Beth Davies Coaching

Squats giving you prolapse symptoms? Here are 6 changes you can make (2024)

If you are experiencing prolapse symptoms such as heaviness, a bulgy feeling or just plain discomfort, I’ve pulled together 6 tips to help you reduce those annoying prolapse symptoms. 

But first, lets talk about the squat pattern itself, and why its so important to train. 

What is a squat (and why train it)

A squat is a multi-joint exercise where you bend your knees to lower and then stand back up (with or without weights). Originally a weight lifting movement, squats are now part of most exercise programmes because 1) they build strength, power, mobility and 2) they can be trained in a variety of ways which means there is a squat variation for every single body.  Squats are an exercise but also a fundamental movement pattern, and one that we do multiple times a day. For example, getting on and off the toilet or a seat, or bending down to pick up a small person or some shopping. 

What is the issue with squatting if you have prolapse?

THERE IS NO ISSUE! However, you may have read that squats are ‘bad’ if you have prolapse. Or that they will make your prolapse ‘worse’. This isn’t true. Indeed, I’ve had clients be told, never to squat again…..There is absolutely nothing in any research that supports this. In fact, incorporating a kegel into a squat creates more pelvic floor muscle activation than Kegels alone (Crawford et al 2016).  As a result of this, the idea of squatting at the gym, or under a barbell can create fear around this movement. 

So, what happens if you are squatting and experience symptoms? Let’s troubleshoot some practical suggestions. 

#1 Keep tension in check

It could be that you are creating too much tension (both in your pelvic floor and across your whole  body) for the exercise you are doing. Many clients tend to have one way to do everything, whether they are doing a bodyweight squat or have a loaded barbell on their back. Antony Lo, coined the term “tension to task” to illustrate the idea that the amount of tension you need to create should match the difficulty of the task – and this is likely to be different for everyone. 

#2 Timing of your breath

Your breath can be a useful tool when squatting with prolapse. There are different breathing strategies we can use, however, a good place to start is to exhale just before exertion (i.e. the hardest part of the movement). This provides a conscious “switching on” of the pelvic floor muscles to provide support and stability. 

#3 Pressure through your foot

Is your weight mostly in your heels when you squat? adjusting this to the midfoot may help. This helps to spread the load across the whole foot and the body, which also means less pressure on the pelvic floor. A useful tip is to think of the foot like a tripod. In this example, you have the weight evenly spread across the entire floor – big toe, little toe and finally the heels. Using this whole foot approach to push against the floor when you come out of a squat may help with symptoms. 

#4 Are you experiencing rib flare?

Looking at the position of your ribs in relation to your hips might give you some insight into why you are having symptoms. Try making your ribs less “thrusty” by creating a neutral position may help. This may also reduce the pressure on your lower back if you tend to squat with an arched back and ribs thrust forward. Plus may help you better access and coordinate the pelvic floor and deep core. 

#5 Range of movement

Changing the range of movement by adding in support above from a band. Or support below by squatting to a bench or box can dial up feeling of safety – especially in a deeper squat position. Or provide feedback and a prompt of when to exhale and engage the pelvic floor. This is one of my favourite variations because it helps clients learn to trust their pelvic floor in a squat pattern. 

 

Pelvic organ prolapse

#6 Too much too soon?

Are you doing too much too soon? Looking at the overall load and volume of your training can provide a useful insight. Are you nudging into symptoms because of volume, or because your pelvic floor is just a little bit tired? This can also directly relate to how well you are sleeping, recovering, and fuelling your body. 

Symptoms can be a useful insight into things that need changing or elements you may want to work on. But squats are not bad – THEY ARE AWESOME. 

Click here and sign up for a free squat session I ran in May 2024 

If you’d like help with your squats (and other strength training exercises, check out my 1:1 coaching programme 

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