Immediate Recovery: Pain, Movement & Early Healing

Immediate Recovery: Pain, Movement & Early Healing

A guide for those first few days when everything feels new, weird, and slightly unfair.

Congratulations, you’ve made it through surgery, the big part is done. Now it’s all about helping your body do what it’s designed to do: heal.

The first few days can feel like an odd mix of gratitude, grogginess, and wondering whether your insides will ever feel like your own again. (They will, promise.)

Here’s what actually helps recovery . . . and what’s more myth than medicine.

Pain: What’s Normal, What’s Not

First, let’s be real: you’ve just had major surgery. Some pain is normal, even expected. It’s your body’s “under construction” sign, not a sign of failure. You should have been sent home with pain relief, take it as instructed, don’t be tempted to power through. Keep a pain relief diary, so you can keep on top of your pain.

Normal

(a.k.a. expected, not fun but fine):

These usually appear in the first few days and gradually settle:

  • Incision or lower belly ache: like deep muscle soreness or period pain.

  • Pelvic heaviness or ache: where your uterus used to sit (that’s internal healing).

  • Gas or bloating pain: especially in the shoulder or ribs if you had laparoscopic surgery (trapped CO₂).

  • Mild pulling, tingling, or itching: as stitches dissolve and nerves wake up.

  • Cramping: as pelvic muscles and ligaments adapt (can last a few weeks).

You should notice pain slowly improving each day. By 2-3 weeks, you might still feel tender when you move, but you shouldn’t need heavy painkillers.

Grey Zone

(keep an eye on it):

These things can happen (and don’t always spell trouble) but deserve attention if they linger or worsen:

  • Sharp pain that isn’t easing after a week

  • New pain on one side of your abdomen

  • Increased swelling or redness around your incision

  • Trouble peeing or emptying your bladder

  • Constipation lasting more than 3 days even with medication

If you’re unsure, trust your instincts and check in with your care team. They’d much rather hear from you early than fix a bigger issue later.

Not Normal

(time to call your doctor or go to A&E):

These are your “don’t wait and see” signs:

  • Sudden or severe increase in pain after a period of improvement

  • Fever or chills

  • Foul-smelling or pus-like vaginal discharge

  • Heavy vaginal bleeding (soaking a pad within an hour)

  • Pain, swelling, or redness in your calf (possible clot)

  • Persistent nausea, vomiting, or inability to keep fluids down

  • Feeling faint, dizzy, or short of breath

These could signal infection, internal bleeding, or a blood clot, all fixable if caught early.

Gentle movement soon after surgery supports faster recovery and fewer complications. Even walking to the bathroom counts.

Movement: Your Superpower

Prevent Clots

Wake up bowels

Reduce stiffness

  • Walk every few hours during the day (slowly).

  • Sit up for meals.

  • Rest in between - healing takes energy.

Wound Care 101

Most women will have an abdominal incision and/or a vaginal cuff/vault, which is where the top of the vagina is closed off internally if the cervix is removed along with the uterus. Both heal beautifully with the right care, they just need slightly different approaches.

Abdominal Incision (Open or Laparoscopic)

You may have a few small keyhole cuts or one longer horizontal incision, depending on your type of surgery. This is your external wound, and it needs some care and patience while it heals.

  • Keep your incisions clean and dry. Shower daily and make sure your dressings are covered with something waterproof. No baths yet, as soaking keeps things damp and encourages bacteria. Gently pat your tummy dry with a clean towel.

  • Let them breathe. Loose cotton clothing allows airflow and reduces irritation. Think comfy joggers or floaty dresses. Those skinny jeans can wait a while.

  • Support your tummy when you cough or sneeze. Hold a small pillow or folded towel against your abdomen to reduce pressure on your stitches. Coughs and sneezes can sting and make things feel turbulent, but nothing is going to fall out.

  • Avoid lifting or twisting. Nothing heavier than a kettle or small handbag for now. Your body will tell you what is too much. A sharp tug or pulling sensation means you have gone beyond your limit.

  • Expect light itching as it heals. This is normal. Sharp pain, oozing, redness, or any unusual smell means it is time to call your nurse or GP.

Healing skin loves oxygen, protein, and rest. Deep breathing, good nutrition, and time are far more effective than any cream or oil, but a skin balm like Tropic’s Tamuna balm can assist the scarring by hydrating. Scar massage can also help realign the un-cohesive young collagen fibres, but see a qualified scar massage therapist for this.

Vaginal Cuff (Internal Healing)

If your hysterectomy included removal of the cervix, you will have an internal wound called the vaginal cuff. This is where the top of the vagina is stitched closed inside to protect against infection, and it takes several weeks to fully heal.

  • Light spotting or brown discharge for up to six weeks is normal. Some women do not bleed, but keep a few pads handy just in case.

  • Use sanitary pads for any bleeding, not tampons or menstrual cups. And if you do bleed, just remember that once the healing bleeding is done… no more periods ever again. Every cloud right!?

  • Move carefully and avoid bending, lifting, or strenuous exercise because internal pressure affects healing.

  • Avoid sex, or vaginal toys until cleared at your six to eight week check-up.

