Exercises to avoid with prolapse and after prolapse surgery
- these include specific core abdominal exercises. If you have a vaginal or rectal prolapse or when exercising after prolapse surgery you need to know how to avoid st
raining your pelvic floor with the wrong kind of abdominal exercises.
This expert physiotherapist article teaches you:
- 12 unsafe abdominal exercises likely to worsen prolapse symptoms and contribute to recurrent prolapse after prolapse surgery.
- How to identify unsafe abdominal exercises if you have pelvic floor dysfunction
- The 3 myths you need to know about abdominal strength exercises.
12 abdominal exercises to avoid if you have a vaginal prolapse and after prolapse surgery
If you intensely exercise your upper abdominal muscles (i.e. your six pack muscles), you will increase the downward pressure on your pelvic floor.
Recent studies show that when women with pelvic floor dysfunction do sit-up exercises, their pelvic floor is forced downwards. If you repeat this often enough, you will overload your pelvic floor and potentially worsen prolapse symptoms.
Avoid the following upper abdominal muscle exercises if you have a pelvic prolapse or when exercising after prolapse surgery to minimise pressure on your pelvic floor:
1. Abdominal crunch/curl or sit-up exercises (shown right)
2. Incline sit-ups
3. Abdominal curl machines
4. Oblique sit-ups 
5. Oblique machine
6. Ball sit-ups
7. Ball-between-leg lifts (shown above)
8. Bicycle legs
9. Double leg raise
10. Hanging knee raise
11. Pilates “Table Top” exercise 
12. Intense core exercises such as “Plank” or “Hover” (shown right)
For much more information on safe abdominal exercise if you have a prolapse or after prolapse surgery refer to
Inside Out by Pelvic Floor Physiotherapist Michelle Kenway and Urogynaecologist Dr Judith Goh.
Tip for how to identify unsafe abdominal exercises …
Try to avoid any abdominal exercises that involve raising both legs off the ground at once and/or exercises involving raising your head and shoulders off the ground whilst lying down on your back. Both these types of exercises will increase the downward force on your prolapse and your pelvic floor. These exercises require very good pelvic floor strength to counteract the downward pressure associated with them.
3 myths about abdominal core strength exercises
Myth 1. Abdominal exercises will flatten the appearance of my stomach
Unfortunately our society has a culture of abdominal strengthening. Women are often led to believe that the more abdominal muscle exercises they perform, the flatter their stomach will appear! We know that it is not possible to spot reduce fat – to flatten your stomach you probably need to lose fat. It does not matter how many sit-up or abdominal strength exercises you do, they will never flatten your stomach. The way to flatten the appearance of your stomach is to lose body weight by reducing your fat intake and increasing appropriate exercise.
For professional guidelines for how to lose weight with pelvic floor problems refer to Inside Out- the essential women’s guide to pelvic support by Michelle Kenway and Dr Judith Goh.
Myth 2. Pilates exercises will strengthen my pelvic floor
In some cases women mistakenly believe that doing abdominal exercises including Pilates exercises will actually strengthen their pelvic floor. Abdominal strength exercises or intense core exercises will not strengthen your pelvic floor if you have a prolapse or pelvic floor dysfunction. In fact the more intense abdominal exercises women perform, the more downward pressure they place on their pelvic floor. If your pelvic floor is not working as it should, it will not be able to withstand the downward pressure of abdominal exercises and your pelvic floor (and your prolapse) will be forced downwards as shown here in the diagram below. This is potentially a huge problem for women who have had prolapse surgery in the past. If you have a prolapse including bladder prolapse (cyctocele), bowel prolapse (rectocele) or uterine prolapse, the wrong kind of abdominal strength exercise is likely to make your pelvic prolapse worse.
Abdominal muscles pull in forcing a weak pelvic floor downwards
Myth 3. I need to brace my stomach muscles (pull them in strongly) constantly when I exercise and as I walk around
Advice to brace your abdominal muscles strongly is not correct advice. If you constantly pull your stomach muscles in firmly, then you constantly increase the downward pressure on your pelvic floor and your prolapse. Your deep abdominal core muscles are designed to work gently all the time and this is how they should be trained.
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.
Copyright © Pelvic Exercises.com.au
I am a physical therapist with no experience in treating pelvic floor dysfunction. I live in a small town, and our women’s clinic is interested getting a PT trained to treat pelvic problems. I am interested in becoming trained, but am not sure who offers the best courses. My background is more orthopaedics. Your article was very informative, so I thought you might be able to steer me in the right direction. Can you suggest good continuing education programs for the treatment of pelvic floor problems (or do you offer any).
Thanks you so much for any advice you might be able to offer.
Hi Anne
I completed my continence and women’s health post grad training at Curtin University in Perth, Western Australia. They run a fantastic post graduate women’s health program through the physiotherapy department there. I studied as an external student and travelled there as required. They provided wonderful support and continue to do so for overseas students. I hope this information helps you with your further studies Anne
Michelle
I have just suffered a uterine prolapse and believe that several months of pilates exercise classes leading up to the prolapse “moment’ and beyond have exacerbated this condition. my doctor says that the ligaments that keep the uterus in position have stretched and my belief is that the sorts of exercises i was encouraged to do in Pilates are ones i should have, in fact, avoided. I have no idea, at this stage, how to go about getting my uterus back where it should be and ligaments tightened….. I think that Pilates instructors should pre-screen their clients much more closely than they currently do.
Hi Jo
Thanks for your message, it will no doubt help other women to understand that some Pilates exercises can place pressure on the pelvic floor – and yes I agree pelvic floor screening is needed before women perform particular exercises in Pilates classes. This could be a simple as a couple of screening questions. Thanks Jo, Michelle
Hello! I am three days post-op from uterine prolapse surgery and a TVTO for my bladder. Thank you so much for this information. I’ve been thinking about how to exercise again when it’s safe, and this article has been very helpful.
Lisa
USA
Hi Lisa
Thank you for your input. I am so glad that this article has improved your understanding about exercises to avoid after uterine prolapse surgery. I think it is also important that you mention the TVTO surgery also as this is such a quick operation and I think many women are unaware of the need for their tissues to grow through the tape for full healing. It would seem to make good sense to avoid too much downward pressure on the tape especially with the wrong kind of abdominal exercise, especially while you are healing (i.e. the next three months!). Hope you have a good recovery and a great outcome from your pelvic surgery.
Michelle
Hello, Ive had a vaginal prolapse for year I am 41 3 kids 5 miscarriages and had it all relatively under control but after an allergy sneezing fit have found I can feel bulging again, but my main concern is the constant pelvic ache and back pain, I am booked in to see a specialist Physio but need to wait 2.5 weeks to get in. Can I get a brace or something to support my back from feeling sparks of pain if I move too fast?
