Safe Bending After Prolapse Surgery and With Prolapse Problems

Is bending after prolapse surgery safe? Kneel to ground

What’s the best way to bend forwards and lift from the ground?

Recently I received an email from a reader who was too frightened to bend forwards to remove her shoes many months after her prolapse surgery. This highlights the confusion and fear about safe bending after prolapse surgery.

Read on for Physiotherapist information on safe bending:

1. What happens to your prolapse with forward bending

2. Safe bending after prolapse surgery

3. When forwards bending increases prolapse problems

4. Safer alternatives to deep forwards bending

1. What Happens to Your Prolapse With Forward Bending? Pelvic floor descends

When you bend forwards you compress your abdomen (lower belly).

Bending forwards increases pressure downwards from within your abdomen onto your prolapse repair and pelvic floor.

Your pelvic floor muscles and tissues need to be strong enough to withstand downward forces.

If your pelvic floor can’t withstand the increased pressure, it can stretch downwards (shown right). This can contribute to repeat prolapse after repair or worsening prolapse problems.

Pressure or load on the pelvic floor increases according to how far you bend forward – the further forward you bend, the greater the pressure on your prolapse or repair.

2. Safe Bending After Prolapse Surgery

You may need to limit forward bending during early healing (i.e. first 6 weeks) after prolapse surgery.

This doesn’t mean that you can’t bend forwards. Most women can perform limited bending forward quite safely during their recovery at home after prolapse surgery to wash and dress.

It’s helpful to avoid those forwards bending factors that can potentially increase prolapse problems (see below).

As your internal stitches heal after surgery 6-8 weeks after surgery, your pelvic floor will usually be able to withstand more pressure.

Most women can bend forwards more comfortably and safely during everyday activity as healing time progresses.

Note: The ability to bend forward after prolapse surgery can vary among women. Always be guided by your surgeon’s guidelines for your safe bending after prolapse surgery.

Bending and Exercise After Surgery

Deep forward bend

If you’re returning to exercise after prolapse surgery be mindful of exercises that involve forward bending. Many exercises that involve bending can be readily modified.

For example Yoga deep forward bend (shown right) where the depth of the forward bend should be limited to avoid touching the ground.

Bending and Work After Surgery

When returning to work after prolapse surgery some women may need to negotiate alternatives to duties involving repeated forward bending and heavy lifting to reduce the risk of repeat prolapse.

3. When Forwards Bending Increases Prolapse Problems

Forwards bending can increase the risk or worsening prolapse problems when:

  • Frequently repeated
  • Lifting from ground level
  • Lifting a heavy object
  • Sustained duration
  • Combined with deep squatting
  • You’re overweight or obese

4. Safer Alternatives to Deep Forwards Bending

Sit to put on shoes

Some ways to reduce forwards bending and protect your prolapse repair or severe prolapse include:

  • Lunge into a kneeling position on the ground (shown above woman emptying washing machine)
  • Kneel to reach ground level before bending rather than from standing
  • Position objects at waist height or above that require frequent bending to lift
  • Sit to remove shoes and socks (shown right)
  • Use a pick up stick
  • Use cleaning gear with long handles (see below)
  • Delegate bending and lifting tasks to others during early recovery

Always use safe lifting techniques after prolapse surgery and with prolapse problems,

Key Points for Safe Bending After Prolapse Surgery

Long handles brooms

  • Forwards bending increases pressure on the pelvic floor
  • Pressure or load on the pelvic floor is greatest when bending forward to ground level
  • Bending forwards may increase prolapse problems when repeated frequently and/or combined with heavy lifting
  • Most women can safely bend forwards to perform activities of daily living after recovery from prolapse surgery
  • Some women need to modify forward bending during work and exercise long term after prolapse surgery
  • Use alternatives to deep forward bending to protect your prolapse repair and reduce the risk of prolapse worsening.

Further Reading

» Walking After Prolapse Surgery Physiotherapist Guidelines Weeks 1-6

» How Long to Wait for Safe Return to Exercise After Prolapse Surgery?

