Rectal Prolapse Exercises – How to Stay Active and Improve Rectal Support

This health professional information is intended for individuals diagnosed with a rectal prolapse. It teaches how to improve rectal support with rectal exercises and reduce rectal prolapse strain.

Read on now to learn:

• definition of rectal prolapse
• what causes a rectal prolapse
• signs and symptoms of rectal prolapse
• how to do rectal prolapse exercises
• how to exercise with a rectal prolapse.

What is a rectal prolapse?

A rectal prolapse is a condition where the inside of the rectum protrudes out through the anus. This condition is not the same as a rectocoele or prolapse of the back wall of the vagina.

There are 3 types of rectal prolapse:

1. Mucosal prolapse which involves only the rectal mucosa (membrane) protruding through the anus
2. Full thickness rectal prolapse where the rectal wall protrudes through the anus
3. Internal intussusception where the rectum collapses but stays inside and does not protrude.

If you suspect you have a rectal prolapse you are advised to seek prompt medical advice.

What causes a rectal prolapse?

A rectal prolapse results when the supportive tissues that hold the rectum in position become weakened.

Some causes of rectal prolapse include:

• increased age
• chronic constipation and straining to empty the bowel
• chronic diarrhoea,
• pregnancy and childbirth
• anal intercourse
• cystic fibrosis

What are some signs & symptoms of a rectal prolapse?

Signs and symptoms of a rectal prolapse may include:

• A red protrusion may be visible from the anus especially after a bowel movement
• This anal protrusion may be evident with squatting & heavy lifting
• Mucous discharge from the anus
• Staining of underwear
• General discomfort around the anus often worse after activity and towards the end of the day

Initially the rectal prolapse may retract (move back inside the anus) after a bowel movement. As it becomes worse it usually will become more apparent with everyday activities such as walking and prolonged standing and may cease to retract.

How to do rectal prolapse exercises

Your pelvic floor is your supportive hammock for your pelvic organs including your rectum. Your pelvic floor muscles work with other strong tissues to withstand the forces of everyday activity on your pelvic floor and support your rectum in the correct position.

When training your pelvic floor muscles it is very similar to training the strength of other muscles in your body. You should progress through the following 3 stages to achieve your best possible pelvic floor strength and support:

Stage 1 – Find your pelvic floor muscles

Stage 2 -Train your pelvic floor muscles

Stage 3 - Training your pelvic floor muscles for everyday activities

Inside Out Chapter 2 guides you through these essential stages.

Rectal prolapse exercises – tips for improved rectal support

• Choose positions such as lying down where your prolapse is more supported for your pelvic floor exercises when starting out
• Perform your pelvic floor exercises (kegels) when your muscles are less likely to be fatigued (e.g. early in the day)
• Always draw up your pelvic floor muscles after using your bowels
• Progress your pelvic floor exercises into upright positions when you are able.

How to exercise with a rectal prolapse

1. Practice good bowel habits using the correct technique to empty your bowels and NEVER STRAIN to use your bowels

2. Choose supported positions wherever possible (for example sitting will be more supportive than standing)

3. Spread out your activities during the day and take time to rest and elevate your legs in the afternoon to reduce pressure on your pelvic floor if you have time                      

4. Avoid heavy lifting which increases pressure on your pelvic floor

5. Manage your weight well and avoid unnecessary weight gain which increases the load on your pelvic floor

6. Support Briefs can help reduce pressure on the pelvic floor, especially if you are on your feet for extended periods of time or working long hours.

Pelvic floor safe exercises strength and fitness with a rectal prolapse

Learn how to choose safe fitness and strength training routines that reduce pelvic floor strain by reading Inside Out - the essential women's guide to pelvic support by Michelle Kenway (Physiotherapist) and Dr Judith Goh (Urogynaecologist). Inside Out provides you with expert guidelines and advice for choosing safe general fitness and strength exercises and minimising the pressure on your pelvic floor as you exercise.

1. Choose appropriate fitness exercise (low impact) for prolapse protection where at least one foot remains in contact with the ground at all times (e.g. cycling is usually ideal to minimise pelvic floor strain).

2. Adhere to the Prolapse Protection Principles for strength training to exercise for strength and reduce pelvic floor strain. These include choosing supported positions, exercising with light weights, gradual progression and avoiding specific strength exercises that increase pressure on the pelvic floor.

3. Avoid unsafe abdominal (core) exercises that increase pressure on the pelvic floor. Some specific abdominal exercises such as sit-ups and plank as well as many Pilates-style exercises increase the downward pressure on your pelvic floor and your prolapse. Choose seated fit ball based core exercises to support your pelvic floor and exercise your core muscles.

For more information on how to exercise safely improve your strength and fitness and protect your pelvic floor refer to Inside Out – the essential women's guide to pelvic support by pelvic floor experts Michelle Kenway (Physiotherapist) & Dr Judith Goh (Urogynaecologist)

Please read our disclaimer regarding this information

This information is provided for general information only and should in no way be considered as a substitute for medical advice and information  about your particular condition.
While every effort has been made to ensure that the information is accurate, the author accepts no responsibility and cannot guarantee the consequences if individuals choose to rely upon these contents as their sole source of information about a condition and its rehabilitation.

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