I am also 15 kgs over weight what can I do to shift it and safely not put on the pelvic pressure? I can swim, ride, walk, already doing this though, but I love weights and am now feeling they might not be the best idea, cerrtainly can’t do them whilst I have this flare up, any advice?
Hi 6 months ago I had a vaginal hysterectomy, suspension anterier repair,and TVT surgery. I have had a lot of pain over the last week. Is it possible that I could have the prolaps back again.
Hi Alice
There are many potential causes of pelvic pain and your pain needs to be need to be assessed by your specialist. For your information usually a vaginal prolapse is not painful unless it is very large. Pelvic floor muscle spasm is also a very under recognised and at times poorly diagnised source of pelvic floor pain after pelvic surgery. Many women become very frustrated at ongoing pelvic pain which is not diagnosed and often we find levator spasm or pelvic floor muscle spasm is the cause. This is only one possible cause of pelvic pain after surgery.To determine the cause of your pain you need to visit your specialist as soon as are able to do so. Michelle
I am in a little bit of panic mode right now, I just returned from my OB appointment. I had a hysterectomy approx. 5 years ago and had to have my bladder attached to my vaginal wall with 2 stitches. My doctor said everything looked good, but warned me against weight training basically saying I could cause my vaginal wall to fall. Just a little scary!
I started to weight train a few months back and am doing the Body For Life program. I love to lift and it didn’t occur to me that I might cause more damage to myself than good. I am a little stressed and frustrated now, because I don’t want to give up my weight training or interval running on the treadmill, but don’t know my options. I have ordered the Inside Out Book today, but was hoping that there might be some exercises I can do while I wait for its arrival. I don’t want to stop working out. I am down 10 lbs and am really starting to feel myself gaining strength. I really enjoy weight training and am praying it is not something I have to give up all together. Besides the book are there other resources I can check into for more information. I just turned 40 and don’t want to see myself slip with my health or start to have POP issues.
Thank you.
Lisa
Hi Lisa
Thanks for your email. I think you express the concerns of many other women regarding staying fit and strong and weight training with safe exercises for your pelvic floor. I am not familiar with the program you are currently doing however I will say don’t panic and that there are plenty of safe strength exercises that women can perform and minimise pressure on your pelvic floor. I would siggest that while waiting for Inside Out to arrive read these articles at pelvicexerises.com.au in the prolapse library on how to protect your prolapse when strength training and also have a look at our strength training and abdominal exercise videos at this link. Finally your copy of Inside Out will give you detailed lists of exercises to avoid and those to choose to protect your pelvic floor, plus an illustrated gymworkout. Unfortunately to my knowledge there is little information on this important topic. My knowledge is from my post grad uni studies reading the research and years of exercising with women after prolapse surgery. I hope this info helps you Lisa, Michelle
Hi,
I am a personal trainer and have a client who had prolapse surgery 15 years ago. She has What abdominal exercises would you recommend? Also, she has trouble doing any kind of squat or split leg exercises. Would you advise using any of the universal machines? What about kicking a punching bag. She is very limited since just about anything makes her hammock drop.
Hi Dawn
This is a general reply to your great qns as it is not possible to be specific about your client.
1. When working with women who want to do abdominal exercise after surgery it is best that they avoid intense core work and upper abdominal (rectus abdominis and external obliques) in particular. Rule of thumb keep at least one leg on the ground and head and shoulders on the ground if doing lying down abdominals as demonstrated in our video on safe abdominal exercises for pelvic floor dysfunction Also good to read this article on 12 abdominal exercises to avoid after prolapse surgery Appropriate seated fitball exercises are a great safe way to promote safe core exercise after prolapse surgery see our video on safe core exercises.
Some seated universal machines will place less pressure on the pelvic floor such as seated row, bicep curl, calf raises. Leg press and lat pull down should be avoided with pelvic floor dysfunction. Once again seated fitball weights are a great option and there is plenty that can be done with minimal pelvic floor pressure(see full appropriate work out with pelvic floor dysfunction in Inside Out – the essential women’s guide to pelvic support. Probably avoid high kicks in kick boxing opting for low impact stationary cycle & walking. Hope this information helps you with your prolapse clients, Michelle
I think I’ve made a connection to bladder prolapse with a new biking position. I ride about 100 miles a week. The new position has taken my speed and ability to a new level, which is very exciting (I am much faster due to being very aerodynamic, in other words very low from seat to handle bars on a road bike). I am not sure if it is coincidental, or if the prolapse would get better if I go back to a more upright position. I am purchasing your book today, but would appreciate your thoughts.
Hi Lauren
Interesting question about cycling with a prolapse. I am imagining that your new position involves you leaning right foward on your bike is this correct? Cycling is a great low impact exercise for women with a prolapse – I always suggest avoiding standing in the saddle and high gears (which probably means hills) which increase pressure on the pelvic floor. Leaning foward is a little like bending foward. It increases the pressure in the abdomen which is in turn transmitted to the pelvic floor- a little like squeezing an upside down sauce bottle if this makes sense. If you are leaning forward more than you normally do, I imagine this would increase pressure on your pelvic floor. An easy way to test would be to monitor your prolapse symptoms and comparing them after a ride over the same route on different days using the different positions. But don’t forget the big impact of high gears and standing in the saddle on your pelvic floor. Hope this helps you keep cycling well Lauren, good luck Michelle
Hi,
After developing a grade 2 vaginal prolapse 6 months after the birth of my first daughter I came across your book and religously undertook pelvic floor exercises and modified my gym routine to prevent further severity. It did aid in lessening the symptoms and I was delighted to go most days without ever thinking about it. I have since fallen pregnant a second time and although the obgyn mentioned in the early days that the prolapse shouldn’t become any worse (as long as I keep up the diligent pelvic floor exercise) I have noticed that the feeling of heaviness and bulging has returned, similar to, if not worse than before. I am now 18 weeks and am wondering whether I can expect it to get worse throughout the remainder of the pregnancy as the baby grows and is there any other exercises that I should be including in my routine now that I am pregnant? Pelvic floor exercises have become increasingly difficult as the weight has increased since beginning of pregnancy.
Thanks, Kate.
Hi Kate
Thanks for your question. Yes this is a commonly asked question and valid concern of women who are pregnant with a prolapse and wishing to exercise safely.
As pregnancy progresses pelvic floor or kegel exercises become increasingly important (yes and difficult too). As the weight of your baby increases so too does the stretch on your pelvic floor muscles and tissues which makes your pelvic floor progressively weaker. To make pelvic floor exercises easier with progressing pregnancy there are a number of things women can do:
1. Choose antigravity positions such as lying down, or on all fours even resting on elbows to make the exercises easier
2. Do pelvic floor or kegel exercises early in the day. By the end of the day the pelvic floor muscles are fatigued and prolapsed tissue is further descended in to the vagina. Try to do kegel exercises in the morning and rest if possible in the afternoon to take pressure off the pelvic floor especially as pregnancy progresses.
