If any of your clients has ever given birth — and considering that 85 percent of women do, there’s a…
If you’ve given birth, whether vaginally or via C-section, you owe it to your current and future health to have a good understanding about prolapse.
In Pelvic Organ Prolapse, or POP, one or more pelvic organs have begun to lose their position in the pelvis and descend or “slump” downwards. This can happen when there is weakness or damage to the normal support of the pelvic floor. POP can be a result of pregnancy and childbirth. Other risk factors for POP include: prolonged labor, instrumental delivery of baby, episiotomy, chronic constipation, hysterectomy, and advancing age.
It is best to catch this as early as possible in order to treat it well with physiotherapy and specific exercises, and restore it as closely as possible back to its original position.
The pelvic organs that you’ll most commonly hear about in postpartum prolapse cases are:
Prolapsed bladder, called cystocele | Image: www.healthwise.org
Prolapsed rectum, called rectocele | Image: www.healthwise.org
Uterus, called uterine prolapse | Image: www.healthwise.org
These are all referred to “vaginal” prolapse because they descend into the vagina or vaginal walls.
There are different “grades” of prolapse, ranging from minor to severe:
You can read more specific information on the grades of prolapse in this article from American Family Physician.
The best way to determine if you have POP is to have an internal assessment performed by a skilled pelvic floor/health physical therapist.
POP can be tricky. Many women who have some degree of prolapse are unaware of it.
This could be because they’ve never had a thorough internal examination of the pelvis, they have no symptoms, or they’ve just simply never heard of it before and assume any symptoms they’re having are “normal.”
It’s also possible that other health care providers who perform an internal exam miss the prolapse. Thus, it goes undetected and undiagnosed.
For example, if your OB performs an internal exam post-pregnancy but only does so when you’re lying down on your back, it’s hard to know how the pelvic organs are responding under pressure from gravity when you’re standing up, not to mention when you’re loading your body with stress of exercise postpartum.
Many women with prolapse have no symptoms at all! However, you may be experiencing:
Yes, you absolutely can exercise safely with prolapse, or prevent it while your body is healing postpartum.
There are some things you need to keep in mind with your exercise programming, though. You need to exercise in a way that strengthens your body and supports your core and pelvis, but doesn’t create an environment where the pelvic organs are excessively stressed or have added pressure placed upon them.
You can lift weights. You can do weighted squats, lunges, etc if your prolapse is well managed, your physio gives you the all-clear, and you know what sensations to be aware of.
You really need to hone into these sensations. Are you working out at the end of the day and feel more heaviness? If yes, adjust the workout (for example: move to more seated, side lying, supine positions instead of standing). No ego here, please!
1A. Hip Thrusts with Bands
1B. 1-Arm Incline Dumbbell Chest Press
2A. Bodyweight Squat to Low Box
2B. Seated Cable Row
2C. Half-Kneeling Pallof Press
Treadmill incline walking intervals
As you can see, you definitely can exercise with prolapse. Consult with your doctor before following any the guidelines in this article. So long as your POP is well-managed by you and your medical provider you should be able to exercise safely.
Resources and more information:
There are so many myths about exercising during and after pregnancy, it can be hard to know if you’re doing the “right” thing. Our education materials are carefully vetted by OB/GYNs, PhDs, Registered Dietitians, Women’s Health Physiotherapists, and Pre and Postnatal Exercise Experts, and we have put together this FREE handbook where you’ll learn:
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