How to increase workout intensity without increasing prolapse symptoms
“How can you increase workout intensity without increasing symptoms?” was a comment left on one of my blogs. So, I decided it needed a blog of its own to answer the question!
And of course, there might not be one single answer (because everyone’s situation is unique) but here are the considerations I make in my coaching business, where many of my clients have prolapse and want to lift, run, CrossFit etc
#1 Reframing what symptoms mean
Research shows that severity of symptoms don’t necessarily match severity of prolapse (wild, right?!) but that doesn’t necessarily mean that we jump straight in to the hardest and most demanding exercise. High demand and high intensity exercise is not inherently bad. However, being able to bridge the gap between being in a rehab phase/newly diagnosed with a prolapse and doing all the things, can be a way of minimising symptom bother, building capacity and confidence.
If symptoms don’t always = tissue damage, it does provide freedom to start and to set goals.
#2 The HOW as well as the what
There is a tendency to want to have a list of exercises that are deemed safe. Applying pelvic floor friendly strategies around breathing, alignment and tension can often reduce symptoms during and outside of exercise. Using the example of tension because so many clients have a tendency to grip or hold their pelvic floor (and this make complete sense to the brain!). We don’t need loads of (pelvic floor and core) tension for light loads but a tendency towards gripping can fatigue the pelvic floor and increase sensations of heaviness. Often, its the exercise itself that is deemed bad, rather than a high load/demand strategy being used for low demand activities.
#3 Bridging the gap - it's not all or nothing
The fitness industry has long relied on the all or nothing approach to fuel its profits…! Personal trainers are often seen as someone who “beasts” people, leaving them puking in the corner after a hard workout. But where prolapse is concerned, being able to create progressions from the rehab phase is critical. This can really help to build up strength and capacity and often reduce symptoms alongside this. Breaking down higher demand movements into its component parts or having alternative exercise for key movement patterns is needed. My favourite example is for a squat; I start clients in lying with a 90/90 position and get them to feet press against the wall. This helps them to see the response of their pelvic floor. We then build through kneeling, partial range of movement in standing, box squats with load, loaded squats etc. The same could be applied for running and thinking about ground reaction forces (lower ground reaction forces, lower demand on the pelvic floor). For this, we might start with single leg heavy heels, then into hops, plate taps, forward bounds etc (and etc because there are gazillions of options here).
#4 Know your usual symptom cycle (if you have one)
Many women with prolapse feel the ebb and flow of symptoms alongside their menstrual cycle. Tracking your cycle with prolapse symptoms can be insightful. Plus, it may help you to phase or plan your training for lighter loads/volume/demand around the time of symptoms and train harder during period of fewer symptoms. I don’t love the idea of cycle syncing per se, because I think it’s too rigid. But I do love women taking charge of their hormonal fluctuations and using it in a way that means they can continue moving.
#5 Feeling supported
Supported in terms of the reassurance that your pelvic floor doing its job. Which is why continuing to build or maintain core and pelvic floor function is important. This might be a warm up that includes; mobility, breathwork and pelvic floor/core integrated into movements. And/or continuing with a handful of pelvic floor exercises each day (even if you aren’t doing 3 sets of 10, 3 times a day) or some Hypopressives.
Want help getting back to exercise with pelvic organ prolapse without increasing symptoms?
I offer a 1:1 coaching programme or a done for you online programme for women with prolapse who want to get back to the exercise they love. You can find more info here
Beth Davies is a highly experienced personal trainer and coach with over 10 years experience in coaching pregnant, post-natal, or female pelvic health clients. 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 trains and coaches women with pelvic organ prolapse or who are pregnant or post-natal, and provides 1:1 and face-to-face personal training in Leamington Spa, Warwickshire, and online across the UK and Europe.