3. Women are advised to perform pelvic exercises approximately 3 times daily, holding each contraction up to 10 seconds where possible for 8-12 repetitions
4. The best pregnancy fitness exercises are low impact for women with (and without) vaginal prolapse – such as cycling (stationary). Water based exercise such as walking is an excellent way of exercising with a prolapse as the body is supported and the impact is low which is pelvic floor friendly.
5. Also ensure against constipation and straining with progressed pregnancy is also an additional important factor in protecting a prolapse during pregnancy.
So the key elements for prolapse and exercise in the latter stages of pregnancy are: doing kegel exercises or pelvic floor exercises in antigravity positions, resting the pelvic floor when possible by taking the load off your feet, choosing low impact general exercise (and avoiding constipation). After delivery pelvic floor exercises will be a very important part of rehabilitation and exercise will need to remain appropriate with cautio especially in the early days post natally when the pelvic floor muscles are stretched and very weak.
Good luck Kate Michelle
Hello Michelle
What are hanging knee raise, plank or hover?
> Also I was watching the abdominal exercises and Michelle said to keep the curve in your back, I was taught when doing the pelvic tilts
to flatten out the back?
> Do you by chance know of any gynacologist in the US that is fully aware of pelvic floor dysfunction?
I have been doing some core exercises and I knew not all of them strengthened, some did make me feel weaker.
> Thank you and God bless
Hi Sherry
Hanging knee raise is a gym machine (also called Captain’s Chair) where the body is supported upright through the forearms and elbows. Then you bring your knees towards your chest and lower them down. This is an intense abdominal exercise to be avoided with pelvic floor dysfunction. The plank or hover is a very commonly performed gym exercise (also in Pilates classes and Yoga classes) a little like a push up but resting on your forearms not your hands. This is also an intense core exercise that will increase the pressure on the pelvic floor. Hope this helps, Michelle
Hi Sherry
To correctly activate your core or deep abdominal muscles (and pelvic floor muscles) the spine should have an inward curve. Some great studies have shown that with an inward curve in the back, these muscle groups work better than when the spine is flattened (unfortunately this advice is still sometimes given in Pilates classes). So the spinal position for activating your deep abdominals most effectively regardless of lying down, sitting or standing is with an inward curve in your spine. This is why posture is so important in good core muscle control exercise.
Yes it can be very difficult to correctly locate the deep abdominal muscles, especially if you are accustomed to drawing the upper abdominal muscles in strongly. This is a common mistake when learning to activate your core muscles. Try lying on your side and let your abdomen or belly completely relax. Place your hands inside your uppermost pelvic bone or over your lower belly. Gently draw in the lower abdominal area by again gently tensing the area under your knickers a little like pulling your navel towards your spine just a little. Keep breathing normally and hold this deep abdominal or core muscle contraction.You should not see your upper abdominal (six pack) muscles draw in. This is a very subtle indraw of your lower abdomen. Once you can do this in side-lying try it on your back (more difficult) or ins standing which is sometimes asier than when lying down. Let me know how you go with this technique, cheers Michelle
Hi Michelle
I asked the question above, and I have been trying to do the gentle core exersice you show in the video but I am confused. I place my hand under my pubic bones by the end of my underwear but I do not necessarily feel anything. I do sometimes feel my upper stomch, under my rib cage getting involved and Ihave to correct that. And I also feel my lower back when releasing, so I am not sure if I am doing it right. Can you help further?
Sherry
I am freaking out over this prolapse thing. I just discovered that I probably have a uterine prolapse. I didn’t really know what it was until I watched Dr Oz yesterday and he discribed it. I have slight bulging soft tissue at the opening to the vagina. I am 47 years old, have had two very large babies and I am overweight. I have lost 35 pounds since January but have a long way to go with that still. What can I do to correct this or prevent it from becoming worse? I have been kegaling like a crazy woman since yesterday. LOL But I have been doing kegal exercises for years now. Please ease my stress about this. I am horrified!!
Hi Josephine
First of all take a deep breath and know that you are one of literally hundreds of thousands of women world-wide with this issue. Not that this eases things for you but sometimes it is nice to know that you not the only one with a uterine prolapse, sadly this is not spoken about enough in public and that there is much that can you can do to self manage this is addition to getting specialist help if you require it.
I suggest you start by reading some of our articles on how to manage a prolapse such as How to manage a uterine prolapse see http://www.pelvicexercises.com.au/2010/uterine-prolapse/ and some of the prolapsed bladder information at http://www.pelvicexercises.com.au/2010/manage-prolapsed-bladder/ as many of the same principles for prolapse management apply. Yes kegels can help with uterine prolapse symptoms if the prolapse is mild to moderate so you need to make sure you are doing your kegels correctly. Have you discussed the possibility of a pesary to support your uterus, with your specialist? This is often a great easy non surgical option for managing a prolapsed uterus.
Let us know how you go, hoping this information helps you and other women.
Michelle
Thank you for your reply. I haven’t seen a specialist yet for this but I will make an appointment. Thanks for the links to the articles. I will read them today when I get home from work.
Hi Michelle,
Would you be able to advise safe abdominal exercises for the pool after prolapse repair? Thanks.
Hi Kathy Re: prolapse surgery and aqua exercises
After prolapse repair selected pool exercises are ideal after approval from your specialist to exercise in the water. This is important to avoid infection before your internal wound is fully healed. Also consider the depth of the water, ideally around bust level – the more shallow the water the less buoyancy and the greater the impact. Furthermore start at a slow pace, the faster the pace the greater the water resistance.
When recommencing pool exercise after prolapse surgery ideally start with a basic pool walking program of forwards, backwards walking and side steps. Listen to your body, back off any water-based exercise that causes any discomfort and gradually progress duration walked and speed as fitness levels gradually improve. Water walking provides an ideal platform for exercise usually from weeks 6-12 for most women. During this time upright noodle cycling (noodle placed between legs like a saddle with cycle legs and breaststroke arms forwards and backwards). Alternatively in deeper water this can be performed with a buoyancy vest and gentle cycle legs forwards and backwards. Kickboard lying in the back with the board across the chest and very gentle kicking legs may commence comfort permitting at around 8-10 weeks.
