Pelvic Floor Exercises After Hysterectomy: What to Know (and What to Avoid)
In this blog we’re focusing on what pelvic floor exercises after hysterectomy should look like and how pelvic health occupational therapy (and myofascial release) can support recovery that goes beyond the basics.
Why Pelvic Floor Therapy Matters After Hysterectomy
Whether your hysterectomy was laparoscopic, vaginal, abdominal, or robotic-assisted, the surgery affects more than the uterus. It impacts how your pelvic floor supports your internal organs, how your muscles coordinate with movement, and how pressure moves through your abdomen.
Without guidance, it’s common to develop compensation patterns like:
Gripping or clenching in the lower abs or pelvic floor
Holding tension in the hips, tailbone, or low back
Avoiding movement due to pressure or discomfort
Increased urgency or leaking with bladder or bowel habits
Pelvic floor therapy helps restore strength and mobility so that your muscles are doing the right job, at the right time—not overworking or guarding.
What Pelvic Floor Exercises After Hysterectomy Should Actually Include
If you’ve been told to “just do Kegels,” pause. Not every person needs to strengthen—and doing so without assessing muscle tension or alignment can actually increase pressure or discomfort.
At Imagine Pelvic Health, we focus on coordination first, which often includes:
✔ Diaphragmatic breathing to restore natural pressure systems and calm overactive muscles
✔ Gentle core and hip integration to bring the pelvic floor into daily movement patterns
✔ Pelvic floor down-training if you’re holding tension or feeling discomfort with intimacy or bowel movements
✔ Progressive strengthening (only when appropriate) to improve endurance, support, and confidence in movement
All exercises are based on your specific post-op presentation—never a one-size-fits-all list.
The Role of Pelvic Health Occupational Therapy
Pelvic health OT isn’t just about exercises. We assess how your body moves throughout your day—getting out of bed, lifting, using the bathroom, sitting at work, or returning to intimacy. These daily activities place demands on the pelvic floor, and if you’re compensating, pain or dysfunction can linger long after surgical healing is complete.
We look at:
Body mechanics and movement patterns
Bladder and bowel habits
Posture and breath mechanics
Scar mobility and tissue sensitivity
Emotional or nervous system responses to pain or pressure
Treatment plans combine education, hands-on techniques, and functional movement strategies to restore long-term comfort and stability.
How Myofascial Release Supports Hysterectomy Recovery
Scar tissue—whether from the external incision or internal healing—can create adhesions that restrict movement and cause pulling, aching, or pelvic pain. Many clients don’t even realize their scar is contributing to symptoms until we start working with it directly.
Myofascial release gently addresses tightness in the abdominal wall, pelvic floor, and surrounding structures. This can improve:
Core activation
Bladder control
Sexual comfort
General mobility and tissue glide
It’s especially effective when layered with movement retraining and breath-based exercises.
When to Start Therapy
If you’re 6 weeks or more post-op and feeling unsure about your recovery—or still noticing symptoms months or years later—it’s still a good time to seek out support. We can also help you prep pre-operatively. Whether you’re in active recovery or years down the line, pelvic floor therapy can improve your function, reduce discomfort, and help you feel more at home in your body again.
Ready to feel stronger, supported, and better informed?
Imagine Pelvic Health offers one-on-one pelvic floor therapy for hysterectomy recovery, including in-person care in York and Hanover, PA, as well as telehealth and in-home sessions.
