After anal fistula surgery, resuming exercise habits?
Hello Doctor,
I underwent an anal fistula incision surgery on May 19th, and during my second follow-up appointment on June 2nd, the attending physician informed me that my recovery was progressing well and that I did not need to return for further visits.
I inquired whether I could resume my exercise routine (such as weight training, cycling, and using the treadmill), and the doctor advised me to wait until after June 17th to start exercising.
The images in the following link show the condition of my wound during the first week and on the 26th day post-surgery: https://imgur.com/a/mZTdMUv.
I have the following questions:
1.
Since the fistula was located deeper, it involved cutting the internal anal sphincter.
Will the internal anal sphincter heal over time?
2.
After the internal anal sphincter heals, will it be more relaxed compared to the pre-surgery state?
3.
Generally, how long does it take for the cut internal anal sphincter to fully return to a healed state?
4.
Will exercising affect the speed of wound healing?
5.
Given the current state of my wound recovery, is it safe for me to exercise?
6.
For warming up before exercise, would using the treadmill be more advisable than cycling, as sitting on the bike may put pressure on the wound?
7.
Regarding weight training, would it be unadvisable to perform lower body exercises targeting the glutes and legs? Is it acceptable to focus on upper body exercises such as chest, back, and arms?
Thank you for taking the time to address my questions.
CT, 30~39 year old female. Ask Date: 2022/06/14
Dr. Zhang Shuhao reply Surgery
1.
Based on the wound, it appears that only a portion of the external anal sphincter has been cut, and the function of the internal anal sphincter is not significantly affected.
After healing, the external sphincter will scar, losing some elasticity, but it generally does not impact bowel movements.
2.
If the muscle fibers are cut, they may become more relaxed; however, the sphincter is a circular structure, so other parts can compensate, preventing incontinence.
3.
It will take several weeks, and adequate rest can accelerate healing.
4.
There will not be a significant impact, but it is generally advisable to avoid lower body exercises initially, mainly to prevent strain on the wound.
5.
Yes, considering the above factors.
6.
It is best to avoid using a stationary bike due to the seat design; using a treadmill is acceptable as long as the intensity is not too high.
7.
Chest, back, and upper limb exercises are definitely permissible; for the glutes and legs, start with light weights and gradually return to normal as long as there is no discomfort.
Reply Date: 2022/06/14
More Info
After undergoing anal fistula surgery, it is crucial to approach post-operative exercise with caution and a clear understanding of your body's healing process. Here are some guidelines and considerations based on your questions and the general principles of post-surgical recovery.
1. Healing of the Internal Sphincter Muscle: The internal anal sphincter, which may have been affected during the surgery, typically heals over time. The healing process can vary from person to person, but generally, the muscle will regain its integrity and function. However, it is essential to follow your surgeon's advice regarding activity levels during the healing phase.
2. Tightness and Relaxation of the Internal Sphincter: Post-surgery, the internal sphincter may initially feel looser due to the incision. However, as healing progresses, the muscle should regain its tone. It is important to note that while some degree of relaxation may occur, the body often compensates for this, and significant issues like incontinence are rare if proper care is taken during recovery.
3. Timeframe for Complete Healing: The internal sphincter can take several weeks to months to heal completely. Typically, you might expect a healing period of around 6 to 8 weeks, but this can vary based on individual factors such as overall health, age, and adherence to post-operative care instructions.
4. Impact of Exercise on Healing: Engaging in physical activity too soon can potentially affect the healing process. It is generally advised to avoid strenuous activities, especially those that put pressure on the pelvic area, until you receive clearance from your healthcare provider. Light activities may be permissible, but always listen to your body and avoid any movements that cause discomfort.
5. Current Status of Your Wound: Since you mentioned that your wound is healing well and you have minimal pain, it is a positive sign. However, it is crucial to adhere to your doctor's recommendation to wait until June 17 before resuming exercise. This waiting period is likely to ensure that your body is adequately healed to handle physical activity.
6. Warm-Up Recommendations: When you do resume exercise, consider starting with low-impact activities that do not put pressure on the surgical site. For example, using a treadmill may be preferable to a stationary bike, as the latter could place pressure on the area. Always prioritize gentle warm-ups to prepare your body for more intense activity.
7. Weight Training Considerations: When it comes to weight training, it is advisable to avoid exercises that heavily engage the lower body, particularly those that involve the glutes and legs, until you are fully healed. Focus on upper body workouts, such as chest, back, and arms, which are less likely to strain the surgical site. Gradually reintroduce lower body exercises as you gain confidence and receive medical clearance.
In conclusion, while it is understandable to be eager to return to your regular exercise routine, patience is key in the recovery process. Always consult with your healthcare provider regarding your specific situation, and follow their recommendations closely. This approach will help ensure a safe and effective return to physical activity while minimizing the risk of complications. Remember, your health and well-being should always come first.
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