Exercises for Prolapse – Professional Prolapse Exercise Techniques

Exercises for prolapse can help women to reduce prolapse symptoms and improve prolapse support. This article teaches you how to do prolapse exercises that get you results.

Read on now to learn:

  • What is a prolapse?
  • What are the symptoms of prolapse?
  • Can pelvic floor exercises or kegels help manage a prolapse and stop it from worsening?
  • How to do prolapse exercises that work?
  • Important mistakes to avoid when doing pelvic floor exercises for prolapse
  • When to seek professional help for prolapse exercises

This information on prolapse exercises applies to women with uterine prolapse, bladder prolapse, bowel and rectal prolapse.

What is a Prolapse?

prolapse exercises

  • Vaginal prolapse occurs when the vaginal tissues and supporting structures inside the pelvis become weak. This allows the pelvic organs that sit close to the vagina to bulge into the vaginal walls.
  • Bladder prolapse (cystocoele or prolapsed bladder) involves the bladder bulging into the front wall of the vagina
  • Bowel prolapse (rectocoele) involves the bowel bulging into the back wall of the vagina
  • Uterine prolapse involves the uterus losing its support and moving down into the vagina
  • Rectal prolapse involves the walls of the rectum protruding out of the anus.

Symptoms of Prolapse

A prolapse can produce a variety of symptoms, and some of these prolapse symptoms depend on the type and/or severity of the prolapse.

Symptoms of prolapse may include:

  • Feeling heaviness in the vagina;
  • Dragging sensation in the vagina or pelvis;
  • Lump or bulge at the entrance of the vagina;
  • Difficulty inserting tampons;
  • Wind escaping from the vagina with intercourse; and
  • Difficulty emptying the bladder and/or bowel.

Can Exercises for Prolapse Help?

Yes, specific pelvic floor exercises for prolapse can assist women with prolapse management in the following ways.

1. Symptom relief

Many women report that doing pelvic floor exercises regularly helps alleviate their prolapse symptoms. This is often the case for women with mild to moderate prolapse. When the prolapse extends beyond the entrance of the vagina, pelvic floor exercises may not improve a woman’s symptoms however this doesn’t mean pelvic exercises are not beneficial.

2. Prolapse support

The pelvic floor muscles are designed to assist in the support of the pelvic floor including the pelvic organs susceptible to prolapse (bladder, vagina and rectum). It makes sense that improving pelvic support with strong, firm well functioning  pelvic floor muscles will help to manage a prolapse. If the pelvic floor muscles become strong enough to withstand the pressure associated with everyday activities, then a well functioning pelvic floor may even help to prevent the prolapse worsening.

3. Reduced straining

When the pelvic floor muscles are working as they should, they assist bowel emptying and lessen the need to strain.  Women can benefit from knowing correct bowel emptying technique to use to avoid straining as part of their overall prolapse management strategy. Well functioning pelvic floor muscles can help empty the bowels and reduce straining.

Exercise for prolapse

For more information about safe prolapse exercises please refer to Inside Out – the essential women’s guide to pelvic support. This easy to read book provides comprehensive professional guidelines for how to improve pelvic support with prolapse exercises.

 

How to do Exercises for Prolapse?

Pelvic floor exercise are an inwards lift and squeeze of the pelvic openings (urethra, vagina and anus). It is then important to fully relax your pelvic floor muscles and allow them time to rest between each exercise or contraction.

Check you are using the right muscles by:

  • Feeling a lift and squeeze inside the area where you sit; and
  • Feeling a sensation of letting go when you relax these muscles.

Tips for exercising pelvic floor muscles with a prolapse:

  • Practice your prolapse exercises earlier rather than later in the day;
  • Position yourself where you can best feel your pelvic floor muscles working, perhaps lying down to reduce the downward pressure on your pelvic floor and your prolapse; and

For further details on how to do exercises for prolapse, please refer to our daily prolapse exercise guidelines.

Mistakes to Avoid With Exercises for Prolapse

Some mistakes are commonly made when women attempt to exercise their pelvic floor muscles.

