When Women Need To Avoid Pelvic Floor Exercises

Pelvic floor exercises are not always the treatment of choice for all pelvic floor problems.

Scientific studies support pelvic floor exercises for treatment of women suffering from stress urinary incontinence or mild to moderate pelvic organ prolapse.

There are however some specific instances where women should avoid pelvic floor exercises, for the short-term at least.

Read on now to learn when to avoid pelvic floor exercises.

1. With Pelvic Floor Muscle Tension Pelvic floor muscle tension

Pelvic floor muscle tension occurs when the pelvic floor muscles spasm and become unable to relax.

Pelvic floor muscle tension may cause pelvic floor symptoms including pelvic pain, pelvic floor weakness, bladder/bowel and sexual dysfunction.

Pelvic floor exercises can exacerbate pelvic floor tension and worsen or perpetuate these symptoms.

Long-Term Management

If you have pelvic floor muscle tension avoid pelvic floor exercises and intense core abdominal exercises until you can voluntarily relax your pelvic floor muscles.

A graduated program of pelvic floor exercises may be gradually introduced in some cases when your symptoms ease and you can relax your pelvic floor muscles. Pelvic Floor Physiotherapy can treat and assist recovery from pelvic floor muscle tension.

2. Immediately After Prolapse Surgery

Pelvic floor exercises are usually avoided during early recovery from prolapse surgery.

Prolapse surgery involves internal sutures to repair pelvic floor tissues. Most women require sufficient time to allow for the pelvic floor tissues to heal before commencing postoperative pelvic floor exercise rehabilitation.

Long-Term Management

If you’ve had prolapse surgery refrain from pelvic floor strengthening until you have obtained your surgeon’s approval to commence pelvic floor exercise. This is usually around 6-8 weeks after surgery but can vary from one woman to the next. Progressive pelvic floor strengthening is the best approach after prolapse surgery.

Ideally your long-term management after prolapse surgery should include regular pelvic floor exercises to maintain pelvic floor strength and support, and minimise the risk of new pelvic floor problems developing.

3. With 3rd or 4th Degree Tearing After Childbirth

The pelvic floor muscles and tissues may be torn during vaginal delivery. 3rd and 4th degree tearing involves damage to the pelvic floor muscles surrounding the anal canal and anal sphincter respectively.

Pelvic floor strengthening exercises are not usually recommended for at least 6 weeks in cases of 3rd and 4th degree tearing to allow for healing of sutured tissues.

Long-Term Management Physiotherapy and pelvic floor exercises

Pelvic floor recovery after more severe 3rd and 4th degree tearing is ideally undertaken under the supervision of a Pelvic Floor Physiotherapist.

If you’ve experienced 3rd or 4th degree tearing you may be initially encouraged to perform gentle pulses of your pelvic floor muscles to increase blood flow and reduce swelling for healing.

Pelvic floor strengthening exercises are usually recommended for long-term pelvic floor recovery from severe tearing associated with childbirth. Progressive pelvic floor exercises may be commenced from around 6 weeks following delivery but only with the approval of your treating obstetrician.

4. With Incorrect Pelvic Floor Exercise Technique

Studies reveal that many women perform the incorrect pelvic floor exercise technique.

Women often bear down with pelvic floor exercises rather than lifting and squeezing inwards, often without realising that they are making this mistake. Bearing down upon the pelvic floor can stretch and strain pelvic floor tissues causing pelvic floor weakness and making pelvic floor problems worse.

Long-Term Management

If you can’t feel your pelvic floor exercises, if you experience worsening symptoms or no improvement despite your pelvic floor exercises you may benefit from the guidance of a Pelvic Floor Physiotherapist.

Physiotherapy can help you correct your pelvic floor exercise technique and provide you with exercise guidelines to help you get the most benefit from your routine.

Key Points For When To Avoid Pelvic Floor Exercises

Pelvic floor exercises are the treatment of choice for some of the most commonly experienced pelvic floor problems.

There are however specific instances when pelvic floor exercises should be deferred;

  • With pelvic floor muscle tension
  • Immediately after prolapse surgery
  • With severe tearing after childbirth
  • With incorrect pelvic floor exercise technique

Pelvic floor physiotherapy can provide you with guidance for your long-term recovery from these pelvic floor problems.

