Can I Exercise With Pelvic Organ Prolapse?

Being diagnosed with pelvic organ prolapse can be worrying, particularly if you're someone who enjoys running, lifting weights, going to the gym or playing sport.
You may have been told to "take it easy" or even worry that exercise could make your prolapse worse.
The good news is that having a pelvic organ prolapse doesn't necessarily mean you have to stop exercising. In fact, staying active is important for your overall health and wellbeing. The key is understanding your symptoms, managing the demands placed on your pelvic floor and finding an approach to exercise that works for you.

What is pelvic organ prolapse?
Pelvic organ prolapse occurs when one or more of the pelvic organs, such as the bladder, uterus or bowel, move downwards from their usual position due to changes in the supporting muscles and tissues.

Prolapse can vary considerably between people. Some women have a prolapse without experiencing any symptoms, while others may notice:

• A feeling of heaviness or pressure in the pelvis
• A vaginal bulge or lump
• A sensation of something "falling down"
• Symptoms that become more noticeable during exercise
• Difficulty with bladder or bowel function

If you're experiencing these symptoms, a pelvic health physiotherapist can assess your pelvic floor function and help you understand how to manage your symptoms.

Can exercise make prolapse worse?
This is one of the most common concerns women have after being diagnosed with prolapse.
Exercise increases pressure through the abdomen, and some activities place greater demands on the pelvic floor than others. However, this doesn't mean that exercise is automatically harmful or that you need to avoid activities that increase pressure.
Your response to exercise is important.
If a particular activity consistently causes increased pelvic heaviness, pressure or bulging, it may be a sign that the activity needs to be modified or that you need to build your capacity gradually.

Rather than avoiding exercise altogether, the aim is to find an appropriate level of activity and gradually build your strength and tolerance.

What types of exercise can I do?
For many women with pelvic organ prolapse, a wide range of exercise can still be part of a healthy lifestyle.
Depending on your symptoms and current fitness level, this may include:

• Walking
• Strength training
• Pilates
• Cycling
• Swimming
• Running
• Group fitness classes
• Sport and recreational activities

You may need to modify the intensity, duration or type of exercise initially, particularly if you notice symptoms during or after activity.
There isn't a single list of exercises that everyone with prolapse should avoid. Your symptoms, prolapse severity, pelvic floor function, fitness level and goals all need to be considered.

What can a pelvic health physiotherapist help with?
A pelvic health physiotherapist can help you understand how your pelvic floor is functioning and how to manage the demands of your chosen activities.
Your assessment may look at:

• Pelvic floor muscle strength and coordination
• Your breathing and pressure management
• How you move during exercise
• Your current exercise programme
• Your symptoms during and after activity
• Your goals and the activities you want to return to

Your physiotherapist can then help develop an individualised programme that may include pelvic floor training, strength and conditioning, exercise modifications and a gradual progression towards your goals.

What if I want to run or lift weights?
You don't necessarily have to give up higher-impact exercise or strength training because you have a prolapse.
However, if running, jumping, heavy lifting or other high-impact activities cause symptoms, it may be helpful to temporarily modify the activity while you work on your pelvic floor function and overall strength.
This might mean:

• Reducing the duration or intensity
• Increasing rest periods
• Modifying certain exercises
• Building strength progressively
• Improving breathing and pressure management
• Gradually increasing your exercise load as your symptoms allow

The goal isn't necessarily to avoid these activities forever. It's about building your capacity so that your body can manage the activities you want to do.

Should I stop exercising if I notice symptoms?
Not necessarily.
Some symptoms may indicate that the intensity or volume of exercise needs to be adjusted, rather than meaning you need to stop completely.
If you notice increased pelvic heaviness, pressure, bulging, pain or bladder or bowel symptoms during or after exercise, it's worth discussing these symptoms with a pelvic health physiotherapist.
They can help you work out what may be contributing and how to modify your exercise appropriately.

You can still be active with pelvic organ prolapse
A diagnosis of pelvic organ prolapse doesn't have to mean giving up the activities you enjoy.
With the right assessment, education and rehabilitation, many women can continue or return to exercise while learning how to manage their symptoms and build their physical capacity.

If prolapse symptoms are affecting your confidence or stopping you from doing the things you enjoy, pelvic health physiotherapy can help you work towards returning to the activities that matter to you.

Learn more about our pelvic organ prolapse physiotherapy services at Better Bodies Physiotherapy in Palmerston North.

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