Exercising With a Stoma: The Complete Guide
Living with a stoma can make exercise feel confusing and even a little scary. Will I cause a hernia? Can I lift? When can I start? This guide answers those questions and teaches you the one skill every ostomate should learn first.
Written by Hassan Qureshi
Accredited Exercise Physiologist and founder of Holistic EP
Hassan works alongside stoma nurses across Sydney and has presented on stoma and exercise at Westmead Hospital and at patient support groups. Last reviewed: October 2026.
On this page
Watch: Introduction to Exercising With a Stoma
Hassan's talk at Westmead Hospital covers what to avoid, how to activate your core safely, and how to return to exercise step by step.
What is a stoma?
A stoma is an opening on the abdomen, created during surgery, that lets waste leave the body into a pouch. People who live with a stoma are often called ostomates. There are three main types:
- Colostomy: formed from the large bowel (colon)
- Ileostomy: formed from the small bowel (ileum)
- Urostomy: diverts urine away from the bladder
A stoma may be temporary or permanent. Common reasons include bowel cancer, Crohn's disease, ulcerative colitis, diverticulitis and bladder cancer.
Why exercise matters after stoma surgery
Most ostomates want to exercise but aren't sure how to start safely. That uncertainty often leads to doing nothing, and doing nothing leads to lost strength, fitness and confidence. The right exercise helps you:
- rebuild the strength and fitness lost during illness and surgery
- return to work, hobbies, sport and family life
- move with confidence instead of fear
- build well-coordinated abdominal muscles around your stoma site
- improve energy, sleep and mood
Understanding parastomal hernia
A parastomal hernia happens when part of the bowel pushes through the abdominal wall next to the stoma. It is one of the most common complications after stoma surgery and the biggest worry we hear from clients.
Creating a stoma means making an opening in the abdominal wall. When pressure inside the abdomen rises, that opening is a weak point. That is why how you exercise matters more than whether you exercise.
Signs to watch for: a bulge or swelling around the stoma, a dragging or aching feeling, or your pouch suddenly not fitting the way it used to. If you notice any of these, speak with your stoma nurse.
5 things to avoid
Abdominal bracing
Pushing your stomach outward, as if bracing for a punch, raises pressure inside your abdomen and pushes out against your stoma site.
Holding your breath while lifting
Straining with a held breath (the Valsalva manoeuvre) spikes internal pressure.
Sit-ups and crunches
Repeated forward curling strains the abdominal wall around the stoma.
"No pain, no gain."
Never push through pain or discomfort around your stoma.
Too much, too soon
Avoid heavy lifting, sprinting, high-impact exercise and very tight clothing early in your recovery.
Bracing vs hollowing: the core of the matter
Ask anyone to "switch on their core" and most people push their stomach out, hold their breath and tense up. This is bracing. It raises intra-abdominal pressure, which is why weightlifters grunt. That pressure protects the spine under heavy load, but it also increases hernia risk. If you have an opening in your abdominal wall and you increase the pressure behind it, things want to come out.
Hollowing is the opposite. Instead of pushing out, you gently draw your stomach in. It activates your deep core muscles and supports your spine and organs without increasing pressure. It is the first thing we teach every ostomate, and it becomes the foundation for all safe movement.
Bracing
- Stomach pushes out
- Pressure goes up
- Breath is held
Hollowing
- Stomach draws in
- No added pressure
- Breathing stays relaxed
The 5-step hollowing method
Step 1: Diaphragmatic breathing
- 1. Lie on your back, knees bent, feet flat.
- 2. Place one hand on your chest and one on your stomach.
- 3. Breathe in slowly and gently, then breathe out. Repeat 5 to 10 times.
What you're looking for
Your stomach hand rises more than your chest hand, and the breath feels low and relaxed. If your chest rises more, that's okay. Your diaphragm just needs practice.
Step 2: Learning to hollow
- 1. Stay on your back with knees bent.
- 2. Breathe in gently, then breathe all the way out.
- 3. As your stomach falls with the out-breath, slowly draw it in a little further.
- 4. Pause there for 2 to 3 seconds. Keep it relaxed, with no straining or pushing.
- 5. Breathe in and let your stomach rise naturally.
- 6. Repeat 5 to 10 times.
What it should feel like
A gentle drawing in, with no force or pressure and no pain around your stoma.