Water exercises requiring caution in the first three months at least after prolapse repair surgery:
Recumbent cycling (lying backwards cycle legs), water running (especially in shallow water), jumping such as star jumps and bunny hops jumping and bringing knees to chest. Take care with traditional strokes such as freestyle and breaststroke which involve quite a bit of stretch and should be avoided until well healed at around 10-12 weeks. Obviously no butterfly stroke following prolapse repair – I would suggest avoiding this indefinitely. Also avoid using fins/flippers for the first 12 weeks at least post-op as these increase pressure within the abdomen. Be cautious using water resistance devices for the upper body for abdominal exercises and upper body exercises which also recruit the strong upper abdominal muscles.
Hope this helps your return to fitness Kathy and thank you for your comments
Michelle
Hi Michelle
What is the difference in technique or feeling when you do the deep lower abdominal contraction and a pelvic tilt?
Thanks
Sherry
Hi Sherry
Re: Deep abdominal contraction and a pelvic tilt
Thanks for this question, I think this is a confusing issue at times…
1. A deep abdominal contraction is performed by gently activating the lower abdominal muscles (also known as core muscles or TA muscles). This is achieved by gently drawing in the area under your knickers towards the spine. You should feel a gentle tightening of the lower abdominal area. A very common mistake made when isolating these muscles is to draw them in too hard. These muscles have been shown to work most effectively with the low back arched or in its neutral resting position.
2. A pelvic tilt is an exercise that involves flattening out the curve of the low back. If you lie down and try to flatten out the low back you will usually find that your pelvis tilts backwards. This is quite different to a deep abdominal muscle contraction and this uses different muscles (the hip flexors). We know that flattening out the back curve will not help but in fact hinders the ability to activate the deep abdominal muscles.
Hope this helps Sherry, let me know if this is still not clear.
Michelle
Hi. I am 56yrs of age & have had a complete hysterectomy 10yrs ago & 2 cystocele, rectocele & prolapse repairs in the last 2 years. The last one was a mesh repair 12 months ago. At the moment I am walking/exercising for 30min or more each day. I also am doing kegel exercises. Is this enough at this time or could I be doing more?
Hi Kay
Kegel exercises should be performed daily when strengthening, 3 sets of up to 8-12 repetitions of 10 second holds when this is possible. When doing kegels to maintain pelvic floor muscle strength, a woman should aim to perform her kegel exercises on at least 2 days a week. Also remember the importance of using your pelvic floor muscles to protect before and during a cough/sneeze/lifting. Also remember not to do kegel exercises when walking. They should be preformed when standing still and the pelvic floor muscles need to be fully relaxed between each contraction.
Regards
Michelle
Hi Michelle – Was grateful for your help before my extensive pelvic floor repair 9 months ago. I need your advice on aquarobics. I used to do it suspended with feet off the bottom of the pool wearing a belt. Much of the class involved raising legs using abdominal muscles. (“seated row” etc) I am concerned this is now contraindicated, although I would love to do the classes again. Many thanks Linda
Re Aqua aerobics after Prolapse Surgery
Hi Linda
Lovely to hear from you, I hope you are well.
Yes I think you are spot on in identifying some deep water aqua exercises as potentially stressful upon the pelvic floor. The lovely thing about deep water aqua is the fact that it is low impact which is what we advocate for pelvic floor safe exercise.
Despite this I think there is some potential for some intense core work in some deep water aqua exercises. Particularly with exercises bringing your knees up to your chest and some of those involving resistance devices in the water for example resisted triceps push downs using paddles or flotation devices. Also consider those exercises lying on your back once again bringing your knees to your chest like cycle legs.
Aqua aerobics has the potential to be an ideal exercise for pelvic floor protection. As for many forms of group exercise I think it’s a matter speaking to the instructor up front and advising him/her that you need to be avoiding specific exercises and modifying others so that you are not performing intense abdominal exercises for your own health reasons. Attend classes where you know your instructor will understand your desire to modify, and perhaps assist you in doing so during the class. Start at a beginners level so that you can progress gradually. Modify where you can and if in doubt always leave it out.
As always don’t forget the importance of your pelvic floor or kegel exercises on an ongoing basis. Remember you are capable of doing what your pelvic floor can withstand. This is reduced owing to your previous surgery. It is in your interests to have your pelvic floor muscles functioning for support in their best possible condition to help your long-term safe general exercise. Similarly staying fit, strong and within a healthy weight range will help reduce the load off your pelvic floor as I am sure you are aware.
Stay in touch Linda I will be very interested to hear how you go.
Cheers
Michelle
Hi I’m 38 and have a prolapse of the womb. I’ve recently started using a hula hoop. It doesn’t seem to be making my prolapse any worse. Do you think it is safe to use?
Hi Kerry
Yes I would think that the hoola hoop would is not an exercise that would place a lot of pressure on the pelvic floor. If you think about the muscles used during hoolahoop, they are trunk muscles but not so much the strong upper abdominal muscles that increase pressure down upon the pelvic floor when they contract. I also think symptoms are quite often give a clear indication that an exercise may not be appropriate.
Enjoy your hoola hoop Kerry
Michelle
I was told I had suffered a minor prolapes a few weeks ago, the doctor was not very helpful and said just come back if it gets worse. I asked about exercises, as I am obese, I exercise alot and have lost 105lbs already, the only thing the doctor told me was no heavy lifting and do pelvic floor exercises and that I could continue with all my other activities. I have been feeling a lot better, as before, but I think I may have done myself harm over the last week by doing proper sit ups. I’m not sure what to do now, I’m not in any pain, but I am worried.
Abdomial exercises, weight loss and prolapse
Hi Andrea
Thank you for your comment. Yes managing a prolapse and weight loss is potentially tricky. It is really a matter of understanding those exercises that are suitable and those to avoid.
First and foremost sit ups will not and never help you lose weight. For some reason there is some crazy myth that sit ups flatten the abdomen. They don’t. It is not possible to spot reduce fat through exercise. Lean people have flat bellies and “six pack abs” because they don’t carry fat that covers their abdominal muscles.
What sit ups will do if your pelvic floor is weak, is to push your pelvic floor down with every sit up you perform. This will progressively weaken and stretch the weak pelvic floor and increase the likelihood of a prolapse progressing further. So I would suggest that anyone with pelvic floor problems avoid sit up exercises at least until they are very confident in the strength of their pelvic floor muscles to counteract the associated downward pressure.
Andrea there is a lot to this issue, so much so that I have written Inside Out on exercise and pelvic floor with a chapter entirely devoted to weight loss and pelvic floor safe exercises so it is very difficult for me to summarise in a couple of lines.
What can be said briefly is that to protect the pelvic floor and perform weight management exercise:
Perform low impact exercises (at least one foot on the ground)
Perform appropriate resistance training exercises and techniques
Avoid those specific exercises that increase pressure on the pelvic floor
Vary your exercise program and your daily exercise routine regularly
I hope this helps a little Andrea and keep up your great work. A prolapse diagnosis is no reason to stop your great weight loss efforts which will help greatly to decrease the pressure on your pelvic floor and prolapse.