These include:

  • Bearing down or straining rather than lifting up the pelvic floor muscles with exercise;
  • Breath holding when contracting the pelvic floor muscles;
  • Pulling in the upper abdominal muscles strongly with the exercise; and
  • Squeezing the buttocks or inside thigh muscles.

When to Seek Professional Help With Exercises for Prolapse?

If you are having difficulty with your prolapse exercises, it is advisable to seek treatment with a Pelvic Floor Physiotherapist or a Continence Nurse Advisor. These health professionals can assist with common problems encountered when exercising the pelvic floor such as;

  • Difficulty feeling your pelvic floor muscles lifting or relaxing;
  • Problems breathing and activating at the same time;
  • Lack of confidence in performing the correct action; or
  • Lack of progress with your pelvic floor exercises.

‘Exercises for Prolapse’ is by Pelvic Floor Physiotherapist Michelle Kenway. Michelle is the author of Inside Out – the essential women’s guide to pelvic support along with Dr Judith Goh, Urogynaecologist.

prolapse exercisesABOUT THE AUTHOR, Michelle Kenway

Michelle Kenway is a Pelvic Floor Physiotherapist and author of Prolapse Exercises Inside Out. Prolapse Exercises is a complete exercise guide for women with prolapse and after prolapse surgery seeking to exercise safely and protect their pelvic floor.

Comments

  1. I had a partial hysterectomy in 1979. As I understand it, that removed my uterus. I feel the prolapse more toward the front so does that mean it is a bladder prolapse or is there such a condition as vaginal prolapse? Although I sometimes feel it to the side.

    Thanks for your help.

    • Pelvic Exercises says:

      Hi Mary
      For a correct diagnosis you need to be examined by a gynaecologist. This information may help you understand prolapse a little more. A vaginal prolapse can commonly involve the front wall of the vagina which is known as an anterior vaginal wall prolapse or cystocoele which happens when the weakened front wall of the vagina is unable to support the bladder which bulges into the front wall of the vagina. When the anterior or front wall prolapse is large it can cause difficulty emptying the bladder by kinking the urethra or urine tube. The back wall of the vagina can also prolapse and this is known as a posterior vaginal wall prolapse or rectocoele and this involves the rectum bulging into the weakened back wall of the vagina. This causes many women difficulty with their bowels and constipation. After a hysterectomy the top part of the vagina can still prolapse or descend down into the vagina so the uterus does not necessarly need to be present for the top of the vagina to move down into the vagina as well. Hope this helps you Mary, Michelle.

  2. Hello first I would like to say Thank God for your web site . My prolapse started a couple of months ago, at first I didn’t realize or know what had happened I thought just like everyone else I had a tumor. It was my bladder which had bulged somewhat through my vaginal . The doctor told me that due to menopause a sudden drop of 25 pounds in 3 months due to my husband and father in law passing away a week apart in Oct of last year and I was mugged the day after Christmas my body just colapased . I am trying to survive with a part time job in retail standing up is there a way that I can stand to help while I am at work also I have been making sure that i take a lot of fruits and vegs daily also it was recomended to take probiotics to help there as well along with vit c vit d I just got myself a ball and have been just starting to follow your site . My doc recomended to me to have a insert to support the bladder what are your feelings on this can I continue to exercise there will be no sex for me there hasn’t been for several years so that could of played a role in my prolapse as well Whatever I just thank god your site is not one of those money making sites and thank you for what ever help you can send me. Thank you for being there

    • Pelvic Exercises says:

      Hi Claudia
      Thank you for your great input. It sounds as though you have had the most awful time recently physically and emotionally. I am so glad that pelvic exercises has been able to help you in asome small way. In response to your questions, I can only generalise to most women…The option of a pessary ring is often a great option for women who prefer not to have surgery, for those who cannot have surgery and for women who just wish to see how their pelvic floor exercises (kegels) help to improve their prolapse symptoms. A pessary ring sits inside the vagina and supports the wals of the vagina and in this way can reduce the prolapse bulge. If it is well fitted and if the prolapse isn’t too big, most women are unaware that they have a pessary in place, a little like a tampon I guess. There is usually no reason why a woman cannot have sex with a pessary ring in place however some of the other designs of pessary such as the large shelf pessary prevent intercourse. You can discuss your options here with your doctor. Most women can continue to exercise very happily with a pessary in place, however as you will realise from the information on this site, it is very improtant to choose the correct exercises for prolapse and avoid those exercises that may place pressure on your prolapse. I hope this information helps you further in your quest to regain your health Claudia, Michelle

