Author: John Busch

Over the next two weeks, we will add new strength exercises. Walking will continue to be part of your programme, with the amount increasing gradually. 

 

1. Walking 

Walk for 15 minutes every day. Walk on flat and easy terrain. The exertion should be light to medium. 

 

2. Mobilisation and strength 

Practise the following exercise twice a week: 

• Blade stretch: 2 x 10 repetitions  

• Sit & stand: 2 x 10 repetitions 

• Tricep curls: 2 x 10 repetitions

• Bicep curls: 2 x 10 repetitions 

 

Physical activity programme, post-op – Phase 3: Weeks 4 & 5 tabular view 

 

Walking – 5 times a week

20 minutes

Flat, easy terrain

Medium exertion

 

Mobilisation and strength – 3 times per week
Blade stretch	2 x 10 repetitions
Sit & stand	2 x 10 repetitions
Tricep curls	2 x 10 repetitions
Bicep curls	2 x 10 repetitions
Chest press	2 x 10 repetitions
Shoulder rolls	2 x 10 repetitions

It is now the second week after discharge. We will continue to focus on light mobilisation exercises for the next two weeks, increasing the number of mobilisation exercises.  

In two weeks, you will progress to phase 3. 

 

1. Walking

Walk for 15 minutes every day. Walk on flat and easy terrain. The exertion should be light to medium. 

 

2. Mobilisation 

Practise the following exercises every day: 

• Calf raises: 2 x 5 repetitions 

• Side stretches: 2 x 5 repetitions 

• Shoulder rolls: 2 x 5 repetitions 

 

3. Breathing 

Do all breathing exercises every day:

• Deep breathing – 30 repetitions  
• Lateral breathing – 30 repetitions
• Abdominal breathing – 30 repetitions 

 

Physical activity programme, post-op – Phase 2: Weeks 2 & 3 tabular view 

 

Walking – 7 times a week	Breathing – 7 times a week
Flat, easy terrain	Deep breathing
Light to medium exertion	Lateral breathing
	Abdominal breathing

 

Mobilisation – 7 times a week
Calf raises	2 x 5 repetitions
Side stretches	2 x 5 repetitions
Shoulder rolls	2 x 5 repetitions

You have done it! Your life after bariatric surgery begins now.

Immediately following surgery your body is in recovery mode. Our focus, therefore, is on light mobilisation exercises for the first week.  

 

Mobilisation exercises lubricate your joints and improve their function. They can also relax your muscles and the surrounding tissue. Regular mobilisation exercises can increase your awareness of your joints and alleviate pain and oedema –the fluid build-up that causes swelling. Mobilisation exercises concentrate on your biggest, most visible joints – ankles, knees, hips, elbows and shoulders. 

 

Always start mobilisation exercises with small, gentle movements. If you feel any stiffness or pain, try moving in the opposite direction. If a movement is too painful, avoid it until the pain subsides and you are ready to try mobilising that area again. 

 

The goal in this phase is to keep your joints lubricated to retain mobility and your muscles active to retain muscle mass.  

 

Daily walking and breathing exercises are also recommended. Take care to listen to your body and gradually progress your activity level.  

After one week, you will progress to phase 2. 

 

 

1. Walking 

Walk for 15 minutes every day. Walk on flat and easy terrain. The exertion should be light to medium.  

 

2. Breathing 

Do all breathing exercises every day:

Deep breathing – 30 repetitions  

 

Lateral breathing – 30 repetitions 

 

Abdominal breathing – 30 repetitions 

 

Walking – 7 times a week	Breathing – 7 times a week
15 minutes	Deep breathing
Flat, easy terrain	Lateral breathing
Light to medium exertion	Abdominal breathing

 

 

Welcome to your daily activity program!

Here’s a daily activity regimen for you to follow over the next few weeks.

Make sure you continue to stay active and perform your daily activities. Reduce your sitting time and change positions at least once every hour.

 

Mobilisation and strength

Mobilisation and strength exercises are crucial for maintaining your ability to move. Increasing strength also means your muscles require more energy (burn more calories), which supports your weight loss goal. You will find a description of each exercise here. 

• Shoulder rolls: 5 repetitions  

• Calf raises: 5 repetitions 

• Ankle rolls: 5 repetitions

• Chair march: 5 repetitions 

• Chair padeling: 5 repetitions 

Welcome to your daily activity program!

Here’s a daily activity regimen for you to follow over the next few weeks.

Make sure you continue to stay active and perform your daily activities. Reduce your sitting time and change positions at least once every hour.

 

Mobilisation and strength

Mobilisation and strength exercises are crucial for maintaining your ability to move. Increasing strength also means your muscles require more energy (burn more calories), which supports your weight loss goal. You will find a description of each exercise here. 

• Shoulder rolls: 5 repetitions  

• Calf raises: 5 repetitions 

• Ankle rolls: 5 repetitions

• Chair march: 5 repetitions 

How to cope with unexpected events

Unexpected events can have a tremendous impact on both your motivation and your stress level. Being aware of different types of unexpected events and how to perceive a potentially stressful situation as a new opportunity can help.

