are BREATHING). Progress to quadruped (on all fours) and then standing. Start with 5 reps total.

2. Rectus activation: lie on your back, extend your arms down by your sides, and keeping your neck neutral, slowly lift your head up off the ground. You can put your fingers on the rectus to feel the activation if you want. Progress to phase one curl ups (arms extended toward knees), then phase two (arms crossed over chest). Repeat for 2 sets of 10.

3. Beginner planks: find an elevated surface that is about hip height (if you have a Smith machine, this is a good use of it). Place your hands on it about shoulder width apart and keep your body straight, like you are going to do a pushup. Hold for as long as you can, working up to one minute. When you hit one minute, find a lower surface. When you get down to the ground, you can drop to your elbows, and work up to 2 minute holds. Repeat for 3 "sets".

Hope that helps!