      For further reading see our free prolapse articles at prolapse information articles

  3. Hi I have been told that I have a slight prolapse I have tried doing pelvic floor exercises but cant feel anything

    • Pelvic Exercises says:

      Hi Dawn
      You are not alone! Yours is probably one of the most common problems we hear about, not that this lessens the frustration of it all in any way. On our home page you will see a small boxon the top RHS – it will link you to our free video on how to find and feel your pelvic floor muscles working. Hoping you find this starts you on your way. We also have a large library of free pelvic floor exercise articles and videos If still in doubt, seek an appointment with a physical therapist trained in pelvic floor rehabilitation. Regards Michelle

  4. Hi Michelle
    I found your site and found it very informative and recently puchased your book inside out. When I first dicovered I had a vaginal prolapse after the birth on my second son I went pretty hardout on the pelvic floor exercises and did them religiously every time I breastfeed. My GP said when I had a smear after 3 months said my prolapse had improved significantly. yay, However once I stopped breastfeeding at 7 months I kind of stopped them, I have never had any leakage whatsoever and had relatively quite a good pelvic floor control. But over the summer I started playing tennis with my partner an touch which I play competitively (up on then I had just done walking with theh buggy) but I noticed that I had an uncomfortable heavy and irritable sensation when I played thosed sports. I subsequently saw my GP 2 months ago who referreed me to a gyno. She gave me pessary ring to wear, which I am not sold on as it slips every time I have a bowel motion and I hae to push it back up, so that irritates it a little. But it has been ok for playing a bit of sport.
    My question is this can I buy a smartballs teno exercises thing and use it while I have a pessary in. My gyno is nice but quite old fashion on the benefits on pelvic floor exercises. I never really progressed to practicing long holds when I am standing (prob as with 2 young kids once I’m standing I’m on the go lol) But I want to really try and improve them again. I also followed the advice in your book about the pricinpals of exercise and maintaing a slight squeeeze on your lower transverse muscles. When I am out walking should I try and maintain that the whole time?.
    Also I shouldnt’ be trying to lift and squeeze my pelvic floor the whole time when walking rather just when I am using exertion eg lifting?. I do body balance and that has been good I don’t to the wideleg hindi squat.
    My last question is I have ongoing constipation issues which I don’t know are a result of the prolapse but I know they are def making it worse or preventing it from getting better. I really want to address it, and have a high fibre, low fat diet and eat all the vegies, fruit, drink water. It is so frustating. Will pelvic floor exercises potentially help that?, my other option is to start drinking coffee daily, but that gets me a bit wired.
    Well look forward to your advice, my baby is 14 months yesterday and I am getting over having this issue which holds me back. and gets me down at times. I was previously a dance instuctor and would love to be back doing it as it is my passion.
    Cheers Claire

  5. Hi Michelle
    Thanks so much for that information it is awesome. I checked out the video for proper bowel elimination technique (I will have to work on that) and also saw the video for bladder retention and technique for emtying as I take along time to get going if you know what I mean.(I think I have always been a bit inclined to be like that even before kids and prolapse but def has gotten worse. I was just wondering if you could explain as my GP hasn’t really shed any light as to why constipation is sometimes caused by the prolapse. I’m thining it might be maybe the uterus pressing down on the bowel but not sure. I am on a tiny amount of medication which I have taken for 3 years for mild anxiey/depression but I’m thinking the tiny amount 10mg aropax might be adding to the constipation so might look at trying to come off or change meds as the constipation has really been an issue for over a year now and def not helping the prolapse.
    Cheers Claire

    • Pelvic Exercises says:

      Hi Claire
      How does a prolapse increase constipation? Great question as so many different and complex factors can contribute to ease of bowel movements and completeness of emptying the bowels.