Step 3: Breathing while you hollow
Goal: hold a gentle hollow while you breathe and talk.
- 1. Breathe in and let your stomach rise.
- 2. Breathe out and create your hollow.
- 3. Holding the hollow, take small, shallow breaths without letting your stomach rise.
- 4. After 5 shallow breaths, take one deep breath and let your stomach relax fully.
- 5. Repeat the cycle 5 to 10 times.
Step 4: Hollowing in other positions
Standing: hands on a benchtop or sink. Breathe out, hollow, hold, relax. Add breathing once it's comfortable.
Sitting: firm chair, feet flat, lean forward slightly with your hands on your thighs or a table. It is the hardest position, but you can practise it anywhere: driving, meetings, watching TV.
Step 5: Hollowing through life
Use a gentle hollow before anything that takes effort: standing up from a chair, carrying shopping, stepping off a kerb, housework, or lifting a bag.
A helpful rule
If you lose the hollow during a task and slip back into bracing, the movement or load is too hard for now. Slow down, go lighter, or find another way to do it.
Your recovery timeline
Always follow your surgeon's and stoma nurse's guidance. As a general framework:
0 to 6 weeks
Rest and recovery, diaphragmatic breathing, short daily walks.
6 to 12 weeks
Formal hollowing practice and light functional movement, ideally with professional guidance.
12 weeks +
Gradually build resistance, duration and general activity while keeping good technique.
Building your exercise program
Once you can hold a hollow comfortably, the next three building blocks are:
Low-impact cardio
Walking, water walking and swimming are great starting points. Think little and often: 10 minutes a day adds up to 70 minutes a week. Build gradually from there.
Controlled strength training
Start with bodyweight exercises such as sit-to-stands from a chair, or light resistance bands. Technique and your hollow come before load. Machine-based exercises, such as a seated chest press, give you more stability than free weights while you build strength.
Progressive core strengthening
Once hollowing is automatic, we progress your core work gradually and safely. That means no sit-ups or crunches, and nothing that makes you bear down.
Practical tips for exercising with a stoma
- Hydrate. This matters most with an ileostomy, because the large bowel normally absorbs water. Exercise and sweat add to fluid loss, so drink before, during and after.
- Empty your pouch before exercising.
- Consider a support garment or belt. Many ostomates find it adds comfort and confidence. Ask your stoma nurse about fitting.
- Wear comfortable clothing that isn't tight over your stoma.
- Yes, you can swim. Modern pouches are designed for water. Start once your surgeon clears you and your wound has healed.
When to stop and get advice
Stop exercising and contact your stoma nurse, GP or surgeon if you notice:
- pain, swelling or a new bulge around your stoma
- your stoma changing colour (dark red, purple or black)
- bleeding from inside the stoma
- signs of dehydration: dizziness, dark urine, cramps or very high output
- wound pain, redness or discharge
In an emergency, call 000.
Free download: Stoma and Exercise Starter Guide
Stoma and Exercise Starter Guide
A 16-page guide to the hollowing method, with photos and step-by-step instructions. Enter your name and email and we'll send it to you. You'll also get early access to the full Stoma and Exercise Handbook when it's released.
How Holistic EP can help
We work with ostomates at every stage, from weeks after surgery to returning to the gym.
- 01
Assess
your surgery, stoma type, current strength and goals.
- 02
Teach
hollowing and safe movement patterns, tailored to you.
- 03
Progress
a structured cardio and strength program that builds as you do.
Available in clinic at Wentworthville, as home visits, or via telehealth anywhere in Australia.
Stoma nurses and surgeons: we welcome referrals and are happy to present to your patient groups.
Refer a patientFunding
NDIS
We're a registered NDIS provider and work with self, plan and agency managed participants.
Medicare
A GP Chronic Condition Management Plan gives a rebate on up to five allied health visits a year.
Aged care
Support at Home packages can include exercise physiology. We work with your provider.
DVA
DVA cardholders may be covered with a GP referral.
WorkCover and CTP
We work with your case manager and insurer after a work or car accident injury.
Private health
Most private health funds pay a rebate for exercise physiology.
Frequently asked questions
Ready to move with confidence?
You don't have to work it out alone. Book an assessment and we'll build a plan that protects your stoma and gets you back to the things you love.