Michelle
Hello,
Thank you for this important information. I am 5 weeks out from vaginal cystocele repair (without mesh but with permanent prolene sutures), rectocele repair, and hysterectomy. I was progressing nicely but two days ago walked up a steep hill carrying about 5 lbs of groceries. I had a small amy of bleeding and now feel that I’m back at about week 3 with pressure upon standing and mild pelvic pain. I’m supposed to go back to work half time in 1 day. My job is part sedentary part walking down halls. Should I wait one more week before returning? I’m going to buy your book now.
Thanks!
Laura
Hi, i am 4 months post hysterectomy for a prolapse. I have received my copy of Inside Out & have found it very informative & interesting. One of the reasons why i bought a copy is because i want to return to the gym & want to know which of the resistance exercises to avoid & which ones i can do. Whilst the book is very informative, i’m not entirely confident of putting myself in the hands of an instructor & so would like to ask if it is possible to have a few more of the exercises clarified for me please. The ones that i would like to know if are ok to do are:- leg adductors & abductors; seated good morning with barbel across the shoulders; deep squats (no weights) as i thought the gluts did the work.
Thanks
Jane
Gym exercises after prolapse and hysterectomy surgery
Hi Jane
Thanks for your questions regarding gym exercises after hysterectomy and prolapse repair.
1. Do you mean lying down abductors/adductors Jane? What type of exercises do you do here and in what position? The lying down adductor/abductor machines will place minimal pressure on the pelvic floor.
2. Seated good morning with barbell across the shoulders is an exercise warranting caution: legs wide open position and forward bend will increase pressure on the pelvic floor and at the same time place the pelvic floor muscles in a position that is difficult for them to work. This is also a potentially dangerous exercise in terms of the possibility for spinal injury.
3. Deep squats: will increase pressure greatly on the pelvic floor owing to the depth of the squat, legs wide apart and legs wide open position. Can you see the photo and instructions for pelvic floor safe squat on p51-52 of Inside Out? There is no additional benefit to be gained by going into a deep squat as opposed to the squat illustrated, which places far less pressure on the pelvic floor.
Squat exercises involve the quads, hamstrings (front and back of thighs) and the gluteals (buttocks). This is not the issue with the squat exercise – the issues being the depth of the squat, where the weight is placed on the body, and the width the legs are placed apart.
Hope this helps Jane
Cheers
Michelle
Hi Michelle, thanks for clarifying those exercises for me. The leg abductors & adductors are done seated at a weights machine aimed at toning the inner thighs. The exercises are carried out by having knees together & using the inner thigh muscles to move the ‘weight’ outwards and then from outwards to together. I’m guessing from what you replied earlier that maybe they might not be suitable due to having the legs wide apart. Thanks again, it’s great to be able to ask these questions & feel confident with the replies. Jane
Hi again Jane
The seated abductor adductor should not place a great deal of pressure on your pelvic floor. Regardless of the position of your legs, there is minimal downward force on the pelvic floor as long as this exercises is done lying back with head against the supporting chair and not straining with the exercise. Enjoy your workouts Jane!
Michelle
Hi I am hoping you can provide me with some advice on yoga and prolapse. I have grade one uterus prolapse but had been having difficulty emptying bladder and subsequent kidney infections. Seeing Physio and have managed to improve pelvic muscle strength from 3 to 4 in a month. But after a yoga session last night I feel a lot more pelvic discomfort than the last few sessions. We did a half shoulder stand which I thought would help as gravity in other direction, also have slight cold at moment. Examined and doesn’t seem to be physically much worse, possibly a little bit but I could be panicking?? Appreciate any advice, thanks,
Re Yoga and Prolapse
Hi Michelle
First of all don’t panic. I think that with any increased pelvic discomfort you are best advised to visit your medical practitioner especially in view of the fact that you report that have a history of bladder infections. Yes I would think that the shoulder stand itself would not be the issue, perhaps the action of raising your legs into the shoulder stand? Or perhaps something else during the class you were not aware of? Furthermore if you are coughing and sneezing your pelvic floor could be compromised with increased pressure or simply from the fatigue associated with being unwell. There are many possibilities. Best to see you general pracitioner for a review and meanwhile remain diligent with your pelvic floor exercises. If all is clear from your doctor, next time observe what happens if you repeat a shoulder stand – can you use the wall to help you walk your body into the stand?
Hope this helps
Cheers
Michelle
Hi
I had a vaginal operation during July 2011 for a moderate/large rectocele prolapse. My prolapse is slowly returning thankspartly to a bad cough and a job that involves lots of walking and carrying(non-smoker); will the excercises in the “Core and the Floor” DVD be suitable for me or can they make the prolapse worse? Thankyou for any help,
Clair
Hi. In a couple of weeks I am having a hysterectomy with bladder and rectal repair due to prolapse. I am an artist (potter) and regularly lift 25 to 50 lb boxes of clay. Will I be able to return to my work after 6 weeks? Would a treadmill be beneficial for excercising? I just ordered your book. I stand a lot more than sit because I make slab built pots.
Return to work after a hysterectomy and prolapse repair
Hi Sandi
Thanks so much for your question regarding lifting and return to work after hysterectomy and prolapse repair. This is an involved question and warrants a detailed explanation. I have summarised key points at the end for you.
First of all in relation to safe return to work you are best advised by your treating specialist as he/she is the person who performed your surgery and understands your overall rate of recovery. Always be sure to clearly outline the exact nature and requirements of your work when discussing your return to work with your surgeon.
It is well understood that a number of factors can increase the likelihood of prolapse because they increase pressure on the pelvic floor. These factors definitely include heavy lifting. It is also important to recognise that after a hysterectomy the risk of prolapse may be increased, and after prolapse surgery the risk of recurrent prolapse is known to increase. So it is evident that there are a number of potential risk factors operating in your situation.
Complete healing from hysterectomy and prolapse surgery takes 3 months for most women. At 6 weeks many women do start to resume activities however this does not mean that healing is complete.
The other factor related to return to activity is the ability of the pelvic floor muscles to withstand that activity. If the pelvic floor is functioning well then pelvic support will be optimised. If the pelvic floor muscles are not in good shape, then the pelvic floor tissues are again more vulnerable to injury. It is almost impossible to tell a woman how much she can or can’t lift postoperatively long-term without really understanding the amount of pelvic floor support she has, including pelvic floor muscle function. A woman with a poorly functioning pelvic floor will be far less able to withstand pressure on her pelvic floor than a woman whose pelvic floor muscles are strong and functioning as they should.