      Different types of prolapse can have different effects on the ability to empty the bowel. A prolapse can create an obstruction that makes it difficult to empty the bowel. For example if the back wall of the vagina is prolapsed (posterior vaginal wall prolapse or rectocoele) the prolapsed vaginal wall collapses in with the bowel movement and the stool can become trapped within the prolapse. If a uterine prolapse is large and it bulges into the rectum it may be hard for the stool to move past. When women have a prolapse they may have poor muscle and tissue (fascia) support for when the stool travels through the rectum and this lack of support decreases the pressure pushing the stool through the rectum. Sometimes the pelvic floor muscles don’t work in a coordinated manner which also causes difficulty with bowel movements. So you can see there are many muscle and support factors at play, not to mention stool consistency, the position of defacation, the technique and many more factors at play.

      What is really important is establishing that prolapse is the source of constipation (by checking with the doctor). Then maintaining a really good stool consistency (sausage like, not too firm and not too loose), being aware the first instant the urge is felt and getting to the toilet then rather than waiting, using the correct position and bowel release technique as you see in our video on overcoming bowel movement problems and most importantly never straining which makes the problem of constipation and prolapse much worse. As stated previously pelvic floor or kegel exercises increase the support to help empty the bowels well. A weak pelvic floor wil not provide good support to empty the bowel effectively.

      Thanks for this question Claire and good luck!

  6. Hi Michelle,
     
    I have recently purchased your book and had a read through to gain a little more insight into my condition….I have recently been diagnosed with a vaginal prolapse (posterior wall) following a rather trumatic posterior delivery of my second child (4 weeks ago). I realise that it is still early days post delivery, and I can now actually do a pelvic floor exercise, where as 2 weeks ago I couldn’t physically do one. I did do my pelvic floor exercises and keep fit throughout the pregnancy, however I have been told that a vaginal delivery of this kind places an extreme amount of stress on the pelvic floor, so this was pretty unavoidable (is that your understanding??).
     
    Your book was informative as it gives me more of an idea of where to start when I do go back and exercise, however, my main question is, will doing regular pelvic floor exercises and inner ab work improve my condtion, or is it purely a matter of not letting it get worse? It is a mild case, however it is something that I feel throughout the whole day (unless lying down) and really hope to be able to improve, rather than just deal with….will this bulging feeling decrease with improved strength of my pelvic floor?
     
    Any insight would be greatly appreciated,
     


    • Prolapse after childbirth

      Hi Jo

      Thanks for your question on prolapse and childbirth. The answer to your question is yes and no. Let me explain further…

      A prolapse is a deficit in the supporting vaginal wall tissues and this allows the pelvic organ to bulge into the wall, in your case the rectum bulging into the back wall of the vagina. It is just like a hernia. Once it is there it is there for good as exercises won’t actually repair the deficit. That’s the bad news.

      The good news is that in mild and moderate cases of prolapse, correct pelvic floor exercises can reduce the symptoms of prolapse such as the bulding dragging feeling that women commonly experience. This is because pelvic floor exercises strengthen and thicken pelvic floor support and they lift the pelvic floor so that it sits higher within the pelvis – this is obviously exactly what you want to help reduce prolapse symptoms and to reduce the risk of the prolapse worsening.

      You are early days post delivery of your second child. Your pelvic floor is suffering the effects of this pregnancy and delivery in addition to the effect of your previous pregnancy and childbirth. Yes it is commonplace to have difficulty even getting a flicker of activity out of the pelvic floor muscles in the early days post delivery. The pelvic floor muscles undergo a large amount of stretch and trauma during vaginal delivery, like a really bad muscle strain and sometimes tearing but the pelvic floor muscles are hidden away and this fact is often not really considered for this reason. We know that weak pelvic floor muscles take 3-5 months for rehabilitation. Added to this new mothers who are breast feeding have the added factor of decreased oestrogen while they feed plus the physical fatigue associated with the care of a new baby (plus another child in your case). This means it can take quite some time to fully rehabilitate the pelvic floor muscles post delivery and that there is usually vast scope for improvement.

