Activity Restrictions During Recovery – Baby steps

These instructions are specifically for my patients. After mesh removal surgery I advise patients to not lift more than 20 pounds and to not exercise more than casual walking for six weeks. Casual walking means on a flat level surface at a casual pace, like you were walking with your mother. After that I want patients to gradually and slowly increase their activity as tolerated in baby steps.

Mesh pain is a combination of acute pain coming from peripheral stimulation and chronic pain coming from central sensitization. Once mesh is removed and the acute phase of healing is over, the peripheral stimulation of acute pain is gone. What remains is chronic pain’s central sensitization. Central sensitization fades over time if it is not reactivated by peripheral stimulation.

This means if you do to much too soon and hurt your self you can reignite the central sensitization after it appears to be gone. This is why I instruct patients to increase their activity in baby steps day by day to avoid grossly overdoing it. If you grossly over do it and retrigger the chronic pain full force you have to go back to square one and not do anything for six weeks. I have heard this story over and over again, patients doing too much too soon. My least successful patients are the ones who try to push through the pain which is a horrible idea.

I don’t want patients to stay in bed either. Inactivity leads to deconditioning, activity intolerance and pain intolerance.

If you take baby steps and you do a little too much one day you are not knocked back to square one. You only need to rest for a couple of days and then you can resume your activity escalation slowly.

The rate of recovery varies greatly between patients. The ones that never seam to get better are the ones who are in an endless cycle of injury, inactivity, re-injury. This is where attitude comes into play. You have to own and take control of your pain while maintaining a positive attitude.

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