Getting Back to Training Following Laparoscopic Surgery

By Cat Trentham

Recovering from laparoscopic surgery can be a lengthy journey, and if you’re an active person, you may be wondering how and when you can safely return to training. Having been through laparoscopic surgery myself for endometriosis, I want to share the best advice I’ve gathered from my experience to help others navigate their recovery. (If you want to read more about my endometriosis journey, you can do so here.)

What is Laparoscopic Surgery?

Laparoscopic surgery, often called “keyhole surgery,” is a minimally invasive procedure where small incisions are made in the abdomen to allow a camera and surgical instruments to be inserted. These incisions are typically placed inside the belly button and lower abdomen, though the locations and number of incisions may vary depending on the procedure. It is commonly used for procedures such as gallbladder removal, appendix removal, hernia repair, and treatment of endometriosis. Despite being considered minimally invasive, it is still major surgery, with significant internal healing required. The small external wounds can be misleading—just because they look minor doesn’t mean that recovery is quick or easy.

The Early Weeks: Rest, Nutrition and Gentle Movement

In the first few weeks post-surgery, you will likely be on strong pain relief, and the primary focus should be on rest, eating nutritious meals, staying well hydrated and getting plenty of sleep. Gentle walking is beneficial to keep the body moving and prevent complications like blood clots and adhesions forming, but it’s crucial to listen to your body. You will fatigue much more quickly than expected, and overexertion can set back your recovery.

Breathing and Stretching for Recovery

Laparoscopic surgery often involves insufflating the abdomen with gas to create space for the procedure, which can cause post-operative discomfort, particularly in the diaphragm and shoulders. Gas and post-surgical pain can make the diaphragm tight, leading to shallow breathing. This can also affect core stability and pelvic floor function, making recovery harder. (In some cases, women who have undergone laparoscopic surgery may benefit from seeing a specialist pelvic floor physiotherapist, depending on which organs were treated and how they may have impacted pelvic floor function.)

To aid recovery, it is important to practice deep diaphragmatic breathing to fully engage the lungs and help restore proper movement of the diaphragm.

A Simple Deep Breathing Exercise:

1. Lie on your back with one hand on your chest and the other on your belly.

2. Take slow, deep breaths through your nose, allowing your belly to rise while keeping your chest still.

3. Exhale slowly through your mouth and allow your abdomen to shrink.

4. Try to inhale and exhale slowly, each lasting a full 5 seconds, and continue this pattern for 5 minutes.

Deep breathing helps keep the diaphragm working properly, improves lung function, and prevents tightness or adhesions after surgery. Since the diaphragm supports core stability and breathing, regaining full movement is key for recovery and getting back to exercise.

Gentle stretching can also aid in mobility and comfort. However, it is important to perform these slowly and carefully, avoiding overstretching or straining. The following stretches were particularly helpful in my recovery:

• Child’s Pose: Helps gently stretch the lower back and relieve tension.

• Happy Baby: Opens up the hips and lower abdomen.

• Sphinx/Cobra Pose: Encourages gentle extension of the abdomen.

• Cat-Cow: Promotes spinal mobility and core activation.

Reintroducing Light Exercise

After around six weeks, it’s usually safe to add in some static cycling, as it puts minimal strain through your core (assuming your doctor gives the go-ahead). I used a heart rate monitor and aimed to stay in Zone 2 (around 60-70% of max heart rate), focusing on building volume before intensity. To begin with, 15-20 minutes was more than enough, and I started with a schedule of one day cycling, followed by two days of rest. From there, I progressed to alternate days, and once I could cycle daily without setbacks, I slowly added a couple of minutes to each session. When I could manage 30 minutes in Zone 2 with no negative aftereffects, I began to increase the intensity or introduce some interval sessions.

I used Whoop to track my recovery (you can try it for free using my referral link here). The data helped me assess how well I was bouncing back from each session and plan how many rest days I needed. If I pushed too hard, it became obvious, either through Whoop’s metrics or clear physical signs like fatigue, a tugging sensation behind my belly button, or general discomfort.

This was about as much as I could safely handle in the first three months of my recovery, alongside the breathing exercises and stretches mentioned earlier. However, recovery timelines vary depending on several factors:

• The type of surgery: for example, ablation vs. excision. (Ablation burns off the surface level of tissue, whereas excision cuts it out completely. Excision often leads to better long-term outcomes but typically involves a longer recovery.)

• The extent of tissue and organ involvement: the more extensive the surgery, the longer the healing process.

• Personal factors: like age, medications, and other medical conditions.

At times, it was frustrating not to progress more quickly. When fitness is no longer the limiting factor, and your legs and lungs feel fine, it’s hard to accept that your stomach and internal healing are what’s holding you back. The work feels too easy, and it’s tempting to push harder, but you have to trust the process.

To stay motivated, I set new challenges. I used the Concept2 BikeErg and logged my meters in the Concept2 online logbook, aiming to reach one million meters and earn a free t-shirt. Having a tangible goal kept me focused, even when progress felt slow.

Ultimately, you have to be patient, do the work, and trust that this foundation will get you back to full training in time.