» 12 Unsafe Abdominal Exercises for Prolapse and After Prolapse Surgery

Prolapse Exercises Book

This complete exercise guide is especially for women with prolapse and after prolapse surgery seeking to exercise safely, reduce the risk of prolapse worsening and improve prolapse support.

Prolapse Exercises Book

Prolapse Exercises teaches you how to:

  • Exercise safely after prolapse surgery
  • Reduce your risk or repeat prolapse
  • Avoid unsafe exercises
  • Choose pelvic floor safe exercises
  • Reduce your risk of prolapse worsening
  • Improve prolapse support
  • Increase your strength and fitness
  • Strengthen your core
  • Lose weight

    Learn More

We Welcome Your Comments

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Comments

  1. Hi Michelle,

    Three weeks ago I had prolapse surgery, including a hysterectomy, sacrophinous fixation and repair to both front and back walls by my bladder and bowel. I am 41 years old and have had a weak pelvic floor since the birth of my son 12 years ago which caused third degree tears.

    I have a family trip booked to Japan in April, which will be 9 weeks after the surgery date.

    I would be very grateful if you could advise me on how best to cope with the long 12.5 hour plane journey and can I sit on the floor- if so what position puts the least impact on that area- as we are watching sumo training and having tea with a geisha. Both these activities involve sitting on the floor. We are also travelling via train across the country and I will be laying on a tatami mat to sleep in a couple of our destinations, I am worried on how to do this safely with the least impact to my stitches.

    Any tips would be great.

    Thank you.

    • Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Sarah
      I hope you’re recovering well. It’s early days for recovery at the moment and things will be much improved in another 6 weeks. Your internal wound will still be healing when travelling.

      Things that come to mind for plane travel after surgery: avoid carrying heavy luggage – use luggage with wheels and pack very light, try to avoid too much stretching overhead to the locker – get everything out of your bag that you require prior to take off, extra leg room can help you stretch out while travelling so if it’s possible to pay the extra dollars to get a seat in the front row of your economy section (assuming you’re flying economy) you’ll feel far more comfortable – otherwise an aisle seat will help you stretch out a little, do your circulation exercises (calf pumps) every 20-30 mins while sitting to reduce your risk of DVT and take regular breaks from sitting to walk for your circulation and to reduce your risk of lower back pain. On some airlines if there are spare adjacent seats on the plane and you inform the attendant of your recent surgery they may allow you to lay down and stretch out.

      When in Japan you may find that sitting on a cushion helps you when on the ground. Try to lean back when sitting on the ground rather than leaning forwards (reduces pressure on your pelvic floor when sitting on the ground). Resting back on your elbows at times when in prolonged sitting on the ground would be ideal. I don’t see an issue to your pelvic floor lying down on a mat. You may like to use a cushion or pillow between your legs – perhaps an inflatable cushion could be a worthwhile investment to take with you?

      Other readers may have travel comfort suggestions too, please feel most welcome to send them through. All the best for your travels Sarah, hope this helps!

  2. I’m wondering if the yoga move of down dog into a high plank puts pressure on the pelvic floor. I love this move, but have avoided it since my prolapse repair surgery, 2 years ago. I have not found a physiotherapist in the states who can answer this question. 2 years out and still prolapse free. I’m hoping this move would be considered a safe one. Any guidance on this Michelle is much appreciated.

    • Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Jill
      My feeling is that this move does involve intense abdominal contraction. I don’t know of any research supporting this however I can say that after having abdominal surgery myself it was definitely a Yoga move I needed to avoid (and continue to do so) owing to the pressure I can detect during the move – it’s an intense form of plank. Hope this helps Jill

      • Thank you, Michelle! I will continue to avoid the down dog into a high plank.

        I purchased your books and use them to guide my exercise. They have helped me tremendously. I’m grateful for your leadership on this topic!

        • Michelle Kenway Pelvic Floor Physiotherapist says

          I think that’s a good idea in view of your surgery – so glad the info has helped you Jill!

