Exercising for Bladder and Uterine Prolapse

As a new mum, postpartum recovery can come with unexpected challenges, and for some, pelvic organ prolapse might be one of them. It’s understandable to feel frustrated, especially if it affects your quality of life and limits your ability to stay active. However, prolapse is very treatable. With specific and tailored exercises as well as proper guidance, you can improve your overall wellbeing and regain confidence and control of your body.

This guide will cover safe and gentle exercises for individuals recently diagnosed with prolapse, activities to avoid in the early stages of treatment, and other preventive measures to help reduce discomfort and improve pelvic health.

What are the Common Symptoms Of Pelvic Organ Prolapse?

Sometimes, pelvic organ prolapse has no obvious symptoms and is only identified during a routine gynaecological exam. However, for moderate to severe cases, common symptoms include:

• Bulging sensation in the vagina, which can be described as if something is falling out
• Low back pain
• Painful intercourse
• Leaking of urine
• Chronic urge to urinate
• Constipation or loss of bowel control
• Spotting or bleeding from the vagina

Doing gentle exercises for prolapse can help manage these symptoms without aggravating the condition. Just remember to listen to your body and take breaks when needed. Rest is a vital part of recovery, so give yourself permission to pause when necessary. 

What Types of Safe Exercises Can You Do To Manage Prolapse?

Pelvic Floor Muscle Exercises (Kegels) are foundational for strengthening the pelvic floor and managing prolapse. Here are some pelvic floor exercises for prolapse that you can do:

1. Kegels - Kegel exercises help strengthen the muscles that support the uterus, bladder and bowel. They can reduce symptoms in mild to moderate cases of prolapse and may also help prevent further descent of the affected organs. [1]
2. Squats - If you’re already comfortable doing Kegels in a stationary or bridge position, you can try performing squats. Narrow and shallow squats are more beneficial than regular squats as they better engage the pelvic floor muscles.
3. Bridge Exercises - Bridge exercises facilitate pelvic motions to increase the muscular strength of the buttocks, hip extensors, and pelvic floor muscles, promoting trunk stability and better posture.
4. Low-Impact Cardio Exercises - For those who prefer a more active workout, initially low-impact cardio is a great option without putting too much strain on your pelvic floor while it is regaining its strength. These exercises help improve circulation, boost endurance, and burn calories without the high impact that could aggravate prolapse symptoms.
5. Water-Based Exercises - Aqua exercises use the water’s buoyancy to put less pressure on the pelvic floor, making them safer for people with prolapse. [2] Movements like jumping jacks, which can be hard on the pelvic floor when performed on land, are safer in water if done at a certain speed.

What Exercises to Avoid When You Have Prolapse?

Extra care is essential when exercising with prolapse, especially during the initial phases of treatment, to avoid putting excessive pressure on the pelvic floor. Here are some exercises to avoid for people with a prolapse condition:

1. High-Impact Cardio - Jumping jacks, running, or high-impact aerobics can place significant pressure on your pelvic floor. It’s best to avoid these activities initially or modify them to a lower-impact version if you have a pelvic organ prolapse.
2. Intense Abdominal Exercises - Sit-ups, crunches, and double-leg lifts increase intra-abdominal pressure, which can further strain weakened pelvic muscles and worsen prolapse symptoms. Your physiotherapist will modify these exercises and tailor them to where you're at in your recovery journey.
3. Heavy Lifting - Lifting heavy weights or objects can strain and further weaken your pelvic floor. If lifting is necessary, use proper lifting techniques, such as bending the knees and hips while keeping the back straight to reduce the strain on your pelvis.

Other Preventative Measures to Take with a Prolapse

Apart from doing regular exercises for prolapse, there are lifestyle changes that can help manage your symptoms more effectively.

1. Wear Support Garments

Studies show that wearing support garments can further boost the effectiveness of pelvic floor exercises and alleviate symptoms of prolapse. [3] These compression support garments are specially designed to activate pelvic floor muscles, effectively minimising the pressure felt from prolapse. Wearing support shorts or leggings is particularly useful when you’re on your feet for long periods or engaging in exercises for prolapse.

2. Limit Caffeine Intake

The diuretic properties of the caffeine can stimulate the bladder muscles, which can increase the urine the body produces. This can put extra pressure on the bladder, worsening symptoms of urinary incontinence and prolapse. [4] It’s best to limit your caffeine intake and opt for decaffeinated drinks or water. If you do consume caffeine, try to monitor how your body responds and adjust accordingly.

3. Maintain a Healthy Weight

A high body mass index (BMI) is one of the key factors that contribute to developing pelvic organ prolapse. [5] When you’re carrying excess body weight, especially in the abdomen, the intra-abdominal pressure can put stress on your pelvic floor, eventually causing it to weaken. Maintain a healthy weight by following a balanced diet and staying physically active. If your goal is to lose weight, do it by making gradual and sustained changes. Avoid extreme diets or high-impact exercises that could strain your pelvic floor. Consult your pelvic health specialist for more personalised advice.

4. Avoid Constipation

Constipation is both a symptom and a contributing factor to pelvic organ prolapse. Chronic constipation can weaken the rectal walls and lead to the rectum filling with hard stools, potentially resulting in a rectocele. In cases of existing prolapse, constipation places additional strain on the pelvic floor, which can cause discomfort and make bowel movements more challenging. To prevent constipation, increase your fibre intake and limit foods that may contribute to it, such as dairy, red meat, and highly processed foods.

Take Gentle Steps Toward Improving Your Pelvic Health

Starting to exercise with prolapse can feel intimidating, especially when you're also recovering from pregnancy. If it feels overwhelming, remember that even small, gentle movements can make a big difference, and progress doesn’t need to be quick to be effective.

Begin at your own pace, and don’t hesitate to seek support if needed. Regular pelvic floor exercises for prolapse, paired with adequate rest, can significantly enhance your overall well-being. Wearing pelvic floor support garments can provide added comfort and stability as you exercise. With consistency and self-care, you can gradually strengthen your pelvic health and regain confidence in your body, one step at a time.

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References:

• https://ncbi.nlm.nih.gov/books/NBK525762/
• https://www.pelvicfloorfirst.org.au/pages/pelvic-floor-friendly-exercise-for-aqua-.html
• https://www.ics.org/Abstracts/Publish/349/000429.pdf
• https://www.uab.edu/news/health/item/262-caffeine-intake-linked-to-urinary-incontinence
• https://pubmed.ncbi.nlm.nih.gov/28700456/
• https://www.yourpelvicfloor.org/conditions/non-surgical-approaches-to-managing-bladder-problems/
• https://www.kentcht.nhs.uk/leaflet/tips-to-help-with-bladder-emptying/