Strength and Stability: Building Back Up

Core stability was one of the biggest challenges in my recovery. With multiple incisions through my abdominal muscles, even simple daily tasks like carrying shopping bags or pushing doors open felt difficult. I knew I had to rebuild my strength from the ground up, but the reality of my recovery didn’t live up to my expectations.

As someone who could previously deadlift twice my body weight and hold a plank for seven minutes, it was pretty disheartening to be shaking my way through a five-second plank. But progress doesn’t happen overnight. The key was meeting myself where I was, rather than comparing everything to my lifetime bests. If I hadn't persisted with those shaky five-second planks, I’d have never made it to 10 seconds, then 15, and so on. Now, nine months post-surgery, I can manage 3 x 45-second planks with short rests between. That only happened because I kept showing up, one tiny step at a time.

To start rebuilding core strength, I focused on:

• Farmer’s Carries: Holding a dumbbell in one hand and walking lengths of the gym, switching sides at each end. This helped prepare me for carrying uneven loads (e.g. a shopping bag in one hand).

• Planks: Starting with 5-second holds and 25-second rests, gradually increasing duration over multiple sessions. This helped improve core stability, making tasks like pushing heavy doors open easier.

• Seated Dumbbell Lifts & Machine Weights: These removed excess core activation while allowing me to regain strength gradually.

Being a trainer added another layer of challenge. I pride myself on leading by example, but in those early months, I couldn’t practice as much as I preached. That was tough. Eventually, I had to redefine what "leading by example" meant: not just demonstrating strength, but also demonstrating patience, responsibility, and respect for the recovery process.

If you’re struggling with a slow return to strength, remember that persistence pays off. Meet yourself where you are, no matter how far that feels from where you used to be. The progress will come—just keep showing up.

Returning to Sport-Specific Training

For rowing, my surgeon advised waiting at least three months before easing back in. In reality, it took me closer to five months before I could manage even short, gentle sessions at 18 strokes per minute. At nine months post-surgery, I’m still rebuilding, capping my rowing sessions at 40 minutes, keeping the stroke rate below 24, and reducing my drag factor by 20 to lessen core strain. My performance is still a long way from where it once was, but I’m just enjoying being back on the machine. And when my body is ready to handle more, if anyone can programme for an amazing comeback, it’s me!

Reintroducing strength work has been even slower. Movements that combine core stability with leg drive, especially in a compressed position, remain a major challenge. At nine months post-surgery, I’m still squatting with an empty bar. That’s been frustrating, but I’m keeping the movement in my routine while focusing on lunges, weighted step-ups, and leg presses to keep my legs strong. The hope is that, over time, it will all come together, and I can finally start adding weight to the bar.

Unfortunately, recovery hasn’t been as smooth as I’d like. Every time I progress even the smallest thing: a 5-second reduction in rest time, or one extra rep per set, I can expect a flare-up in symptoms that takes a couple of days to settle. Because of this, I typically only progress movements every 2 or 3 sessions to allow my body time to adapt. It’s frustrating, but I know that rushing ahead would only set me back further.

Some key milestones in my recovery:

• 6 weeks: Zone 2 steady state static bike sessions, diaphragmatic breathing, stretching.

• Month 3: Increased training frequency and intensity, reintroduced static bike intervals, gentle core exercises, machine weights, and seated dumbbell exercises.

• Month 5: Gentle rowing reintroduced (15-20 minutes at 18 SPM, low drag), heavier machine weights/seated dumbbells now possible.

• Month 6: Concept2 SkiErg reintroduced (reduced drag), single-rep chin-ups with timed rests now possible.

• Month 7: Harder Concept2 SkiErg sessions (still reduced drag), barbell movements reintroduced, and moderate-intensity rowing (up to 30 minutes at 24 SPM, still on reduced drag).

The Importance of Patience and Listening to Your Body

Laparoscopic recovery timelines vary widely depending on factors such as the type of surgery, the extent of internal treatment, age, medications, and other medical conditions. While most people take 3-6 months to fully recover, some may need a year or more to regain full strength. I’ve heard many stories of recovery taking much longer and everyone’s journey is different. My starting point is also not like most people’s. Being a multiple world record holder means my “normal”, is not really normal—but if there’s a way to get back to it, I’ll find it!

One unexpected challenge has been scar tissue around my internal organs, particularly my bladder. During colder months, this has made certain movements even more difficult, reinforcing the need to take things slowly and listen to my body. Returning to strength is rarely linear, and while I’d love to be further along, I’m learning that patience is just as important as persistence.

The most important thing is not to rush. Movement aids recovery, but pushing too hard too soon can set you back. Optimising factors like good nutrition, quality sleep, and stress management will help support healing, while excessive alcohol, poor diet, or high stress can hinder progress.

Above all, listen to your doctor’s advice and adapt your recovery to your personal circumstances. Before expecting to return to pre-surgery levels, you need to regain deep breathing control, flexibility and stabilising strength. Every small step forward is progress. No matter where you are in recovery, there’s always something you can do to move forward. Trust the process and give your body the time it needs to heal properly.