      A visit to a physiotherapist trained in continence and women’s health would be most valuable to ensure that you are activating your pelvic floor muscles correctly, and to prescribe an ongoing training program, in addition to helping you to manage other factors that may be affecting your pelvic floor without you realising. In Australia you can locate such a physio by contacting the Australian Physiotherapy Association in your state or by phoning the Continence Foundation of Australia free call 1800 33 00 66

      Hope this helps you with your recovery Jo
      Regards
      Michelle

  7. I've just realised the difference it can make to a prolapse when you stop trying to tuck your tummy and bottom in, allowing all your organs to sit on the pelvic bone rather than being supported by those poor old pelvic floor muscles. Please can you put something on your website about the correct natural posture for women. I have found such relief since I realised this. Thanks Michelle

  8. Hi I have just found the website and there seems to be a wealth of experience and advice which I think will be useful and comforting to me.

    I was diagnosed with prolapse in March this year. I have stage 1 cystocele, stage 1 rectocele, stage 2 to 3 uterine prolapse. My symptoms are dragging feeling, lower back pain( which is the most problematic), some bladder symptoms (around 5 days out of a month) and constipation. I am tyring to do pelvic floor exercises but am unsure as to whether i’m doing enough and in the correct way. I attend Pilates class twice per week. My gyny has suggested anterior repair and vaginal hysterectomy, however I would prefer to avoid surgery. I wondered if you know if i continue with pelvic floor exercises, Pilates, good fibrous diet, maintain healthy weight, can surgery be avoided completely or just delayed for months/years until the prolapse worsens with age? I am 44 years old and have had an early menopause since the age of 38 years I have taken low dose HRT. thank you for your help.
    Sharon

    • Hi Sharon
      Thank you for your comments re prolapse protection, and the possibility of holding off /avoiding prolapse surgery.

      At present we don’t know what the natural course or rate of progression prolapse is – some for some women their prolapse will worsen suddenly or gradually, some women find no progression at all and this needs to be established with future research. What we do know from very recent research is that pelvic floor exercises can alleviate prolapse symptoms and lift the pelvic floor (and prolapse) higher within the pelvis. Some women with mild to moderate prolapse who have commenced pelvic floor exercises when waiting for surgery, find that their prolapse symptoms improve so that they avoid surgery. Others go on to requiring surgery – again no one rule fits all.

      What can be done to help avoid or delay prolapse surgery for mild/moderate prolapse?

      There are a number of factors that are important to address and manage, and these vary from woman to woman according to their general health, physical demands and exercise programs. Some things that spring immediately to mind from your comments are:

      • Pelvic floor exercises
      • – post menopause the pelvic floor thins and weakens, therefore very important for long-term management

      • Avoiding constipation and straining is vital
      • – before and after surgery to avoid recurrence

      • Appropriate exercise
      • – note that not all Pilates exercises are pelvic floor safe, know about those Pilates exercises to choose and those to avoid.

      • Weight management
      • –again important to reduce load off the pelvic floor

      • Treating back pain
      • – low back pain is not necessarily attributed to prolapse (although it can be). Core muscle support is reduced with low back pain, so it is important to get back pain treated as part of a comprehensive approach to prolapse management.

      • Pessary
      • –a vaginal pessary can be a great device to improve prolapse support, to assist pelvic floor exercises and to delay/avoid surgery for some women.

      Hope this gives you some ideas for follow up Sharon. A pelvic floor physio can help identify your risk factors and help you to improve your pelvic floor support. In Australia some pelvic floor physios now fit pessaries too.

      Hope things go well for you
      Michelle

  9. Hi,Michelle,thanks all the information on this site.Really helpfull for me.Had full hysterectomy and pelvic floor uplift in middle of December.Now feel something coming down at bottom of vagina and urgency to empty my bladder frequently.Do i have another prolapse ?and will exercise help .Like going to gym but unsure what exercises to do.Will i need to have surgery again or is there an other opption.Any advice would be gratefull thanks

    • Michelle Kenway says:

      Hi Alice
      The best thing to do is to get your GP for an examination for the cause of your symptoms, or if your referral is still valid phone your surgeons rooms – the only way to know what is going on is to get a pelvic floor examintaion.

