Rethink Recovery: Rebuilding Your Core Strength After Stoma Surgery

22 April, 2026

By Nelam Kumari, Clinical Educator, Convatec

When recovering from stoma surgery, many people are surprised to learn that one of the most important parts of recovery is rebuilding their core strength. When I talk about your core, I don’t just mean your abdominal muscles. Your core includes deeper muscles such as your diaphragm, pelvic floor, side muscles, and those that support your spine. These muscles work together to keep you steady, protect your stoma, and reduce the risk of problems such as a parastomal hernia.

Why your core matters

After surgery, your abdominal muscles are weaker because the surgeon has cut through the abdominal muscle to bring the bowel out to form the stoma. Everyday activity like standing, bending, or lifting can put extra strain on them. If your core isn’t strong enough, this strain can increase the risk of a hernia. A hernia happens when part of the bowel pushes through a weakened part of the muscle wall near your stoma.

Your muscles may be weaker due to the incision though the muscle to bring out the bowel to form the stoma. Everyday activities like standing bending of lifting can increase intra-abdominal pressure increasing the risk of a parastomal hernia.

The positive news is that strengthening your core can lower this risk. Doing the right exercises, safely and gradually, will also make daily life easier. A stronger core helps you move with confidence, lift correctly without worrying, and get back to the things you enjoy doing.

How Rethinking Recovery developed

The Rethinking Recovery programme was developed by Sarah Russell, a clinical exercise specialist who also has a stoma. After her own surgery, Sarah realised there was little clear advice on how to recover safely and the advice that was out there was conflicting. Many patients were told “don’t lift,” but this was based more on habit than on research.

Determined to change this, Sarah worked with Convatec to design a programme based on physiotherapy principles, patient experiences, and her own knowledge. The result was the Rethink Recovery a programme that is now widely used by stoma care teams across the UK to support patients both preoperatively and post-surgery.

My role as a Clinical Educator

In my role, I train stoma nurses, physiotherapists, and other healthcare professionals to use Rethink and Recovery with their patients. This “train the trainer” approach means more people can benefit from safe, practical advice wherever they are in their recovery.

Healthcare professionals learn simple breathing techniques and gentle core exercises. These simple steps can then be taught either in the pre-op phase or to people living with a stoma. From there, patients can gradually move on to safe, functional activities like bending, lifting, and reaching. The exercises are not about doing high-intensity workouts. They are safe, targeted movements designed to strengthen your core and reduce the risk of a parastomal hernia.

Here’s some tips for gentle core exercises you can try at home:

1 Breathing exercise to reconnect with your deep core muscles.

• Start by practising gentle rib or “diaphragm” breathing while lying down. Place your hands on your lower ribs, feel them expand as you breathe in, then let them soften as you breathe out.
• As you exhale, gently draw in your lower tummy without holding your breath or tensing your shoulders. This helps you reconnect with the deep core muscles that support your stoma.
• Once you’re comfortable lying down, repeat the same technique while sitting or lying on your side. These breathing skills can also be used to support your core when you cough, sneeze, or stand up.

2 Gentle movements you can do lying down or sitting.

• Simple stretches such as knee rolls (knees bent, gently lowering them side to side) or small arm and leg lifts help to keep joints flexible and muscles active without strain.
• Pelvic floor exercises can be added at this stage, working in time with your breathing — relax on the in-breath, then gently contract on the out-breath.
• Sitting upright, practise good posture with a neutral spine. From here, you can add small arm reaches or gentle twists, always keeping your breathing relaxed and core engaged.

3 Exercises matched to your stage of recovery and everyday needs.[RU1.1]

• In the early days, focus mainly on breathing, pelvic floor awareness, and short walks if you feel able. Learn safe techniques for moving in and out of bed or standing from a chair.
• As you progress, build in functional movements, such as lifting light items with core support, reaching overhead, or practising balance exercises to feel more secure on your feet.
• Longer term, increase strength and stamina at your own pace. This might mean longer walks, gentle resistance exercises, or more challenging versions of earlier movements. Always protect your core by coordinating breath and movement.

If you’d like to know more, ask your stoma care nurse at your next appointment or alternatively you can register with Me+ our lifestyle programme for people living with a stoma, here you will find support on movement, parastomal hernia, diet and hydration and many other topics to support you.