 

Here are some tips for coping with unexpected events:

 

• Remember that unexpected events can arise at any time and disrupt your exercise routine. Have a backup plan ready for when interruptions occur. Make a date in your diary for your next available exercise session.
• If your day is packed with events, consider getting up 30 minutes earlier for a walk or workout.
• Look for opportunities to exercise during your everyday routine – for example, walk to the train station instead of driving, take the stairs instead of the lift, or take a walk at lunchtime.
• Always have a good variety of exercises ready. Have an indoor routine ready if the weather makes you want to go back to bed. Always have some exercises on hand that you can do anywhere.

 

Here is a list of common unexpected events and how to incorporate exercise into your life despite them:

 

Injury: With an injury, you will most likely need to set new goals for the short term. Make recovery, not exercise, your first priority. Gentle exercise like walking, mobilisation or swimming may be possible. Follow the guidance of your health care team for how to keep fit while recovering.

 

Holiday: Take advantage of the local facilities. Some hotels have swimming pools, tennis courts or gyms. If you’re holidaying at the beach, take a daily swim. Tour on foot – walking is one of the best ways to see the sights and is a great aerobic and weight-bearing exercise.

 

Business commitments: Exercise at your desk. Perform mobilisation exercises and regularly change your position. Take a break from your desk and walk the stairs every now and then. If you move more, you sit less and generally feel better.

 

Bad weather: Adapt your routine or brave the elements. Head to your local swimming pool or gym, or do at-home exercises, such as exercise videos. There are lots of great exercise apps available featuring indoor exercises.

1. Learn to pay attention to how you feel while doing an activity rather than focusing on the activity itself. Observe what’s going on around you – notice the sky, the people, the sounds, etc. This will help keep you focus in the moment and make it easier to notice when you start improving.
   1. How do you feel when you’re active and engaged?
   2. How do you feel after you’ve exercised?
   3. Was yesterday’s exercise session easier? Did you feel more or less tired?
2. Give yourself positive reinforcement. Remind yourself how good it feels to be outdoors or to be active. Acknowledge when you’ve overcome a moment of demotivation and done your exercise routine anyway. Note how good it feels to achieve your goal – especially after coming so close to giving up on it today.

3. Remember that physical activity improves your mood, relieves stress, and helps fight sadness and depression. If your motivation is lagging because you’re feeling blue, remind yourself how good you feel after exercising.
4. Reward yourself – each time you’ve reached your goal for the day, treat yourself to something you really enjoy like a long, hot shower or the next episode in your favourite TV series. Over time, exercising will become the reward – and after a long day working at the computer, you’ll find yourself looking forward to your reward in the form of a walk in the park.

Why are the basic principles so important?

Regardless of your physical condition, it’s important to apply basic principles of exercise to your activities. These principles can help you avoid injury, achieve a steady progression, and stay motivated.

 

Adapt your activity to your present condition

Remember that you don’t need to perform like an elite athlete – all you need to do is increase your heart rate for a little while. Jogging, for instance, is generally not recommended for bariatric surgery patients as it can cause stress on the knees and joints. Instead, go for a brisk walk and try to keep your heart rate elevated as long as possible.

Always try to adapt your level of physical activity to your current condition. For example, if you’re having a day in which walking is painful or uncomfortable, try doing isotonic exercises instead. Isotonic exercises are any movement where the body is lifting, pushing and/or pulling some weight. They include bicep curls, triceps extensions, squats, chest presses, shoulder presses, leg presses, etc.

If you experience joint pain that prevents you from walking daily, you may want to try aquatic therapy. Water exercises are not weight bearing, which makes them ideal for people with joint problems. If swimming is not your style, strive to replace sedentary activities with some other type of physical activity.

 

Tips to remember Regularity: Try to do some form of exercise every day – even if it’s only a little. Listen to your body and respect your limits, but make sure to do some type of movement. Soon you will see progress – from day to day and week to week. Individuality: Try not to compare yourself to others. You are unique with your own goals to achieve. Focus on those and you will begin to see improvement and build confidence. Progression: Gradually increasing your level of activity over time stimulates adaptation and boosts your confidence in your exercise routine.

After surgery

After your surgery it is important that you increase your activity levels slowly over time. The following highlights the important elements:

1 day to 3 weeks post-op

Immediately after surgery your body will be in recovery mode. Light mobilisation exercises are recommended for the first week. During this phase, the goal is to keep your joints lubricated and your muscles active to retain muscle mass. Daily walking and breathing exercises are also recommended. Focus on listening to your body and gradually progressing your activity level.

Remember to follow the suggestions of your health care team.

 

3 weeks to 6 months post-op

During this time, you will begin incorporating some strength training activities. Continue to focus on your breathing and listen to your body. Gradually increase your activity level over time. The goal is to reach and maintain a good basic physical condition.

By the end of this phase, you will hopefully feel like your exercise routine has become your best friend. You will want to spend some time with it every day and you will miss it if, for some reason, you are not able to exercise one day.

 

The rest of your life

This is reinforcement time – time to let your exercise routine take over. You will learn about the importance of varying your routine to keep it interesting and motivating with different activities like swimming, golfing, rowing or other activities you never knew you were going to love. You will also learn about the possibility of joining different exercise groups, so you can mix some social activity into your routine.