      Meanwhile pelvic floor exercises may help to alleviate this problem if it is mild prolapse. I would probably avoid going and starting out at the gym just now until you really know what you are dealing with, especially in view of your symptoms and the recency of your surgery. If you end up doing the wrong exercises, this could potentially make things worse. This information on bladder control training for bladder urgency may be helpful too.

      Do you know how to start with your pelvic floor exercises? Also walking is probably the safest and most appropriate general health exercise just now provided you are in good general health. Let me know how you go.
      Good luck
      Michelle

  10. I cannot believe my luck at finding your web site. I really thought that I was on my own here with my bladder prolapse! I have to say that as my GP told me that it is a very common ailment I don’t know anyone with it! Here in the UK there is a serious shortage of information and it seems to be a very neglected area of women’s medicine. I shall now look forward to reading more on your site and hopefully learn how to live with this hidious condition. thank you .

    • Michelle Kenway says:

      Thanks Pamela, yes there is a shortage of information and open discussion in relation to this area of women’s health, thanks for taking the time to write and good luck on your journey
      Michelle

  11. I have learnt of Contiform from your website. Can Contiform be used for a bladder prolapse?I don’t have any bladder leakage with my prolapse and realize that they are not meant to be used all day but would be useful for me whilst dog walking or doing housework to alleviate the dragging feeling. I am 59 years old quite active and have not been offered any form of treatment.
    Thanks Pamela

    • Michelle Kenway says:

      Hi Pamela
      Thanks for your question. No Contiform is not for prolapse – far better to have a support pessary properly fitted to support your prolapse if you are a suitable candidate. There are a wide variety now available and these are fitted by gynaecologists. You will need to see your doctor and ask for a referral. Pelvic floor exercises along with support pessary both have the potential to alleviate that dragging feeling so well worth pursueing.
      Best of luck
      Michelle

  12. Hi,
    Thank you for your site! Following back problems, I’ve been advised to do Pilates exercises, some of which I now know are unsuitable for a rectocele.
    I’ve just ordered your book & DVD!
    Please can you let me know whether the clam is ok to continue? This seems to be quite an important one for me, provided it doesn’t have any adverse effects on the pelvic floor.
    Many thanks.

    • Michelle Kenway says:

      Hi Sara
      Clam is a great hip strength and pelvic stability exercise. It will not overload the pelvic floor, even when perfomed using a weight on the outside of the thigh. The muscles involved and the side lying position are ideal for pelvic floor safe exercises, so enjoy!
      Cheers
      Michelle

  13. Pelvic Exercises says:

    Hi Claire
    The idea with pelvic floor strengthening is to train your pelvic floor muscles to work actively (by contracting them) when you need them to such as before a cough, sneeze, lifting your new baby … and to work passively (without contracting them) as you are moving about the rest of the time. If your pelvic floor and deep abdominals are working well together you can use your deep abdominal muscles gently activated when you move around, walk, carry etc but it is wise to avoid contracting your pelvic floor muscles constantly while you walk and move as these muscles are not designed to be used in this manner. This is the reason some women develop painful increased pelvic floor muscle tension – from over contracting their pelvic floor muscles and not allowing them to relax. So yes use your deep abdominals gently but avoid contracting your pelvic floor muscles all the time when walking .

    A pessary should not prevent you from using Teneo Uno Smartballs. If anything I think that sometimes a pessary can actually help you exercise your pelvic floor muscles by lifting the prolapse off the pelvic floor muscles.

    Yes constipation issues can be caused by a vaginal prolapse. And yes, pelvic floor exercises can help with constipation by providing a firm platform for elimination. It remains very important to relax the abdominal muscles to help relax the anal sphincter – you can see this technique in our online video http://www.pelvicexercises.com.au/bowel-movement/ . Speak to your doctor about your constipation issue and seek his/her further advice. Remember that some women have too much fibre which can actually make things worse. This is something for you to discuss with your GP or a dietician.

    I hope this information helps you Claire, it can be tough managing a new baby and prolapse issues too. Especially when you have an increasingly heavy baby to carry around! Best wishes Michelle

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