In summary following your pelvic surgery:
1. Discuss your return to work with your specialist
2. Recognise that full healing takes on average 3 months
3. Commence pelvic floor exercises when permitted by your specialist
4. Use your pelvic floor muscles before and during every lift when you do return to work
5. Minimise the amount you lift as much as possible long-term
6. Consider the height from which you lift (lifting from ground height places more pressure on the pelvic floor than from waist height)
7. Consider options to carrying such as trolley wheeling and recruiting the assistance of others where possible
8. Consider alternatives to prolonged standing when returning to work, is it possible to sit on a high stool for example?
9. Attend to regular exercise as appropriate during your recovery to prevent or minimise physical debilitation. This is usually walking exercise after hysterectomy and prolapse repair. Slow treadmill walking on no incline is usually a suitable walking exercise after hysterectomy and prolapse repair for women to undertake when permitted to do so by their doctor.
I hope this information assists in your hysterectomy recovery and safe return to work Sandy.
Kindest regards
Michelle
Hi Michelle. Thank you for the info earlier. I have had my vaginal hysterectomy with bladder and rectal repair 2 weeks ago and I have not had much pain. I had confidence in my Dr. and saw her 2 days ago for followup. Will see her again in 3 weeks. She said I can lift up to 20 lbs now. I am walking for exercise but do get very tired. I am leaking more now than I did before and am wondering if I will continue to have this problem. I will have to contact my dr. I have been doing the kegals, any other suggestions? Thank you.
Hi
I had a vaginal repair operation during July 2011 for a moderate/large rectocele prolapse. My prolapse is now slowly returning thanks partly to a bad cough and a job that involves lots of walking and carrying (non-smoker), but also the dragging sensation never really went away so maybe the surgery didn’t work. I’m trying other approaches now, will the excercises in the “Core and the Floor” DVD be suitable for me or can they make the prolapse worse? I’m asking because I attended pilates for several months prior to my surgery and it got worse due to my and the teacher not realising that some exercises were not appropriate. Thankyou for any help,
Clair
Hi Clair
Thank you for your question regarding safe exercise after pelvic prolapse repair. The beginner exercises in Core and The Floor were originally designed for women 4-5 weeks following childbirth. They are designed to be kind to the pelvic floor and at the same time strengthen the body. The pelvic floor exercise component of the DVD would also be a useful exercise component of this DVD for you to be performing regularly also. So for women who have had approval to return to general exercise after initial recovery the beginner exercises in this DVD provide a pelvic floor friendly option.
I will also add that the stronger your body is generally, then the less pressure you are likely to place upon your pelvic floor during everyday activities such as your regular lifting. So that sensible whole body exercises using pelvic floor safe exercise techniques will also help to protect your pelvic floor too. For example if you practice safe lifting exercises such as seated biceps curls using dumbbell weights, then your lifting muscles will be stronger to take some of the load you lift and reduce the chance of you straining your pelvic floor. For this reason safe strength exercises are a valuable adjunct to management of pelvic floor dysfunction.
I hope this information assists you Clair. If there are any specific exercises that you are not sure about, please don’t hesitate to send them through for evaluation.
Kindest regards
Michelle
Michelle,
Thankyou so much for your helpful reply, you really provide a wonderfully kind service here.
Thanks again,
Clair
Hello Michelle
I am 61 years. At age 43 I had a hysterectomy, since then I have had 3 prolapse repaires. The last one was 3 months ago.
After each of these ops I was always told not to do heavy lifting & exercise etc.. I always rested well & practiced the pelvic floor exercises & then gradually got back into my regular exercises after the 3 months.
After reading all of your information ( a friend just advised me to) I now feel that I may have caused the last 3 prolapses my self. I never knew that I should not go back to doing all of my yoga & aquaarobic exersises. Plus last year I took up cycling.
I miss & want to go back to my classes now, I guess I should speak to the teachers & ask them to let me do other things while the rest of the class are doing any bearing down exercise? Also how safe is riding my bycicle for me now?
Thank goodness I enjoy walking, that can not be harmful?
Kind regards
Janice
Hi Janice
First and foremost don’t be hard on yourself- there may well have been other factors at play in relation to the causes of your prolapse. Before you return to your exercise classes I think that you would benefit from really equipping yourself with knowing what to do and what to avoid, particularly in relation to core exercises.
I also feel that exercise has so many wonderful benefits and that it is very possible to exercise and protect your pelvic floor, I understand your concern and apprehension but don’t despair in this regard.
Have you read the articles and watched the videos in our exercises after prolapse repair library http://www.pelvicexercises.com.au/exercise-prolapse-surgery/ ? Have you access to Inside Out? I am not sure which country you are in worldwide, however you may in fact be more aware of this issue than your instructor so the better informed you are the safe you will be with your general exercises. Don’t assume that your instructor understands your pelvic floor risk and management.
I don’t see an issue with cycling using appropriate gears/intensity and pelvic floor safety unless there is a nerve entrapment problem which is related to pelvic pain. Otherwise sitting on the seat, using low gears and riding flat surfaces should be a lovely low impact low strain exercise.It is wise to avoid standing in the saddle and using high gears.
Please let me know if can assist any further Janice.
Best wishes
Michelle
Wow Michelle,
Thank you for such a speedy reply Michelle (I live in England by the way). Your advice & hepl is so useful, I will now look into where I can purchase your book from 'Inside Out'.
I find it hard to understand why your advice is not given to us when needed from the hospitals. For 3 of my ops I did use the English N. H. S. but I also had private for one of them. Apart from the superior bedroom & food conditions in the private hosp. I was still not given any of your advice other than the first 3 months.
Your book should be advised to be read by the hospitals if they do not have the time to teach the patients. I feel like going into the wards & pasting posters up about your book to make sure that other ladies can be informed.
Thank you once more
Janice
My pleasure Janice, thank you for understanding this issue and recognising the importance of this kind of information for women.
Best of luck, enjoy your exercises and stay in touch!
Michelle
Hi Michelle
I was just wondering what sort of wieght limit you reccomend for lifting? I am 29yrs old have had 2 quite large babies and have a grade 2 uterine prolapse with a grade 1 cystocele. Every where i look for information it just says limit heavy lifting thats not really very helpful as i work in a job that requires lifting of anywhere from 5 to 15kg. I saw a gyno at a public hospital here in qld and he suggested not lifiting any more then 3kg for the rest of my life. This is really unrealistic with a 5mth old baby that already wieghs about 8kg. what sort of job am i going to be able to do with those sort of restrictions? I feel utterly lost in regards to what steps to take to not worsen my prolapse and feel at my age that my life is over. Any suggestons would be greatly appreciated. Thanks very much for your time. Katie of brisbane.