  • Report heavy bleeding, foul-smelling discharge, pain, or a feeling of pressure straight away as these can signal infection or early cuff separation known as dehiscence.

  • Stay hydrated, eat fibre, and use stool softeners to prevent straining.

The vaginal cuff heals well because of its strong blood supply, but it is sensitive to pressure. Too much early strain from lifting, constipation, or sex can disrupt healing. The single biggest cause of dehiscence is sex before it has healed. Smoking, diabetes, poor nutrition, steroid use, and age can all slow recovery. Give your body time and patience. Internal healing cannot be rushed.

Breathing & Circulation Tricks

Slow, deep, diaphragmatic breathing expands your lungs, moves your diaphragm, and gently activates your pelvic floor. It also helps calm your nervous system, lowering pain perception, heart rate, and blood pressure. In short, it’s your built-in recovery tool, and it’s completely free.

Try this every hour or two, especially when resting or before you get up:

  1. Sit or lie comfortably with one hand on your chest and one on your belly.

  2. Inhale slowly through your nose for about 4 seconds, letting your belly rise.

  3. Exhale through your mouth for 6 seconds, letting your shoulders soften and your ribs relax.

  4. Imagine the breath moving all the way down into your pelvis.

    You can do this in bed, in a chair, or standing. If lying flat feels tight, try propping your upper body slightly with pillows.

    Pair your breathing with gentle ankle pumps, calf circles, or toe wiggles to keep blood moving through your legs. This combo helps prevent stiffness and reduces the risk of clots after surgery.

The Glamorous Topic: Bowels & Bladders

Constipation is common after surgery, but it is manageable. If it’s been more than three days and nothing’s happening, give your team a call. It’s an easy fix, and your pelvic floor will thank you for not forcing the issue.

To help things along, make sure you’re doing the following…

  • Start walking/moving early.

  • Drink plenty of water.

  • Eat fibre (fruit, veggies, oats).

  • Add foods that naturally help things move; kiwis, prunes, pears, and flaxseed are all gut-friendly.

  • Have warm drinks in the morning (herbal tea, lemon water, or coffee can gently nudge your bowels awake).

  • Take stool softeners if prescribed (this is not the time to prove your independence). Psyllium powder is a great supplement as it works on both constipation and diarrhoea. The cheap stuff is as good as the expensive stuff and you can throw it in almost anything.

Peeing might feel weird too. That’s normal, your bladder has been temporarily moved around and will have a case of bashfulness for a while! Expect to sit for a bit longer than normal as your power output will be dialled down. If you can’t empty properly, or it burns when you do, tell your GP.

Your Emotions Are Healing Too

Feeling wobbly (relief, sadness, or both) is completely normal. After all, a hysterectomy doesn’t just change your body; it can stir up hormones, identity, and everything in between.


Estrogen levels may shift, pain and exhaustion play tricks on your emotions, and the reality of recovery can take time to land.

Here’s the truth: emotional recovery is part of physical recovery. Your body and brain heal together give them both patience and care. If you need to cry, do it! It’s not weakness, it’s grieving, it’s relief, it’s everything in between.

We’ll go through this in more detail in our chapter Psychological & Emotional Recovery.

Rest without Guilt

Here’s the truth: fatigue isn’t laziness; it’s biology. Healing burns calories, oxygen, and patience.
Your job right now is to alternate rest and gentle activity. Netflix and naps count as rehab too, as long as you get up for a stroll in between.

Sleep is when your body builds new tissue and recalibrates hormones.

If pain or hot flushes are messing with that, talk to your doctor, don’t just power through.

Your Recovery Team (Round 2)

You’ll meet new members of your Dream Team now:

Nurses (at the hospital):

Your recovery angels, tell them everything, especially pain, swelling, or bathroom issues.

Pelvic Health Physio:

Helps you learn safe early movements and breathing strategies.

Therapist/Counsellor:

Emotional support is not optional, it’s essential.

Nutrition Support or Meal Prep Help:

Healing burns fuel; let others cook, you will NOT be able too.

YOU:

You are the true CEO of your own comeback

For what to expect once you’re home, see “Return to Exercise & Loading.”

Key Takeaways:

Pain is expected - unmanaged pain is not.

  1. Gentle movement beats bed rest every time.

  2. Deep breathing helps calm your nervous system and boost circulation.

  3. Constipation prevention is self-care, not TMI.

  4. Healing takes energy; rest is part of the plan, not a luxury.

  5. Ask for help; from professionals and from your people.

This is the wobbly but vital phase, the bridge between surgery and feeling like yourself again. You don’t need to rush it. You just need to move through it, one slow, supported, perfectly normal step at a time.

We’ll see you next on “Nutrition & Lifestyle for Recovery” and “Pelvic Floor & Core Rehabilitation” when you’re ready for the next layer.

You’ve got this - and we’ve got you.

Evidence Summary

This section draws from ERAS, Cochrane Reviews, and Royal College of Surgeons guidance on early mobilisation after pelvic surgery.

Research consistently shows that gentle walking, breathing exercises, and early movement help:

  • Reduce pain and fatigue

  • Improve circulation and bowel function

  • Support faster healing and emotional well-being

Early activity doesn’t “undo” your surgery, it speeds your return to strength and independence.