A super common question I am asked is “what are the best exercises for pelvic organ prolapse?”. Here’s the thing, it may not be a list of safe or unsafe exercises for prolapse. Instead, here are some different ways to think about the best exercises for prolapse which help empower versus fear-monger.
Do pelvic floor exercises help pelvic organ prolapse?
The NICE Guidelines for pelvic floor dysfunction which were published in December 2021 suggests the following;
“a programme of supervised for at least 4 months for women with symptomatic pelvic organ prolapse that does not extend greater than 1 cm beyond the hymen upon straining”
Pelvic floor exercises are an isolated contraction of the pelvic floor muscles. These exercises can help to strengthen the muscles and improve symptoms of prolapse and incontinence. Stronger muscles provide more support to the pelvic organs (including the bladder, rectum and uterus – any of which can prolapse and move downwards into the vagina)
Here is a great article from Woman & Home Magazine discussing the importance of pelvic floor exercises. Plus, considerations for those for whom pelvic floor exercises may not be appropriate.
Want to know if pelvic floor exercises are appropriate for you? The best way is to book an appointment with a women’s health physio. You can ask your GP for a referral or find a private physio using the Squeezy app
I have clients who have had great success with pelvic floor exercises, but we also layer on more functional training and look at their tendencies e.g. if they tend to bear down or grip their pelvic floor muscles.
It's not the exercise itself but how you do the exercise
A useful way of approaching the “best exercises for prolapse” debate is to consider the ability of a person to meet the demands or skills of a particular exercise.
For example, can you:
Manage the change in intra-abdominal pressure created by a particular movement or exercise? The intra-abdominal pressure will depend on the movement, the load and the ability of your pelvic floor and body to manage that pressure.
Engage your pelvic floor muscles (if needed) to provide stability and support? At low level tasks, you probably don’t need to be creating lots of stability and support. However, at higher demand tasks (e.g. lifting something heavier), you may benefit from more of your pelvic floor. Pregnancy, birth, tightness or weakness of the pelvic floor muscles may make connecting to them harder.
Feel safe and confident doing the exercise? Many women experiencing pelvic organ prolapse are fearful of movement and exercise. Whether this is due to having been told to avoid certain movements by a health professional or down to the fact that movement tends to provoke prolapse symptoms.
Feel that the exercise or movement is your next logical step or within your capacity. It can be challenging to meet your body where it’s at. Or “listen to your body” when you don’t really know what to listen/look out for. I love a gradual return back to activity for clients because it not only builds confidence but trust that their body can cope.
Interested in learning more about this area of discussion?
Here’s a link to download my FREE handout “3 C’s for a more athletic pelvic floor”
The best exercises for prolapse are the ones you feel motivated to do!
Let’s not forget that having to find time for pelvic organ prolapse rehab exercises may be tricky. You are trying to create a new habit, which can be challenging in itself. Plus, for many women, it’s not a situation you never thought you would be in. Rehab exercises (bless them) may seem a tad boring. Especially if you are used to high-impact, high-load training like running and weight lifting or CrossFit. Prolapse rehab exercises feel like a world away!
My approach is to weave exercises that can look and feel like a client’s “previous exercise” into rehab programmes. This helps clients feel more connected to their programme and can see how a banded glute bridge, can turn into a barbell hip thrust. Or a lying squat can become a barbell front squat.
Functional exercises combine the pelvic floor and building strength (and make life easier)
Functional training is awesome! Especially if you are incorporating your pelvic floor muscles into the equation! The theory behind functional training is that you train for the movements you do in daily life. They incorporate multiple muscle groups and you get stronger so that everyday life becomes easier.
Here are a couple of functional exercises that I use with my clients:
Squat
The squat is a lower body and core exercise. Also known as; getting off the toilet, standing up from seated and bending down to pick something up.
Hip hinge/deadlift
A deadlift movement is super common in daily life. From picking things off the floor, picking up and carrying shopping to lifting a folded buggy into the boot of a car.
Lunge
A lunge is a lower body and core exercise. It is also a single leg movement (just like walking and running). It helps to improve balance and stability.
Push
A good example of a push movement is an overhead press. Similar to putting something on a high shelf!
Pull
A row or pulldown movement can help strengthen upper body and core. Useful for picking things up (again) or slamming your car boot shut.
Summary for best exercises for pelvic organ prolapse
I hope you have enjoyed reading my article. As you can see producing a list of best exercises for prolapse can be a bit of a challenge!
If you have pelvic organ prolapse and you’d like help finding the exercises that work best for you, or helping you get back to the exercise you love, please use my contact page to get in touch.
Or check out my Positive POP Framework to find out more about how I work with my clients who have prolapse.
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