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Can I still exercise with a prolapse?

By Dr. Brooke Meinema PT, DPT, FAFS

Many women who are told they have a prolapse are also given a list of “noes” to go with it. No running, no jumping, no weight lifting, no sit ups, no no no. For many women, having this list of noes can be extremely stressful and lead to avoidance of exercise and activity. How can I lift my children? How can I lose the weight? How can I feel good about myself? It is possible to exercise and live your life with a prolapse without needing to worry about something falling out of you!

A large part of prolapse management is encouraging pressure management within the abdomen as well as proper form and breathing. Let’s break down what I mean by pressure management. When we breathe, the pressure in our abdomen changes: when you inhale, you should be able to feel your ribs move, belly move, and chest fill up with air during a good, deep breath in, and the exhale should do just the opposite. With some of us, the pressure doesn’t evenly spread throughout our abdomen and can start to push pressure down on our pelvic floor. This can be impacted by our posture, muscle tension, having a baby, and sometimes just our habits of how we breathe. For a quick trial of this, take a deep breath and try directing where the air goes. First, put your hand on your chest and feel the hand move with the breath. Next, try this on your belly. And, finally, imagine you are breathing down into your pelvic floor. If you are already experiencing a prolapse, excess pressure down into the pelvic floor can lead to increased heaviness and fatigue through the pelvic floor muscles making symptoms feels worse, so you can imagine how this could lead to more heaviness if this was how we breathed with all of our daily tasks.

When women ask about returning to exercise with symptoms of a prolapse, it’s a matter of working back into it instead of jumping right back to heavy lifting or cardio training. Retraining our breathing, working with the pressure in our abdomen, and improving the coordination and control of our pelvic floor and surrounding muscles are all essential to safely return to our activity. It’s not a matter of giving up doing what we love, it’s a matter of relearning how to get back to it! One of the first steps is timing our breathing with exertion. Don’t hold your breath! Exhale! Holding our breath during strenuous tasks pushes the pressure in our abdomen down, so you can imagine how this would stress our pelvic floor even more and put increased pressure on those prolapses! When performing a heavy lift or difficult task, try and remind yourself to control your exhale or even count out loud as you perform the task. This will eventually become routine, but in the early phases of that retraining, it will take some concentration.

Living with a prolapse can be frustrating, but understanding what your body is capable of is essential. Your pelvic floor is not broken, and it is still capable of incredible things! Don’t give up on yourself and your goals. Hopefully, this first step is able to help, but if you feel you need more help and guidance, ask! Visit us at https://imovedaily.com/womens-health/ to ask a question or schedule a free 10-minute consultation with one of our Women’s Health Physical Therapists. We would be happy to work with you to get you back to doing what you love and living your best life, even with a prolapse!

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