A common question isn’t ‘how to exercise with prolapse’ but what exercises can I do with prolapse? Or which exercises to avoid if you have pelvic organ prolapse?
Whilst, it would be great to have a list of those exercises, I find a more effective approach is to look at ‘how you can exercise with POP’. These skills can then be applied to any movement so you can find a version that works for you.
Why avoid exercising if you have prolapse?
The narrative around exercising with pelvic organ prolapse has always been very cautious. And caution isn’t necessarily an issue when it’s part of a wider conversation about working back to exercise. Instead, many women are told to avoid the exercise they love with no mention of how they can progress back . As a result, and combined with internet research, it’s often easier NOT to exercise than to navigate around exercises, symptoms, fear mongering etc etc.
Tip #1 - The core & breathing
If you pop back to this blog about postpartum prolapse, there is a fantastic image of the core. This shows how the breath drives a relaxation and lengthening of the muscles during an inhale. Then a drawing in and drawing up of the muscles during an exhale. This provides stability and support and is your pelvic floor working with the other elements of the core.
One of the jobs of the core is to manage intra-abdominal pressure. Often, when exercising with prolapse, we might want to be mindful (not fearful) of too much intra-abdominal pressure (and this is highly subjective and dependent on the individual) and we can use our core muscles to help with this. An exhale is a little release of intra-abdominal pressure and this can be timed with or just before the hardest part of the exercise. Depending on where you in your exercise with POP journey, you may wish to add a conscious pelvic floor contraction to help this action become more automatic. Ultimately, we want to retrain the pelvic floor muscles to do this without us having to think about it.
Tip #2 -Why more tension isn't better
It’s natural for us to think “more is better”, but this isn’t the case where tension and the pelvic floor is concerned.
Anthony Lo, also known as The Physio Detective, coined the phrase “tension to task” which is fab. This phrase often makes so much sense to clients too!
In the presence of pelvic floor symptoms, it’s easier/safe (thank you brain!) to create lots of tension in order to do a task. Or hold on to your pelvic floor muscles as a way of adding strength.
However, moderating how much tension a task needs can be really useful. Extra tension may lead to stiffness in movement (and the pelvic floor) and extra intra-abdominal pressure. We want the pelvic floor muscles to be able to respond (with speed) to what you need it to do.
Tip #3 - Gradual progression over time
Where you start, isn’t where you’ll stay!
Sometimes the road back to exercising with prolapse can seem long and complicated. The gap between where you are now, and where you’d like to be might seem huge. Progressive overload is how you’ll get there!
This may look like starting exercises in lying and then moving positions such as kneeling and standing
Or opt for the light weights and gradually lift heavier ones.
It might look like 1 minute of running and gradually increasing run time and reducing walk time
Progressive overload offers a clear plan whilst also being able to adapt should symptoms crop up
Other methods for progressive overload
- Reducing rest time between sets
- Increasing the speed of an exercise
- Reducing the speed of an exercise and adding a pause
- Adding more instability eg one leg