Training after appendix removal

[Acamp76144]

Just had my appendix removed via keyhole surgery (I type this from my hospital bed!) and wondering when I can get back into training (assuming no complications and due to get released tomorrow post having 3 antibiotics via IV).

Plan was no ‘lifting’ for say 2 weeks and then dial it back up but how much and by when? Is there anything I can do damage to internally by going to hard too early (no external stitches as was keyhole).

been lifting for 10 years, 40 years old, desk job, 3 young kids. Bw 98kgs. Just tested 3rm on main lifts - Deads 185 x 3, squats 160 x 3, bench 120 x 3 with more in the tank. Been making good progress of late so want to be sensible but am guessing conventional medical advice will be overly conservative for a relatively ‘trained’ individual.

Thks!

[Austin Baraki]

There are no data to guide specific recommendations on this topic, so it's mainly going to be a mix of "expert opinion" and your own personal risk tolerance.

If it was me, I'd probably start out with a light workout about a week after an uncomplicated laparoscopic appendectomy. If you'd prefer to wait to 2 weeks, that's certainly reasonable. I would probably keep things well below RPE 7 in the initial phase and avoid any grinders.

[Acamp76144]

Thks for the quick response, really appreciate it. Doc said to wait 6 weeks before doing anything that stresses the core. Said something like there is increased risk of hernia at the entry point near my belly button as they had to go through the wall.

[Austin Baraki]

While that may be true, I'd be interested to see the evidence base for the 6 week recommendation.

[Awk1993]

My anecdotal experience:

I had a keyhole appendectomy a while back and also got told not to lift for 6 weeks.

For a day or 2 after, walking was quite difficult so I progressively tried to walk further and further each day, then moved onto some air squats etc. Felt comfortable enough to do some extremely light work in the gym 5 days after the surgery and progressed from there. Didn't deadlift for a couple of weeks (felt weird). Did a mini-LP with sets of 10. My way of reconciling with the doctor's recommendation was to not go 'heavy' at any point during the 6-week time-frame, although this might have been too conservative. Still, squatted over 70% of previous 1RM for 3 sets of 10 on the day I was supposed to be able to resume lifting, which was quite satisfying.

[Acamp76144]

Thks for responses

[Acamp76144]

One more question, assuming I’m going to be cautious in my recovery, is there such a thing as a minimum effective dose of volume ie is on the side of caution

[Austin Baraki]

I don't understand your question.

[Acamp76144]

What I was trying to get at is what is the minimum intensity/volume that I could utilise to aim to maintain my current strength/muscle mass but minimise risk of aggravating the surgery (with an abdominal wall hernia being the main risk?) - appreciate like most things in life it’s a risk vs return trade off

i also assume that the highest risk exercise would be say a high intensity (RPE) squat or deadlift where I am having to brace hard. If so would (and I hate to say it) machines potentially be lower ‘risk’ as something like a chest press doesn’t require bracing, with BW chins and dips etc being somewhere in between?

Finally what is the 6 week/2 month timespans for recovery that seems to be the standard medical response Based upon? What am I actually waiting on happening under the skin - is the abdominal wall (muscle/fascia?) rejoining at the insertion sites.

thks

[Acamp76144]

This article seems to be pretty much exactly what all surgeons say about the matter.

https://healthcare.utah.edu/the-scope/shows.php?shows=0_jcd5tg17

[Austin Baraki]

What I was trying to get at is what is the minimum intensity/volume that I could utilise to aim to maintain my current strength/muscle mass but minimise risk of aggravating the surgery (with an abdominal wall hernia being the main risk?) - appreciate like most things in life it’s a risk vs return trade off

We don't know.

i also assume that the highest risk exercise would be say a high intensity (RPE) squat or deadlift where I am having to brace hard. If so would (and I hate to say it) machines potentially be lower ‘risk’ as something like a chest press doesn’t require bracing, with BW chins and dips etc being somewhere in between?

Maybe? We also don't know.

Finally what is the 6 week/2 month timespans for recovery that seems to be the standard medical response Based upon? What am I actually waiting on happening under the skin - is the abdominal wall (muscle/fascia?) rejoining at the insertion sites.

Unfortunately ... we don't know.

Sorry man. There is no evidence we're aware of to guide us here.

[Culican]

I went back to the gym 10 days after my laparoscopic inguinal hernia surgery. Had no problem with any of the three holes for the scope and trocars. Managed to mess up my elbow doing hammer curls though. Worked my way up to a squat at 275x1 on day 11 post op. The belt hurt over the incision at the umbilicus but I wore it anyway figuring it would keep everything from blowing out.

Interestingly, when I went for my follow-up with the surgeon at day 13 I found out I wasn't supposed to lift anything over five pounds until the followup. He said no-restrictions after three weeks but "nothing really heavy" until after four. I didn't tell him what I had already done but I think he suspected it. I also didn't ask what "really heavy" meant. Six months later, I am fine. (I am 62yo so you should recover faster.)

Interestingly, many surgeons post their recovery instructions for this surgery on the net (probably to avoid endless phone calls). In my net-travels I found everything from 6 weeks down to 2 days for no restrictions. He says, "On the third post-operative day, unless told differently by me, you have FULL UNRESTRICTED physical activity. There is no limitation, and the more you do, the quicker the pain and discomfort will disappear. Some discomfort and pain is normal. Your body will set your limits, though it is ok to be aggressive." I won't provide the link but if you Google the string I quoted it will get you there.

I think it means, like Dr. Baraki says, they don't really know.

[Acamp76144]

By way of update, I took it pretty easy for 6 weeks (no more than rpe 6/7; didn’t brace hard on anything g), then went back at it as normal with no issues.