Core Exercises after Prolapse Surgery and Prolapse Safe Exercises

‘Core Exercises After Prolapse Surgery’ is a Pelvic Floor Physiotherapist guided exercise video.

This 5 minute core exercise video demonstrates a sequence of pelvic floor safe core exercises suited to women with prolapse and those women seeking safe exercises after prolapse surgery upon returning to exercise.

The simple core exercise sequence involves the use of a  Swiss ball (exercise ball) however these exercises can also be performed seated on a chair.

Video duration: 5 minutes

For more information about core exercises for prolapse please scroll down below this video

Note to ensure the smooth viewing of the video, it is recommended that you press on this play arrow and then when the video starts loading you press the ‘pause’ button until you can see that the entire video has loaded. This will help avoid the video stopping to load while you watch.

Safe Abdominal Core Exercises for Prolapse

The following video demonstrates a sequence of seated Swiss ball exercises (fit ball exercises) that promote abdominal muscle activity and support the pelvic floor while exercising. The emphasis is on slow controlled movements using good posture and gentle deep abdominal muscle activation. The exercises demonstrated are designed to:

  • Gently improve deep abdominal muscle tone and control;
  • Place minimal pressure on the pelvic floor;
  • Exercise those deep abdominal muscles that should work with pelvic floor muscles for pelvic floor support;
  • Assist women in flattening the appearance of the abdomen with appropriate deep abdominal muscle control exercises.

Always seek your doctor’s approval before commencing any new exercise program and immediately cease any exercises that cause you discomfort.

About Unsafe Abdominal Exercises after Prolapse Surgery

Research tells us that some intense core abdominal exercises can increase the downward pressure on the pelvic floor (including vaginal or rectal prolapse and prolapse repair). Inappropriate core exercises such as sit-ups, and even some intense Pilates and Yoga exercises can cause downward movement of the pelvic floor. What can result is progressive stretching and weakness of the pelvic floor muscles which become less able to support the prolapsed or repaired tissues. Intense core abdominal exercises are high on the list of exercises after prolapse surgery to avoid when exercising to minimise the risk of recurrent prolapse and worsening existing prolapse.

Unfortunately for many women the potential for pelvic floor injury with intense core exercise is not well recognised within fitness circles. After prolapse surgery, some women even get the go-ahead to return to their regular gym exercises with little understanding of the potential risk of recurrent prolapse with the wrong kind of abdominal core exercise. For a summary of some of these exercises refer to our popular free article abdominal exercises to avoid with prolapse or after prolapse surgery.

For more details on pelvic floor safe exercises after prolapse surgery and with existing prolapse refer to Inside Out – the essential women’s guide to pelvic support.

Inside Out Book & DVDABOUT THE AUTHOR, Michelle Kenway

Michelle Kenway is a Pelvic Floor Physiotherapist and author of Inside Out – the Essential Women’s Guide to Pelvic Support, along with Dr Judith Goh Urogynaecologist. The Inside Out exercise DVD and book show women how to strengthen the pelvic floor and exercise effectively with pelvic floor safe exercises.

We Welcome Your Comments



  1. Hi
    So glad I have found this site. I had a vaginal hysterectomy and prolapse repair (anterior and posterior) 18 days ago. This was my third repair having had my first aged 28, my next ten years later and now my third coupled with a vaginal hysterectomy as my womb was prolapsed as well (I believe a suture was used to attach the vagina to add extra support (but not the sacral spinal stitch). I am now 50. I am desperate to get this right and have received little advice on how to build up my fitness. I want to lose some weight as the menopause seems to have hit big time too and I have put on 1 1/2 stone over the last 12 months. I love swimming and walking but realise swimming is out of the question for the first 6 weeks. I have been walking from week 1 building up to about 20 mins. I want to buy a fitness ball like the one you use but wondered what size to buy and how I go about purchasing your vidoes for using it etc (i’m in the UK). A friend recommended pilates as a good form of exercise but when would it be safe to start that? I really dont want a fourth repair (will there be anything left to chop??!). Do you have any tips for me?

    • Michelle Kenway says

      Hi Jane
      Thank you for contacting me – you are probably aware that you are at high risk of recurrent prolapse which means safe exercise is an absolute must along with getting the best possible support from your pelvic floor muscles. I would suggest that if you can seek some guidance from a trained Pelvic Floor Physiotherapist to help you train your pelvic floor muscles and address any other relevant factors that might increase your risk.

      Jane unless you can find a Pilates instructor who really understands your risk of repeat prolapse and how to prescribe your exercises accordingly it would be wise to leave Pilates – if the core exercises with Pilates are too intense you will be likely to overload your pelvic floor.

