• Amy Slater

Week Four Post Abdominoplasty: All about reaching!























With increased ability in week four of my recovery comes increased responsibility. The responsibility comes from me handling more household duties AND the responsibility of me staying within my boundaries of ability. The kids are still home for the summer and I am VERY fortunate to have my mother and mother-in-law helping me hugely with the kids. When my husband is traveling, I try to not have all four home alone with me as their needs exceed my endurance right now.


I was cleared to take off my brace last week, but I just don’t feel comfortable for extended periods without it yet. There is no pain without it on, it is more fatigue. When I start to get fatigued, the muscles start to spasm.


Every night for the first three weeks I would get spasming in my abdominal wall when I would reflexively try to straighten out from my propped up position. It is happening less now, but when it does, it is a very unique feeling!


Here is a four-week general update

  • lots more mobility

  • Mid back pain

  • exercise progression

Four-week update: Nutrition Strategy

  • Intermittent fasting–I will write a lot mor4-week on this very soon!

Four-week update: Cardio strategy

  • One big bout of walking in the morning (3-3.25 miles)

  • Two-Three small bites of walking throughout the day (about .5-.75 miles)

  • Gait tweaks on walks, including backward, sideways, and crossover gait

Daily Activity Routine


I wake up early in order to beat the kiddo's early rising and my breakfast duties. My current routine has the following strategies:


  • Start with mobility using hyper volt, spiky ball, and self-care footwork. You can find all of these strategies demonstrated in Day 14 Post Abdominoplasty-Progress!

  • I then progress through a series of patterns, including the ones below as well as ones demonstrated in previous posts. The routine takes me about 45 minutes.

  • I end with my favorite!! A long 60-75 minute walk, listening to podcasts and enjoying the sunrise.

  • I then break the fast with my first meal and make the kids breakfast

  • We all (whichever kids are at home) then go for a walk around the nature trail and rest a bit.

  • Mid-morning I do another handful of patterns and work with the kids

  • Lunch for the kids comes early, around 11:30 to avoid the snack train! I have a green smoothie if I am hungry and go for one more short walk.

  • I then lay down for a bit.

  • Mid-afternoon I do another series of exercises and prepare dinner.

  • I usually eat between 2:30 and 3:00 and then go for one more walk either outside or in (depending on how hot it is).

Onto the patterns!


This series is all about reaching and incorporating a variety of stage-appropriate movements.


Hip rocking matrix, hands and knees modified

It feels really good to add in developmental patterns this week! My hips and mid back feel great after the developmental hip rocking sequence. I am performing these from a modified hands and knees position as it is too much to do flat on the floor. That is the next progression. I am using my Expand-a-lung tool for a little breath overload to recruit all of the intercostals during breath.


This is a GREAT postpartum series as well!!



Kneeling hand reach matrix: bilateral hands and alternating hands


Performing the reaches from my knees is a regression from standing as the lever is shorter for my core to control Also, the variable knee position combined with the angulation of reach creates a nice reaction in my hips and pelvic floor. Again, as I am only one-month post-op, the tissues of my abdominal wall still cannot withstand a big load. This is a nice progression building towards a standing, unsupported hand reaches matrix.

The alternating hand reaches matrix adds more rotation and lateral flexion into the pattern. This is still unloaded and at initial range, so I am not stressing the tissues of my core. The inhale comes with the reach away from the center and exhale comes as I return to the center.

Seated shin to head and overhead reach: bilateral hands and alternating hand


The purpose of these exercises is to begin to introduce some extension, lateral flexion, and rotation from the flexed position along with the shortened tissue. Reaching down to shin height also stretches out my upper and lower back, which can get stiff with my limited range of motion. I am sitting on a sit disc, which they don’t sell that brand anymore, but you could use a dynadisc which would give a similar effect of increasing the range of motion of your pelvis with the reach.

The alternating had reach adds in a bit more rotation. I also feel more confident with my reach going all the way overhead. Notice how I follow my hand with my eyes, which further integrates the core.

Squat to step matrix with breathing exerciser

This is a fun pattern with endless possible variety. This is a progression from Week 3 where I was squatting without the breathing exerciser. The extra step can be taken in any direction and can be progressed to greater distance and/or speed. Each step requires me to unload the stepping foot and increases the neural drive to the pelvic floor upon returning to a bilateral stance.

1/2 Kneeling bilateral and alternating hand reach matrix

This is a great way to gently stretch out the hip flexors and quads which are VERY congested on me at the moment! Remember my incision runs hip to hip and has not had much motion in over one month. So, this pattern feels great. The breathing exerciser adds to the fluid pump with breath. Changing foot position changes the load to the hips.

The alternating hand reach again adds more rotation and greater range of motion through my core.


Pelvicore initial range rolling from internal and external rotation


Back to developmental sequences with initial range, rolling using the Pelvicore with the goal of reorganizing using the proper movement sequencing.

Pelvicore variable foot position bridge


This is a progression from Week 3 where I used a single-foot position bridge. Now I am varying the foot position using the Pelvicore which adds a variety of input into the pelvic floor.

I typically only do one set at a time of each exercise when I include all of the foot position and hand reach variations. I spread out the load throughout the day so I am continually inputting motion into the tissue.


I hope that you have enjoyed this series so far! I plan to continue progression for the whole

12-week continuum!