  3. Elizabeth says

    Michelle,thank you so much for your really helpful articles and videos. They are really useful and much appreciated. You mentioned making new videos. I really like yoga and adapt postures as much as I can using advice from your information. I would find it very helpful if you made a video showing how to adapt some of the most popular yoga postures that could put strain on the pelvic floor so that they could be done more safely.
    Just an idea.
    Thanks again.
    Liz

    • Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Elizabeth
      Thanks so much for your input. I’ve listed this great suggestion for the next video shoot, much appreciated indeed!

  4. Hi I had rectocele surgery 1 week ago. I feel great I have rested, no lifting , bending, limited stairs 2-xs a day max. This is probably going to sound ridiculous but I have an event to attend I can sit the whole time if I need to. But can I wear heels or heeled boots or will that put too much pressure on bladder and rectum?

    • Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Lisa
      Very interesting question & I don’t really know the answer. I don’t know of any reason why this would aggravate your pelvic floor other than perhaps changing your posture (and causing lower back discomfort) however to be safe perhaps take a flat pair just in case. Interested to know how you go!

  5. I’m 4.5 months Post Prolapse Surgery, my Physical therapist is amazed at my recovery time.
    I use your Relaxation CD every night, Pelvic Floor Daily workout 2 times a day, You tube Videos and just started the Insideout DVD.
    I can not THANK YOU Enough, I tell everyone about your educational site, You have helped me to recover properly and to get my life back. Your encouraging voice Michelle helped me to keep going on day I was so Down and didn’t think it was possible.
    THANK YOU SO MUCH, Robbin, From Arizona, USA

    • Michelle Kenway Pelvic Floor Physiotherapist says

      I’m so glad that the exercises are helping you Robbin, thanks so much for taking the time to comment. All the best for your continued recovery.

  6. Can I receive your News letter. I did subscribe to your site, but never got a new letter.
    Thank you

    • Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Robbin
      We’ve run a check and you’re definitely on the mailing list – it must be going to your spam folder. Will resend to your email address again, all the best.

  7. Hello Michelle, your site is so useful! I had a posterior repair and episiotomy repair on 29th March. I’m 36. I have 2 young children aged 3 and 1. I wasn’t told the extent of not lifting, bending etc after surgery and was originally told I would only need help for 3 weeks with them. I’m not having to try to arrange an awful lot of child care for the coming weeks. My posterior repair was for laxity so do you think I’ll need to avoid lifting for the whole 12 weeks? At week 5 I’m due to do a lot of walking (going to a concert and need to go on trains, tubes, climb stairs etc). Is this going to be ok?
    With regards to recovery is there anything else I need to be aware of? My physio hasn’t given me any exercises to do for the pelvic floor, only a couple of knee bends and to the side. Thanks for your help.

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Louise
      Thank you for your enquiry. This information may help other readers too. With regards to lifting, enlist help where you can, encourage your 3 year old to move independently as much as possible and rest lying down with them when you can – even if they’re playing on the floor, lie down with them and take this opportunity to rest your pelvic floor while healing. Re week 5 concert that will really depend on how well you’re feeling. You’ll still be healing so rest where you can. Sitting on the train won’t be a problem. Try to avoid walking too far if possible. Is your physio a pelvic floor physio? Perhaps your surgeon has instructions to avoid commencing Kegels for a certain time frame after surgery? It could be worth phoning your surgeon’s receptionist and asking when you’re permitted to commence your pelvic floor training. If you haven’t already seen a specialist pelvic floor physio then this would be something I would also recommend since you’re very young and so this repair needs to last a long time. Let me know if there’s anything I haven’t answered for you Louise – all the best

  8. Hi Michelle
    Only just noticed your site for questions I have used your advise for a few years following a vaginal repair and hysterectomy. Your knowledge and advice is amazing.
    Unfortunately I had s vaginal vault repair three weeks ago. I’m really hoping this works. So far I have made a good recovery. I follow your walking plan which is a good guide. I have always liked walks and exercise even though I’m 66 years old. I feel ok walking for at least an hour without any ill effects. I’m fact feel I could do more. I do this walk at least 5 to 5 times a week is this too much? I’m sensible about no lifting or heavy housework and I do get rest during the day. Please could you let me know what you think. Thank you