      Most women benefit from walking as their primary form of exercise for the first 6-8 weeks post op. Fitness ball sizing depends upon height, if the ball is too small then core muscle training will be less effective and the lower back can be at increased risk of injury. How tall are you in centimetres Jane?

      Inside Out Strength DVD for women is available in the UK either from this site (we send daily) or from the UK direct see Inside Out DVD

      All the best

  2. Hi Michelle- I had a hysterectomy just over a year ago and have made a good recovery but have gained one stone in weight which I am struggling to shift despite a relatively healthy diet. I’ve been doing pilates at a class and recently brought a DVD but found that my tummy muscles have been hurting the following day or two – initially I thought this was a good sign that I ‘was working’ but having reviewed a lot of the material on your site have decided that its probably not a good idea. I’m going to try and modify my pilates as you suggest – i.e. keeping head/shoulders down and only single leg raises.
    I have a few more questions though:
    1. when doing the core strengthening exercises on the ball, can I add hand weights? i.e. for the arms out/up movements?
    2. If I add weights to squats/lunges at pelvic height – isn’t this increasing pelvic pressure? Which I thought we should avoid??
    3. Can you clarify what is good for what and what is a good weekly combination? i.e. walking and/or exercise bike for cardio, exercises on the ball and floor and squats/lunges – are these for strength (in all muscles or just core?)
    Also, I note you mention bone density – is this covered in the ball/floor/squats type exercises?
    4. What about swimming – is this cardio? I’ve read that it isn’t particularly beneficial for weight loss but then its meant to be a good low impact exercise that’s good for the whole body?

    Its all quite confusing and I feel like I’m not sure what I should be doing for the best really – I really want to lose weight (although I guess this is a common struggle for women post hysterectomy) and also want to stay fit, strong and healthy in the years to come (I’m 47 currently).

    I’m glad to have found your site – like many ladies on here, I’ve found that there is a lot of poor information out there that is probably doing more harm than good for women’s health!
    Thank you very much in advance for your reply.

  3. Barbara Taylor says

    Hello Michelle, I just had abdominal hysterectomy,bladder sling,and sacrococolpexy 3weeks ago. I am concerned about what exercises I can return to when I am able.Is walking the best overall exercise? I am also worried about returning to work and the demands my job requires. I am a respiratory therapist and I work 12 hr shifts with lots of walking and pushing of ventilators as well as other equipment. I want to allow my body to heal properly and I do not want to injure myself. Can you give any suggestions that may help me gain my strength and endurance before I go back? I have 5 more weeks until I return. Thanks.

    • Michelle Kenway says

      Hi Barbara

      I understand your concern about returning to work. In view of the nature of your work is it possible to coordinate a graduated return to work with scheduled time off your feet and reduced pushing of heavy equipment? I do see both these factors as potential risk factors for you during your recovery which will take around 3 months in total.

      In the early stages the best exercise is progressive walking for preventing debilitation. You can see the gentle core exercises in this video which are those types of exercises hat are gentle and usually appropriate for women seeking gentle core abdominal exercises. This article on walking after hysterectomy will provide you with some relevant information on progressing your walking program. Have you seen the Inside Out strength exercises on my pelvic floor safe DVD or book? These materials include full programs for women seeking to exercise for strength when they have their surgeon’s approval to return to strength exercise.

      I hope this gives you a starting point Barbara.
      Best of luck

  4. Thank you very much for your answer, Michelle.

  5. Michelle,

    First of all thank you so much for your videos and book. The information I got from them was extremely helpful for me. I am 55 yrs. old and had a total hysterectomy 6 month ago and a repaired prolapse procedure. Now I have a question about our gym’s equipment: what can I use for my upper and lower body exercises? My gym uses Cybex equipment.

    I would like to use these machines for lower body: Leg press, Leg extension, Seated legs curl, Prone Leg curl and Glute and mild use of the Abdominal Machine. I’m not sure if I can or should use these machines. What are your thoughts?

    I also use the upper body machines: Pulldown, Overhead Press, Row, Chest Press, Fly/Delt, Arm Extensions, Arm Curl; however, I expect these machines would have no adverse effect on my condition. Am I right about this?

    Would you please tell me which of these machines are safe for me to use?
    Thank you so much for your answer.

    • Michelle Kenway says

      Hi Alla

      Thanks for your comment and questions.

      Unfortunately I am unable to advise you regarding specific resistance exercises that are safe or unsafe for your pelvic floor – every woman differs in her ability to withstand pressure created using weight training equipment. You will find lists of pelvic floor exercises to choose and those exercises for caution in women with pelvic floor dysfunction both on this site, and outlined in detail Inside Out. You will find more free information using this link on strength training exercises and pelvic floor issues.

      I can say that having has a repair procedure your risk of repeat prolapse is increased with those strength training exercises that are heavily loaded and overwhelm your pelvic floor capacity for support.
      For individual advice and treatment best to see a Pelvic Floor Physio who can advise you regarding your specific needs.

