I’m hearing more and more from people having stoma surgery that their nurse has told them to do Pilates as part of their recovery. This is brilliant and a million miles away from ‘don’t lift a kettle and avoid exercise for 6 weeks’.  So thank you for listening nurses  keep sharing that message.

Pilates is actually a therapeutic type of exercise and was originally developed by Joseph Pilates – a German carer working in hospitals during World War I – to help the recovery of injured veterans.

One surgeon I work with tells his patients to do Pilates or yoga. Again great! And Id much rather see this than being told not to do anything.

The problem is that there are many different types of Pilates and yoga with different styles, focus, approach and levels of difficulty.  And Pilates is actually very different from yoga altogether.

Pilates generally is more focused on the abdominals or the ‘powerhouse’ as it’s often called with lots of specific abdominal isolated exercises whereas Yoga has many different styles and can be more about control, alignment, flow and breath.

I’m currently on holiday and have had the pleasure of enjoying the hotels classes. This is no criticism as the teachers are incredibly experienced and very good, but many of the exercises especially in the Pilates class here, would be entirely inappropriate for the majority of people with a stoma or hernia (or both), and would be way too advanced, perhaps even causing a hernia or making one worse.

So while I’m a believer that any movement and exercise is better than no exercise, it does need to be safe and appropriate especially post surgery, when starting for the first time or if living with a hernia. It’s vital to choose the right class and the right level and be aware that there are different levels and techniques.

So how do you choose the right class or teacher?

For most people living with a stoma or in the post operative period what we need is clinical or rehab Pilates where the focus is on the breath and deep core engagement with gentle levels of exercise that can be adapted and progressed.

In Pilates look for a teacher or class that has the words clinical, physiotherapy led, rehab or trained by APPI. Post natal style classes would also work well.

Beginners level is often still too hard. Here at The Ostomy Studio I teach 3 different levels and I would describe my advanced level more akin to a standard or intermediate ’normal’ class.

Pilates focus on the deep core and pelvic floor is exactly what we need to develop the ability to manage intra abdominal pressure and build a strong powerhouse. Don’t shy away from specific abdominal exercise but embrace it in gentle steps.

Yoga on the other hand can mean very different things and won’t have the isolated specific focus on the core that Pilates does.

At the start choose a gentle beginner class for general well being, breathing exercises and movement – something like Hatha or therapy yoga – and progress to something like traditional Iyengar yoga.

Ultimately over time if you can get strong enough and you can manage intra abdominal pressure well, you should be able to do any style of Pilates and yoga, with a few modifications where needed. But that can take many years of practice and development of strength.

It’s important to remember not to lump it all into the same bucket and that there are many different styles, levels and approaches.

My advice is always choose rehab Pilates first and go from there. It forms the foundation of everything else.

Here at the Ostomy Studio I have developed a clinical Pilates informed approach to core rehab designed exclusively for the needs of people post abdo surgery or with a hernia, pelvic floor dysfunction or a stoma. It’s safe and appropriate but with progressive steps to build up to advanced level if desired.

Come and join a live class or work through the online videos at your own pace.