Hi Katie
Can you describe the type of work you do for me in addition to your work as mother of 2 children? There are factors in addition to the weight lifted that are worth discussing in relation to your good question. Let me know so I can respond to this in detail and help you more.
Cheers
Michelle
Thanks michelle for your very quick reply. I work in a bakery at coles so we carry a lot of boxes with frozen dough weighing roughly 12kg each and boxes of packaging that can weigh upto 15kg. I have not yet returned to work but was planning to do so first week of jan 2012. The doctor didn't suggest a pessary which i would of liked to give a go. My job as a mother is just the usual housework no gardening. My eldest is 4yrs so i don't lift him at all. I have been seeing a womens physio for 2mths and have managed to get a grade 2 cystocele down to a grade 1 but no improvment with the uterine prolapse. She dosen't fit pessaries there so i was going to try to get a appointment with sue croft as i saw on her web page that she fits pessaries. Do you think if it worked ok that i would be able to lift a bit more then the 3kg? Thanks so much for replying to me.
Safe lifting with a prolapse
Hi Katie
Thank you this gives a good overview of your physical demands. It is great that you are seeing a women’s health physio for pelvic floor rehabilitation. I agree it is an excellent idea to determine your suitability regarding a pessary, there are some great user friendly pessaries now that can be used as required, and some that are fitted for up to six months at a time.
Regarding safe lifting with a prolapse – the amount that can be lifted varies form woman to woman. Some specialists advise their patients to avoid lifting any more than 10 kg post operatively long term. The amount a woman can lift will vary from woman to woman depending on many factors such as physical strength, history of previous prolapse surgery and pelvic floor function and capacity to withstand downward pressure.
There are many factors that come into play in determining how much a woman can safely lift with a prolapse for example a mature woman who has had a number of prolapse operations with poor pelvic floor function would be capable of lifting far less than a strong young woman with good pelvic floor capacity and no history of prolapse surgery.
The amount that can be safely lifted with respect to pelvic floor dysfunction can really can only be accurately assessed in the clinic using real time ultrasound to look at what happens to the pelvic floor during lifting i.e. does it descend? Or does it hold up as it should? Once again other factors can come into play such as lifting frequency, the height from which lifting occurs and whether or not the pelvic floor is well braced before and during lifting.
Tips for safe lifting with a prolapse
1. Keep the object close to your body
2. Breathe out as you lift
3. Brace your pelvic floor muscles before and during lifting
4. Use lunge rather than squat position whenever you can to lift from a low height and avoid wide legs deep squat position
5. Try to keep lifting from waist height- the lower the height from which you lift the more pressure on the pelvic floor
6. Never lift a weight that makes you strain
7. Try to minimise the weight you lift wherever possible e.g. ask cashier to pack your goods into smaller loads at the supermarket
8. Try to reduce the frequency of lifting heavy loads
9. Consider alternatives to lifting and carrying e.g. sliding rather than lifting, using a laundry trolley
10. Employ the assistance of others wherever you can
11. Avoid lifting when your body is fatigued- your pelvic floor muscles wont function as well
12. Discuss your lifting restrictions with your employer if possible and work together to determine suitable alternatives or supports such as trolleys and better lifting heights
More tips to help…
• Regular kegel exercises/ pelvic floor exercises
• Discuss your suitability for a pessary with your gynaecologist
• Wear good quality support briefs when on your feet for extended time
• Stay physically strong with regular appropriate resistance exercise – the stronger your body is physically the less pressure on the prolapse with lifting.
There’s a lot here Kate but this is a big issue for you to manage. I do hope this information gives you some idea and direction to help you work and self manage.
Michelle
Thankyou very much for your very informative reply. I am so very grateful to you that you took time at of your day to give me some advice. I think i have decided to look into other options for work as i really don't think my job is really suitable anymore for me. I think the frequent lifting will prove to be to much and i really don't know if i am willing to make my prolapse worse. I will be looking into making an appointment for a soon as i can for a pessary fitting and see if this option will work for me even just to give me support when lifting my bub and day to day chores. I will look into some sort of further study so i can find a job a bit less physicaly challenging and then go from there. I am trying to delay any sort of surgery as i am too worried about causing myself further problems. Thanks again Michelle.
My pleasure Katie, I really do hope this helps you in your life and in caring for your little family
Best wishes
Michelle
Hi Michelle,
I am a personal trainer and a ZUMBA Instructor with a history of fibromyaelgia I have worked hard to rebuild my life, and health after going through early menopause (40) and gaining over 10kg. I am finally at a time in my life that I am the fittest,and happiest and am at within 1kg of my ideal weight. And then I had a prolapse afew days ago. I am currently waiting to see a specialist.
My life and my livelihood is exercise – at the moment I feel that I am hovering on the borderline of depression just thinking about how helpless I felt in the decade of my 40's (I am now 51) and I cannot bear the thought of going down that path again. I work at Curves a womens gym which is a circuit of hydraulic equipment. I wonder if you wouldn't mind logging onto http://www.curves.com and checking out the equipment. We have hundreds of thousands of women (many post menopausal) who are members and I would greatly appreciate your views on the equipment so that I can confidently adapt their (and my) workout. Also I know the answer to this in my heart but how much pressure is placed on the pelvic floor during a zumba class? After a hysterectomy how much time would I need befor I can resume my zumba teaching? I have ordered the inside/out book and aim to educate as many of my members as I possibly can about this condition. Many thanks
Curves, Zumba and prolapse
Hi Teri
Thanks so much for your email.
Yes I do understand your fears, first and foremost I will say that it is very possible to exercise for fitness, weight management, emotional and mental wellbeing without compromising the pelvic floor. It relation to exercise and prolapse, this is a matter of being informed about appropriate exercise, avoiding those exercises with the potential to place strain upon the pelvic floor and at the same time working long-term to increase and maintain pelvic floor support with pelvic floor/kegel exercises.
As far as Curves go, yes there is a big postmenopausal population with many particioants at-risk of pelvic floor dysfunction with inappropriate exercise. Ideally women should be be screened before commencing their exercise program in order to determine their individual risk of pelvic floor dysfunction with the wrong type of exercise, and exercises prescribed accordingly. I prefer not to comment on Curves exercises or any specific exercise chain or program. Rather to say say that some exercises and resistance training machines do have potential to impact upon the pelvic floor – you will read more about these exercises under the circuit training information and general strength equipment and exercises to avoid in Inside Out. Specific exercises for caution include weighted squat machines, leg press machines and abdominal exercise machines.
