I got an email a few weeks ago from a mom who what’s to workout. She had been very active in the past and since having a baby less than a year ago, she began running. Her baby was about 4 months old and she figured she was good to go.
As she was running, she felt the need to pee and from week to week, it progressively got worse. She start noticing that there was some leakage and decided it was time to get assessed by a pelvic floor physio.
She was devastated to find out that she was diagnosed with a pelvic organ prolapse. She had been fit her entire life, had an easy pregnancy and couldn’t believe this was happening. Had no idea that this could be an issue with a healthy, athletic young women.
Pelvic organ prolapses are not just for our moms and grandmothers. More and more women are being diagnosed because they’ve never been educated on the importance of training their pelvic floor. Many women have never heard of the pelvic floor or it’s purpose.
So here it is: Your pelvic floor is a collection of muscles and ligaments that are located within your pelvis. Picture it like a hammock and when you hop in, if the hammock is good and strong, then you can take a long and comfy nap. If there’s hole and a bit worn, hoping in may cause it to become even weaker over time. If you choose to keep hoping in without addressing the hammocks weak spots, then it may get gradually get worse and you may even fall through.
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Now, it’s possible for your pelvic organs (bladder, rectum, uterus, and intestines), come down and out through your vagina. I’m not going to get too technical but there are varying degrees of pelvic organ prolapse. You may have some pretty obvious symptoms or if you’re like me, have none at all. Yes, I have a mild prolapse and would not have known that if I didn’t get assessed by a pelvic floor physio soon after my daughter was born. If you want more detail about pelvic prgan prolapse, click here
If you’re reading this, I’m guessing that you have already been diagnosed with a pelvic organ prolapse and you’re in need of some fitness advice. You’ve come to the right place. If you haven’t seen a pelvic floor physiotherapist.
Common symptoms to look out for:
Difficulty with bowel movements
A feeling of heaviness or pressure in your pelvic floor
You can feel your pelvic organs coming out of your vagina (e.g. you can touch them with your fingers)
As far as exercise goes, you CAN workout safely but I highly recommend that you continue your treatment plan with your pelvic floor physio. They can ensure that the level of training is headed into the right direction by regular reassessments. They can also test your strength, endurance look for and release trigger points. In working with my clients, there’s usually a little more going on then just the prolapse itself.
Your exercise selection may depend on the nature of your prolapse and your symptoms. If you notice symptoms during any particular movement or at any time during your workout, Check your alignment, breathing and overall technique. If symptoms persist, you can try to modify to make the exercise lower impact by decreasing the weight, reducing speed and power, or try from a seated position instead of standing. If you continue to have symptoms, it may be too much and it's wise to remove it from your repertoire temporarily.
Here are some things to keep in mind:
Limit the time you spend on your feet during a session and switch from standing to seated and laying. At least until your symptoms are well managed.
Be careful of the amount of weight you’re using, especially squats, lunges, or overhead movements like overhead presses.
If your physio gives you the all clear, you can lift weight but if you begin to feel heaviness, then it’s best to modify.
Remember to breathe. When you hold your breath or use the Valsalva technique, intra-abdominal pressure builds within your abdomen and pushes the pressure downward.
Here is a video from my friend, Kim Vopni (The Vagina Coach), showing you how to do the Core Breath
Maintaining a neutral alignment is extremely important when exercising with a pelvic organ prolapse. This will help your deep core system function optimally, reducing intra-abdominal pressure.
Anterior Pelvic Tilt
The diaphragm has a harder time engaging with TvA because it’s compressed and out of alignment with the pelvic floor.
The diaphragm has a harder time engaging with TvA and the pelvic floor because it’s behind the pelvic floor.
Sets up the diaphragm and pelvic floor for loading. The TvA connects to both the ribcage and pelvic to optimally engage.
I understand that a pelvic organ prolapse can be distressing but know that you can still be active. Consulting with your doctor, following your treatment plan from your pelvic floor physiothereapist and working with a personal trainer that has been specially trained to provide fitness programming in this department will be your best bet to getting into a safe and effective routine.
Sticking with your treatment plan ensure that you get to where you want to be sooner. But you need to stick with it because it may take some time and patience on your part.