Next: Pelvic Floor Exercises Workout Formula  

Comments

  1. Thank you for your videos and info on prolapse. I was very angry and scared to find out that at 30 I have a prolapse(adter the birth of only my first child). Im healthy, don’t smoke, and usually fairly active(though I did slack while pregnant and after giving birth). I wish all the pregnancy books(or woman’s magazines) would have a link to your site and state the importance of keeping up with pelvic health.
    I have only watched a few videos now but I find having a professional available online (as I am currently on a pelvic physio’s waitlist just to get an assessment!) very uplifting. Thank you again.

    • Michelle Kenway Physiotherapist says:

      My pleasure Nicole, thanks so much for your feedback. So glad that the videos have helped you what you wait.

      All the best with your rehab
      Michelle

  2. Hi Michelle,

    Thanks for the emails and also for your book which I received a while ago. I have been told that I am a candidate for surgery to repair my stage 2 prolapse. Should I be doing strengthening exercises (Kegel and otherwise) in preparation, or is this inadvisable. I have been told that walking is all I should do in the way of exercise.
    Many thanks, Pats

    • Michelle Kenway Physiotherapist says:

      Hi Pat

      I’m really glad that you written with this question – now is the ideal time for you to be really diligent with your pelvic floor strengthening exercises to prepare for your surgery. Kegel exercises before surgery aim to improve support for the surgical repair and prevent other pelvic floor problems from arising as a result of the surgery e.g. bladder leakage. Start now with what you’re able to do comfortably, even if this involves lying down for your exercises. Let me know if you require any further guidelines for these exercises before your surgery.

      All the best for your surgery Pat
      Michelle

  3. Hi Michelle.

    I think I have pelvic floor muscle tension.
    Sex is difficult to get going at the best of times because my vagina is always in spasm. And about 8 years ago I had to have surgery to fix anal fissures, which I have only recently realised were a result of muscles in spasm and not only IBS. In the last couple of weeks the fisdures have returned and I don’t want to have surgery again.

    Are there exercises that can help me?

    Regards,
    Andrea
    (Johannesburg, South Africa)

    • Michelle Kenway Physiotherapist says:

      Hi Andrea

      Great to hear from you, yes there are exercises that help with pelvic floor muscle tension and these are known as pelvic floor relaxation exercises. They usually include whole-body guided relaxation along with specific pelvic floor relaxation techniques. You may benefit from reading this article on pelvic floor muscle tension and watching this video I have on-site that guides some pelvic floor relaxation techniques. There is also an excellent CD by Dr Trish Neumann called Pelvic Floor Relaxation and many women find that using this daily is a very helpful adjunct to treatment.

      All the best
      Michelle

  4. I was told I have relaxed pelvic (needing hysterectomy) it’s not critical, yet! but they told me Not to do Any core exercises & I am glad I found Michelle and can continue to stay active

  5. Hi Michelle, my GP toldme I have a “Saggy” cervix. I am 50 & have had 3 vaginal deliveries. Would pelvic floor exercises help?

    • Michelle Kenway Physiotherapist says:

      Hi Nette

      Yes, appropriate pelvic floor exercises should help improve your pelvic floor support for your cervix especially with perimenopausal changes that increase pelvic floor laxity.

  6. Hi Michelle

    It is time to return to the doctor for a check up after having a rectocele surgery a year ago. I am concerned that the Dr. will ask me to bear down for the exam. Do you feel it is necessary to put that kind of pressure on the pelvic floor or can you suggest what I may say to the doctor if he asks. Really dreading this visit. Thank you.

    • Michelle Kenway Physiotherapist says:

      Hi Donna

      Yes I understand your concern about bearing down. Explain your concerns to your doctor and perhaps err on the side of caution and avoid bearing down forcefully as if straining hard. A gentle push down will reveal any major deficit in your vaginal walls during your examination. Hope all goes well.

      Michelle

  7. Your comment is awaiting moderation.

    hello michelle
    thank you for your wonderful website
    here is a question…. ARE YONI EGGS HELPFUL. its become quite fashionable to do vaginal training using jade eggs. I was interested for relieving menopausal symptoms and I thought hmm, what about the weight? (not weight lifting as some advanced people do) just the weight of the egg itself? for someone with mild prolapsing would this be a disadvantage or advantage to do internal training as well as the kegel exercises I use your video’s for?
    thank you

    • Michelle Kenway Physiotherapist says:

      Hi Carol
      Good question! I think it really depends on how the vaginal weight is used and the woman’s capacity for pelvic floor exercises. Just using the weight passively is unlikely to benefit and potentially cause some strain in women with poor pelvic floor function. If the weights are used actively with active pelvic floor exercises, then it may be possible to strengthen using vaginal weights. When managing mild prolapse, pelvic floor strengthening is definitely a treatment goal.