Prolapse surgery may be performed with/without a hysterectomy according to your medical specialist’s diagnosis. In the past hysterectomy alone was sometimes performed for prolapse treatment and we now know that this was ineffective for some forms of prolapse. This is because removing the uterus in the hysterectomy procedure does not repair the vaginal walls through which prolapse often occurs. When you can return to exercise will depend on the surgery performed, your specialist’s preferences and your recovery post-op. It usually takes 3 months for full healing after prolapse or hysterectomy surgery.
Zumba exercises need to be kept low impact to be pelvic floor safe. This means maintaining contact with one foot on the ground throughout, as opposed to high impact exercise where both feet are off the ground. Use your judgement in relation to the higher impact exercises and modify them to low impact for pelvic floor protection.
Good luck Teri, if you have any further comments/questions please send them though.
Kindest regards
Michelle
Hi Michelle, I am 50 years old and I had a complete hysterectomy almost 6 months ago. My husband and I are thinking of purchasing a stepper or an elliptical exercise machine and I am wondering are either of these safe for me to use?
Elliptical machine and stepping machine exercises and hysterectomy
Hi Diane
Thanks for your question regarding the choice of appropriate exercise machine long-term after hysterectomy recovery.
Unfortunately I am unable to say what is safe for you to use specifically in terms of your general health and well being. However I can say that the stepper and the elliptical machines are both low impact machines that will usually place minimal pressure on the pelvic floor during exercise. Both machines will provide a good cardiovascular workout and assist with weight management. Low impact exercise is the exercise of choice long-term after a hysterectomy for most women.
When using either piece of equipment there are a couple of further considerations.
When using a stepper it may be that a larger stepping action that is permitted with some stepping machines can perhaps slightly increase pressure on the pelvic floor as opposed with a smaller step height. In addition large steps will undoubtedly increase pressure on the knees so are not the ideal choice for women whose knees are at risk. Some stepping machines also increase resistance with increased speed so that a slower speed will often promote less resistance and pressure than a faster stepping speed. Ideally keep steps small and slow to minimise pressure on the pelvic floor.
The elliptical machine usually has less height involved in the alternate lower leg movements as the foot supports/pedals usually rotate through a reasonably small circumference. This would in theory create less pressure on knee joints and the pelvic floor when compared with a large stepping machine action. The arm supports that are pushed back and forward when using the elliptical would I suspect increase upper abdominal muscle activity which may somewhat increase pressure on the pelvic floor. This could be readily accommodated by moving the arm supports gently rather than forcefully using the upper body.
There are no comparison studies done on the effect of either machine on the pelvic floor to my knowledge. I am merely speculating here from my understanding of the muscles and forces involved. I do hope this gives you a little information with which to assist in your decision.
Thanks again Diane
Michelle
Hi Michelle,
Thank you for your advice.
Hi, Michelle. I reread some of the posts from other hysterectomy and prolapse repairs about how soon to return to walking and exercise. I am going into my 3rd week from surgery and think i have overdone it. I have limited my lifting and no heavy housework but when I grocery and other shopping it takes about 2 hours of driving, shopping, pushing carts etc. and I am exhausted when I return home. How much should I limit the time on my feet at a time? Is sitting to do tasks better than standing? and is laying down better than sitting? I am (or was) a very independent person (artist-potter). I feel well, no pain, just get tired easier. I am 60. So in a nutshell, in a 12 hour period, how much time should i spend on my feet, sitting, and laying down? I surely don't want to undo the surgery. Thank you. Your website has been very informative.
Sandi
Fatigue after a hysterectomy/prolapse repair
Hi Sandi
Finding a good balance for rest and activity during hysterectomy recovery/prolapse surgery recovery can be really difficult and is a very individual thing. Women typically vary in the amount they can do post op. This can be due to factors such as the type of surgical procedure performed, age, pre-operative fitness strength and fitness levels and post operative complications.
What many women do describe is feeling very tired (and being surprised at this), and this fatigue can continue for quite some time post op. Unlike some other forms of surgery, with pelvic surgery such as some forms of hysterectomy and prolapse repair there are often no external signs of the surgical procedure while internally there can be quite a deal of repair and recovery taking place.
There is usually no hard and fast rule for most women regarding how much time to spend upright/doing activity owing to the vast differences among women and surgical procedures. However we do know that the least amount of pressure on the pelvic floor occurs laying down, when compared with upright. Sitting involves less pressure on the pelvic floor than standing. When recovering from hysterectomy and/or prolapse surgery it is wise to really listen to your body and rest regularly so that you avoid becoming really tired. The position of least pressure on the wound (lying down) will help promote healing so some time should be spent on a regular daily basis lying down. Activity is usually best varied between laying down, sitting as tolerated and short walks as tolerated, again all very individual.
If you are concerned about fatigue levels, then always discuss this with your specialist or your general practitioner. Sometimes there can be other medical factors contributing to excessive fatigue for example as anaemia can be an issue for women who have undergone hysterectomy, particularly when performed for heavy menstrual bleeding pre operatively.
To optimise early healing after a hysterectomy and minimise fatigue:
-Rest regularly throughout the day
-Plan short outings only wherever possible and only when you feel up to it
-Eat well choosing a variety of fruit, vegetables and protein for healing
-Balance a small amount of daily exercise (usually walking) with rest
-Choose to sit rather than stand as tolerated, in the case of prolapse repair some women find it more comfortable to lay down with a pillow under their knees
-Listen to your body and act accordingly, some days will be better than others
-Gradually progress the amount of activity/exercise you can do according to how you feel
-Always speak to your medical practitioner if you have concerns about your fatigue levels.
Best of luck with your recovery Sandi, hope this information helps a little,
Michelle
Hi Michelle,
I had a complete hysterectomy and I read in your book, that squats were bad to do. I was wondering if I need to get down low, for example to pick something off the floor or get into a low cupboard or gardening, what is the safest way to get down low without hurting myself and putting my pelvic floor at risk?
Diane
Safe lifting after hysterectomy
Hi Diane
Yes you are correct, after a hysterectomy or pelvic prolapse surgery women should try to avoid deep wide leg squats. These place pressure on the pelvic floor especially when squats are deep and even more so if carrying a load. A much safer option is to use a lunge position with legs in long stride position. Lower your body down by bending your legs and then push back up into standing using your leg strength as much as possible and helping with your arms leaning on a nearby object such as an armchair if necessary. We have a free video on how to lunge with safe lunge exercise technique that may be of interest to you. Some of the research suggests that more pressure is placed on the pelvic floor with lifting from a lower height so the more lifting can be kept to waist height the better.
Thanks for your great question Diane
Michelle
Hi Michele,
You have encouraged me that exercising the pelvic floor muscles will help with my prolapse. Thank you. Along with excersising would a pessary help when I'm gardening? Is it reasonable to find one I can put in and take out myself for this purpose using it only when I am doing something that I know will require a lot of work?
Thanks,
Vicki