Can you Exercise with a Pelvic Organ Prolapse?
We need to regularly exercise in order to help maintain a healthy weight and to stay fit and strong. It is one of the most important ways to help prevent a pelvic organ prolapse. Being overweight or obese puts extra strain on the pelvic floor, weakening it, increasing the severity of existing prolapses and the opportunity for additional prolapses to occur.
If you already have a pelvic organ prolapse, or you are at an increased risk of developing a pelvic organ prolapse, then you may not be clear on which exercises you can undertake. This guide gives advice to help keep you active and improve the strength of your pelvic floor muscles.
Which Exercises Can I Do?
As long as you keep your activity to a low/moderate intensity and don't over-exert yourself, you can stay in shape and tighten up your pelvic floor. You can also use speciality support clothing, to reduce the pressure put on your pelvic floor muscles as you exercise.
To Strengthen Your Core
Kegel / pelvic floor strengthening tummy toning exercises (as demonstrated in the video below) are perfect for building a strong core whilst also looking after the pelvic floor. They’re less intense than some of the more traditional core exercises such as sit ups and crunches, putting less pressure on the muscles of the pelvis.
These exercises include gentle forms of push ups and leg raises that all help to tone the abdominal muscles. They all can easily be done in the comfort of your own home, at your own pace.
To Lose Weight
Losing weight is recommended in most prolapse management programmes, but most weight loss exercise is too high impact for a woman with a prolapse. Great low impact exercises that still allow you to break a sweat include:
- swimming and aqua aerobics
- fast walking
- yoga and Pilates - most poses can be modified to move weight from your feet onto your knees more evenly, where needed
These exercises all raise the heart rate enough to constitute aerobic exercise which is ideal for burning fat, especially abdominal fat. Aerobic exercise is better at shifting pounds and therefore at helping you to lose weight, than resistance (weight) training alone. Try using the cardio machines at the gym to control exactly how intense your workout gets. Look to the exercise bike and elliptical machine as great options.
We advise that you mix up your workouts to give each set of muscles, including your pelvic floor, time to recover between workouts. We also recommends exercising before breakfast so that you burn body fat rather than just the fuel you’ve eaten for breakfast. It’s also the best time of day for your pelvic floor muscles too, when they’re refreshed from eight hours of you laying down!
To Gain Muscle
Generally, weight lifting is a no-no. However get advice from your doctor and personal trainer to learn what modifications you can do to limit the pressure you put on your pelvic floor. Try wall squats or lunges that balance the weight more evenly. And if anything is uncomfortable, stop!
To Improve Your Prolapse
Kegels (pelvic floor exercises) have been developed to help strengthen the pelvic floor muscles as they cannot be strengthened or exercised by swimming, walking or cycling. The more they’re trained, the stronger they become and the more they can do their job – holding all of the pelvic organs in place.
They should be completed daily, gradually building them up so that you can hold them for longer, and more frequently. They can be made more beneficial by combing them with an electronic pelvic toner. Electronic pelvic toners contain programmes specifically designed to improve each prolapse you suffer from.
Which Exercises Should I Avoid?
You should avoid any exercise that puts too much high impact or downward strain on your pelvic floor area. That means avoiding 'Body Pump' and 'Cross Fit' until you are back to optimum health. These exercises shoot damaging jolts up your body as your feet land on the floor heavily and quickly. Causing damage to all your joints and muscles, including the all important pelvic floor muscles. Avoid:
- high impact exercise such as running or plyometrics (‘jump training’)
- High Intensity Interval Training (HIIT) or short, sharp bursts of exercises such as burpees, wide leg squats and star jumps
- weighted squats, or using any kind of weights above the head and bringing them down to waist level such as lat pulldowns and overhead presses
- leg presses or generally being on your feet for too long at a time – try to mix up the exercise you do with standing, seated and laying down types
- the rowing machine or leg press which add lots of strain to your abdominal muscles
- anything wide legged, such as wide legged squats, sumo squats or lateral (sideways) lunges
- incorrectly performed abdominal exercises such as crunches, planking or sit ups, which if done incorrectly, can cause a prolapse to worsen. Especially one where the prolapse pelvic organ visibly protrudes outside of the vagina
If you only take away three bits of advice...
- Each one of us is different. If your doctor has told you that you can exercise as normal because your prolapse is under control then listen to them. If they’ve told you to avoid all exercise for now, then listen to that advice too.
- If you feel any pain or discomfort in your pelvis whilst exercising, stop. Make an appointment to discuss your options with your doctor again.
- Breathe correctly when doing exercise. It’s often tempting to hold your breath whilst exercising, sometimes even without realising. But it’s crucial to breath in and out rhythmically to avoid increasing the pressure on your pelvic floor. Try getting into the habit of breathing in and out as you count your reps or with each swimming stroke.
Ellis, J. Hargreaves, E. (2013) Newcastle upon Tyne Hospitals NHS Foundation Trust, 2013 [viewed 28/03/2018]. Available from: http://www.newcastle-hospitals.org.uk/downloads/Therapy%20Services/Physio_Vaginal_prolapse2.pdf
NHS. (2016) Easy exercises [online] National Health Service, 2016 [viewed 28/03/2018]. Available from: https://www.nhs.uk/Livewell/fitness/Pages/Lowimpact.aspx