      Kindest regards

  6. I have had laproscopic hysterectomy sacrococolplexy to repair vaginal prolapse of bladder, rectum, and uterus. I wanted to confirm which abs exercises I could do and found your website. What is the problem with Plank? Instinctively that seems like a static exercise that would be OK. How come it is risky? What options are available to go further in core strengthening beyond the ball video? Is there any way to really tone up the core beyond basics? What about running? Is it safe to take up running again? What about distance running? Like a previous post, my doctor has been very casual about being able to do almost anything except lifting more than 20lbs. I look forward to your repay. Thank you for offering this information. There is very little on the web about post prolapse surgery exercise safety.

    • Re Core exercises and running after prolapse surgery
      Hi Julianne
      Yes I understand your dilemmas here, I think these are experienced by many women post prolapse surgery so I am glad you have raised these issues.

      The Plank involves the upper abdominal muscles working at varying levels of intensity depending upon the type of Plank performed. Yes it is static but the activation of the upper abdominal muscles can increase intra abdominal pressure – this is the pressure within the abdomen that is conveyed to the pelvic floor.

      Some women can very well withstand the pressure associated with full Plank whereas others will need to modify Plank by kneeling or avoid Plank altogether, especially if their risk of pelvic floor dysfunction is increased. This will ultimately depend upon their pelvic floor strength and capacity to resist the associated downward force and this is an individual thing, there is no one rule fits all. Yes it is great to have a strong well functioning core, and this can readily be achieved with functional whole body strengthening, and appropriate core training such as modified Pilates and ball-based exercise and whole body exercise such as swimming.

      On a personal level I feel there is way too much focus on intense core abdominal exercise in many women’s exercise programs. It is a myth that we can spot reduce our bellies with abdominal exercises yet so many women persist in a disheartening and fruitless quest with sit ups and intense core abdominal exercises in the hope of a flatter abdomen. An individual needs to be very lean to have six pack abs. Women seeking to reduce their abdominal weight should be guided to whole body weight reduction, as this is the only (non-surgical) way to reduce abdominal weight.

      As far as running goes again this is individual and women need to weigh up the risks and benefits. The risk is that with repeated impact, the pelvic floor is under repeated downward pressure – something to be avoided for women seeking to protect their pelvic floor, especially post op prolapse. This information about running and prolapse may be helpful for women seeking to run despite their prolapse. My preference is definitely for spinning for cardio workouts over running when it comes to pelvic floor safe exercises.

      Hope this info helps you exercise safely Julianne

  7. Hi Michelle.
    Please can you tell me if rowing machine counts as safe or unsafe pelvic exercise? (I’m referring to the standard row machines that gyms have).
    Many thanks,

    • Hi Tanya
      Good question, I think the safety of the rowing machine really depends upon how you it (in addition of course to the capacity of your pelvic floor).

      I hope these tips help you to reduce pelvic floor pressure when rowing in the gym:

      If you can maintain the inward curve in your spine throughout, especially with the pull back then your pelvic floor muscles will be able to work more effectively. I also find that maintaining this tall posture and inward spinal curve as you slide back in also helps to reduce pressure on the pelvic floor – You may notice that when you lean forwards and then pull back from the lean forwards position, the pressure on the pelvic floor increases – this is what I sense however I don’t know of any research regarding rowing so I am basing this on what I feel and what I understand about the lean forwards position and the associated pressure.

      Finally if the pull back resistance is kept low, then the pressure on the pelvic floor will be minimised by virtue of the fact that there is less strain involved. So keep resistance low and always breathe out with the effort to reduce pelvic floor pressure – in the case of rowing this is the pull back.

      Sorry a lot to this question Tanya, I hope this makes some sense. Let me know if this is clear to you, I can explain further if needed.
      Good luck and best wishes

  8. I had a sacrocolpopexy along with complete hysterectomy six weeks ago.  It was done with the davinci robotic surgery and with mesh.  I purchased your book awhile back when I knew I was going to have the surgery.  My question is that My surgeon says that after six weeks I can go back to doing everything I used to do.  I told him that I had read that you needed to wait 12 weeks.  I had asked about exercies.  He said the books I had read pertained to the traditional surgery and not when it is done with the mesh.  I am very hesitant and afraid and will follow your guidelines on exercises.  Just wondered if you had any thoughts on this mesh verses the traditional (which I guess does not include mesh)  I am still having lots of bowel problems too.

    • Robotic prolapse repair and hysterectomy

      Hi Debra

      Thanks for your interesting question. First of all I am unable to comment on the success rates or relative risks of recurrence related to mesh prolapse repair surgery and hysterectomy performed traditionally versus robotic surgery.

