When thinking about exercising with pelvic organ prolapse, it can be easy to simplify exercises into safe or unsafe, good or bad etc. You avoid the “unsafe” or “bad” ones and do the “safe” or “good” ones. Using this language often means that you don’t progress (because something like lifting weights is deemed bad for someone with prolapse). Or that you are very bored because someone very rarely wants to get back to just glute bridges or pulling a band.
So, to avoid the trap of good or bad, here are 3 strategies that can be used in exercise. These can help to change the “how a movement is done” versus what the movement actually is.
DISCLAIMER: this doesn’t mean that you completely ignore some of those gentler exercises you may have been told to do. This blog does not replace any individual advice you have been given by your healthcare provider.
Strategy 1 for exercising with pelvic organ prolapse - Breathing
If you pop back to the previous blog, 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.
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 intra-abdominal pressure 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.
Strategy 2 for reducing the heavy feeling - Manage tension
Anthony Lo, also known as The Physio Detective, coined the phrase “tension to task” which I love. 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.
Strategy 3 for getting stronger - Progressive Overload
Meeting the body where it’s at and providing scope for progression and improvement!
Because, I am guessing you’d like to get stronger and do more?!
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