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Mary
      Thanks for your great question. Great to hear you’re being sensible with housework etc. Yes I do think this is too much uninterrupted walking at the moment. Unfortunately you can’t see the internal wound and healing which takes around 3 months to fully heal. You want this repair to sit as high as possible as it repairs. If you feel well doing a bit of distance, I would split it into 2 walks and rest in between as well. The prolonged loading with walking could add some strain to the repair which isn’t worth it long-term having been through what you have. After 6 weeks think about doing a little more if your doctor gives you the ok. At the moment less is more, err on the side of caution. All the best!

  9. Hi Michelle
    Thank you so much for your reply and advise re walking. It’s so helpful. I really want this op to work this time. It’s very difficult as I’m sure other ladies agree we don’t get enough advise and guidance from doctors in discharge from hospital. I will continue to look on your site and follow you amazing advise.

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      My pleasure Mary, I’m glad it helped. Thank you for your questions which are bound to help other readers too. All the best for your recovery.

  10. HI Michelle,

    Thank you so much for your reply and advice. Unfortunately on Monday this week I haemorrhaged following the posterior repair which was 10 days prior to that. My surgeon said the blood was coming from the wound. When I asked him if this would set my recovery back to day 1 again he wasn’t sure.

    I now have a couple of questions for you.
    He’s said not to do any pelvic floor exercises for the time being. I’d previously been advised to do them on day 10. When do you think I could start them again?
    I’m also petrified about bending, walking etc now so I’ve not been doing anything much. What do you think would be safe to do? I think what caused it was me pulling our very heavy patio doors open as 45 minutes later I haemorrhaged.

    Any advice would be greatly appreciated. My surgeon said he’s never ever come across this on day ten before. Do you think this would have set me back?

    Thank you,

    Louise

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Louise
      I’m so sorry to hear of your setback. Yes pulling heavy doors could well have been a contributing factor.

      Did your surgeon say that you can undertake some gentle walking? It’s important to mobilize after surgery to prevent complications and minimize debilitation. Progressive walking is usually the best approach after prolapse surgery, you can read more here Walking After Prolapse Surgery Physiotherapist Guidelines Weeks 1-6 just make sure you have your doctor’s approval to walk. It may sound counter intuitive but the more you become debilitated the greater the load on your pelvic floor and I think I recall you have children to care for too so physical strength and fitness are important for your pelvic floor management long term. As far as pelvic floor exercises go, once again be guided by your surgeon. Many women don’t start them until 4-6 weeks post op and in some cases later depending on the surgery and the surgeon’s guidelines. Balance sensible activity with resting where you can Louise, does this help?

      • Author: Michelle Kenway Pelvic Floor Physiotherapist says

        Hi Louise
        You need not completely avoid bending. Try to avoid bending too much below waist height in favor of using a lunge technique if you need to lift off the ground. Best to avoid lifting any heavy load from ground level during the first 6 weeks. Keep things at waist height or above as much as possible.

  11. Thank you Michelle, that’s very helpful indeed.

    In terms of bending, should I avoid this as much as possibly during the first 6 weeks?

    Louise :-)

  12. Bit of a personal question so hope this is allowed. I know that you aren’t allowed to have sex until weeks 6-8 but wondered if it was ok to orgasm? Or would this affect the pelvic floor muscles? I am at week 5 now. Thank you.

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Louise
      The issue with intercourse post op is infection and tissue stretching. Orgasm does involve a strong contraction of the pelvic floor muscles so I would say it’s probably dependent upon the type of prolapse surgery you’ve had done. I would suggest you er on the side of caution and wait but could stand corrected. Some women do say they experience discomfort post op with pelvic floor exercises. Please don’t hesitate to let me know if you hear otherwise, all the best

  13. Thanks so much for your reply. I had a posterior repair.
    I was told no intercourse for 6-8 weeks so I shall wait until this point as I don’t want to mess anything up this late on. You’re very helpful with your replies. Thank you very much.