      First and foremost I do think that you are indeed very wise to be mindful of those activities and exercises you resume postoperatively in both the short and long-term as there is no doubt they do continue to have potential to place pressure on your prolapse repair, especially during recovery.

      The fact that you had a prolapse in the first place indicates that there has been dysfunction in the pelvic floor support mechanism, these are both the pelvic floor muscles and the supportive tissues that work together to hold the pelvic organs up. When for example there is dysfunction in the pelvic floor muscles, then the supports are placed under additional strain and eventually being unable to work alone they can fail. Other factors come into play for support also including hormone status and postmenopaual women are at even greater risk owing to the thinning and weakening of the supportive tissues. Now that your pelvic organs(vagina) have been suspended and are now supported by the mesh, it makes good sense to promote this support and avoid undue pressure, especially if your pelvic floor is not working as well as it could be to assist with support.

      There is also evidence to suggest that women may be at increased risk of prolapse following hysterectomy surgery. Whether this risk applies to robotic surgery I cannot comment upon.

      Another big issue following hysterectomy and prolapse surgery is bowel management post operatively. Straining to empty the bowels places downward stress and strain on the pelvic floor and stretches the pelvic floor tissues, weakening them and increasing the likelihood of prolapse. This is a major factor to be addressed post operatively. If you are having difficulty with bowel management after your prolapse surgery speak to your medical practitioner and get a good management plan happening. This video on how to empty bowels without straining may also assist you.

      In summary regardless of the type of prolapse surgery the fact still remains that inappropriate exercises will increase pressure on the pelvic floor as will bowel emptying problems. These are both major factors to address and manage very well long term after any pelvic prolapse surgery. The other important aspect for long-term pelvic floor support is keeping your pelvic floor in good shape through regular pelvic floor/kegel exercises.

      Best wishes for your recovery

  9. I was wondering if a rectal prolapse could cause trouble with breathing and also out of your exercises what would be the best for rectal prolapse Im not clear as to how to breath right through the exercises and still having trouble with locating the vaginal muscles also when I am able to rest at work what would the best way to take some of the pressure off my lower bum thank you for your web site all of your feed back is all I have had to survive since I have had my prolapse thank you claudia

  10. Thank you for your recent video on prolapse exercises.
    I live in the U.S., in Seattle. Although we have many good doc’s and therapists here, their time is limited. A visit with a doctor is limited to 4 minutes, therapists usually meet with you for a few minutes, then give you a sheet of exercises to do at home. Your book and this video of yours is superior to anything I have found here.
    Thank you,

    • Hi Mary
      So glad we have been able to help you improve your health! Thank you for taking the time to comment here
      Pelvic Exercises

  11. I Recently had that horrible cough/pneumonia thing foing around for a month, then I was well for two weeks and relapsed. I coughed so hard it felt like my insides were ripping out. (I already had a mild prolapse) Now it seems to have gotten much worse and I am still coughing a little. I have an inversion board that I am very comfortable on, when it seems to be unbearable I go hang upside down and everything falls “up” and nothing hurts. I try to do my keigal exercises while upside down, just to prevent any downward push. My question is: Is this a good thing to do, using the inversion board? And I don’t mind if anyone else sees my comments if it can help someone.

    • Pelvic Exercises says

      Hi Vickie
      Thanks so much for your comments on coughing and prolapse. It is relatively common for mature women to experience a worsening of their existing prolapse after an episode of severe coughing. Some women find that their incontinence becomes much worse too. This is due to the downward pressure associated with coughing directly upon the pelvic floor. This pressure can further stretch and weaken poorly functioning pelvic floor muscles.

      Using the inversion board for kegel exercises is an interesting strategy. Women often find that kneeling and resting their weight on their forearms with their bottoms upright, or lying down helps them to perform their pelvic floor exercises especially when their pelvic floor muscles are weak as it helps to eliminate the downward force of gravity. Using the inversion board sounds like a similar strategy to this by taking the weight of gravity off the pelvic floor and the prolapse, it would help activate the pelvic floor muscles and relieve pelvic floor pressure. We are unable to comment on the safety of using an inversion board and its potential effect on blood pressure and other joints in particular.

      After women have learned to activate and ahve trained their pelvic floor muscles in anti gravity positions, it is then important for them to start training against gravity in upright positions. This will ensure their pelvic floor muscles work for them when they need them to – in upright.

      Thanks for your input Vickie!

  12. Where can I PURCHASE your videos for exercises after pelvic prolapse. I purchased your book Inside Out, it was GREAT!!!!!(every womens doctor should have in there office)

    THANKS! Debbie

    • Pelvic Exercises says

      Hi Debbie
      Thanks so much for your lovely comments! So glad to help out…do you want to purchase the videos we curently have online? If so i can organise this for you, just email us on our contact page. Cheers Michelle

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