Will lifting weights make my prolapse worse?
If you have been told that lifting weights will make your prolapse worse, this blog post is for you! I’ll include some of the research we have looking at lifting and the pelvic floor. Plus, pelvic floor considerations when lifting weights or building back to lifting weights.
Where did this narrative come from?
It’s believed that research (from the 1980’s!!) showed that heavy occupational lifting could worsen pelvic organ prolapse. It is a narrative that has since been applied to everyone and anyone with ANY stage of prolapse and carrying any weight. Coupled with restrictive post-surgical guidelines which often include “never lift anything ever again”, strength training or lifting weights can feel off-limits for many women. Prolapse can be more than simply a weak pelvic floor, so more individual and more nuanced advice is needed.
What is pelvic organ prolapse?
Let’s start with a recap on the definition of pelvic organ prolapse, as defined by the International Continence Society:
“anatomical prolapse with the descent of at least one of the vaginal walls to or beyond the vaginal hymenal ring with maximum Valsalva effort”
AND
The presence of bothersome characteristic symptoms, most commonly the sensation of a vaginal bulge, or functional or medical compromise (such as urinary retention, obstructive renal failure or severe vaginal wounds) due to prolapse in women without bother (Collins et al, 2021)
This image from BurrellEducation shows different prolapses versus “normal” anatomy.
Do we have research to support heavy lifting as a benefit for pelvic organ prolapse symptoms?
Research by Lori Forner at al 2020, aimed to determine the prevalence of prolapse symptoms (eg a bulge) in women who lift light (less that 15kg), moderate (16-50kg) and heavy (50kg+) for exercise and those who do not.
The study showed that women lifting 50kg+ had fewer POP symptoms than those lifting lighter loads and concluded more research was needed on the contribution of heavy weight lifting as part of physical activity regime to pathophysiology of prolapse.
Research looking at the acute effect of heavy weightlifting on pelvic floor muscles in strength trained women by Skaug et al, 2024. This study study showed no statistically differences were found when comparing the change in pelvic floor muscle resting pressure, strength, endurance and resting activity. Plus there were no statistical correlations between pelvic floor muscle strength and whole body strength. This suggests we also need specific pelvic floor training alongside whole body strength training.
In reality, there’s a lot we don’t yet know…
What are some pelvic floor considerations for safe weight lifting?
It is a fact that lifting weights leads to an increase in intra-abdominal pressure. The goal isn’t to eradicate IAP (intra-abdominal pressure) because this is impossible, but to ensure that:
- the pelvic floor (and whole body) has the strength and function to manage the load and meet the demand placed upon it
- IAP is managed across the whole body, through strategies such as breathing and positioning
- Capacity is built (over time) to identify where someone’s threshold may be
- Someone is given balanced and individualized advice versus a blanket “just avoid”
If you have been given a blanket “NO” even for light loads then I would ask your provider where this advice comes from. It could be that they don’t have tons of knowledge about strength training or have never lifted themselves. Or that you’re the first person who has asked that question. Seek a coach and a physio who will support your lifting goals so you can get back under that barbell.
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.