Can strength training help improve your prolapse symptoms?
If you’ve been told to avoid the gym, put the weights down, or “just be careful” since your prolapse diagnosis, this might not have been the most helpful advice.
It’s a conversation I regularly have with clients and prospective clients. Women who were strong, active, capable, being told to shrink their lives down to what feels “safe.” The result isn’t protection. It’s deconditioning, fear, and often not the resolution to their prolapse symptoms.
Strength training isn’t something to fear with prolapse. For many of my clients, it actually provides the missing link to improving symptoms, feeling more confident to train with prolapse and spending less time hyperfocusing on the pelvic floor.
The evidence supports strength training to improve female health
Strength training on its own is well-established for reducing cardiovascular risk, preserving muscle mass, protecting bone and joint health, and supporting mental health. We have reams of research supporting the benefits of strength training.
What’s less talked about: when strength training is combined with pelvic floor muscle training, it outperforms pelvic floor work alone for leaking in women over 60, according to a study by Virtuoso et al.
So why is the default advice still “avoid heavy lifting”?
Three training principles that explain why lifting helps
Strength training rests on three principles:
- Load
- Specificity
- Reversibility
Once you understand them, the case for training through prolapse rather than around it becomes obvious.
1. Overload: your pelvic floor needs a reason to adapt
Every muscle, including your pelvic floor, gets stronger by being asked to do more than it’s used to. Research from Dakic and colleagues points to this as essential for anyone managing prolapse.
Overload doesn’t have to mean loading up a barbell (though it might). It can be tempo, time under tension, or a harder position. The goal isn’t to push the body past what it can handle, it’s a gradual dial-up that builds capacity over time. Life is loaded and we need to train the pelvic floor (and whole body) to better manage the demands of life.
2. Specificity: lying down and squeezing isn’t preparing you for your life
Dakic’s research is clear that training has to reflect how a muscle actually gets used, including intensity, not just movement pattern.
A pelvic floor squeeze on your back has its place as a starting point. But you don’t live life on your back. You lift your kids, carry the shopping, stand through a physical job, or get up off the floor a hundred times a day. Training should mirror that. A generic pelvic floor exercise sheet was never going to prepare you for the actual demands of your life but a specific, progressive programme can.
3. Reversibility: deconditioning might make your prolapse feel worse
Strength and endurance you don’t maintain, you lose. This reversibility is also outlined in Dakic’s work. This is often the missing piece for women who feel weaker, more fragile and more disconnected to their body, the longer they live with prolapse symptoms.
That weakness isn’t the natural progression of the condition. It’s frequently the direct result of being told to stop, rest, and “just avoid” training in a way that builds strength and capacity.
Symptoms aren’t just driven by position of the organs
Research by Drage and colleagues found that how bad your symptoms feel may not reflect the actual grade or stage of your prolapse. Psychological distress plays a huge role – sometimes more than structural change.
Distress breeds catastrophic thinking, and catastrophic thinking breeds more distress. Add in advice to give up the activities you love, and you’ve got a feedback loop that leaves women stuck, hypervigilant, and afraid to lift, train, or move at all.
Constantly monitoring your pelvic floor can actually intensify symptoms and make you feel like structural change is happening even when it isn’t. This is where strength training does something advice sheets can’t – it gives your brain something else to focus on.
And the fear that heavy lifting is inherently risky? Forner et al found that women lifting heavy weights showed no higher rate of prolapse symptoms than those lifting moderate loads. A stronger body isn’t a liability with prolapse – from what I see in my own clients, it’s an asset.
What this means for you
You don’t have to choose between managing prolapse symptoms and staying strong. The research supports strength training, applied with the right principles and the right coaching, is beneficial (even with pelvic organ prolapse) and not something you have to give up to feel better.
If you’re ready to strength train with confidence instead of fear, check out LIMITLESS! – a 3 month strength training and pelvic health programme for women with pelvic organ prolapse. Programme for women with prolapse who want to lift, get strong, and leave the fear behind. Book a call here and let’s talk about it.
Beth Davies is a highly experienced personal trainer and coach specialising in female pelvic health, pelvic organ prolapse and exercise. Her programmes educate, empower and support women back to training or their active life, eliminating symptoms and building strength and confidence. She has been featured in women’s lifestyle magazines and websites, including Stylist, Metro, Woman & Home and Marie Claire UK.
Beth’s training and coaching for women with pelvic organ prolapse provides face-to-face personal training in Leamington Spa, Warwickshire, and online across the UK and Europe.