How to Modify These 7 Exercises for Women With Prolapse

Are you trying to exercise safely with prolapse problems? Knowing the most appropriate exercises for women with pelvic organ prolapse can be challenging.

If you notice prolapse symptoms during or after exercise, modified exercises may help you reduce the load on your pelvic floor.

This Pelvic Health Physiotherapist information provides modifications for 7 commonly performed exercises for women that can help reduce prolapse symptoms and continue exercising.

1. Deep Weighted Squats

Deep weighted wide leg squats are commonly performed strength exercises for women. Squats strengthen and tone the thighs and buttocks.

The load on the pelvic floor increases with the depth of the squat.

Adding load to the upper body during squats increases the load on the pelvic floor.

Variations of weighted squats include:

• Wide Stance Barbell Squat (shown above)
• Wide Stance Dumbbell Squat (heavy dumbbell held to chest during deep wide stance squat)
• Kettle bell squat (shown above)
• Body weight squat jump (jump off ground after deep squat)

How to Modify Squats

Regular squats are readily modified into pelvic floor safe squats. Here are some alternative  leg strength exercises you may like to try:

• Mini squats (shown here)
• Ball to back wall squat
• Lunges with dumbbell weights rested against your hips
• Exercise ball to wall lunges

2. Star Jumps

Star jumps are high impact fitness cardiovascular exercises.

Star Jumps load the pelvic floor with landing. If the pelvic floor can’t withstand this repeated loading, it will be forced downwards along with your prolapse or prolapse repair.

How to Modify Star Jumps

Modify Star Jumps to low impact fitness exercises stepping side to side or by touching one foot to the side at a time always keeping at least one foot in contact with the ground. Move your arms out to the side as you would do in a regular star jump to promote your fitness.

3. Men’s Push Ups

Men’s push ups involve lying face down supporting the entire body weight through the hands and the feet.

Men’s push ups are upper body, chest and abdominal muscles strength exercises for women.

How to Modify Men’s Push Ups

Men’s push ups can be modified to be pelvic floor friendly with:

• Wall push ups (feet close to the wall)
• Ball wall push ups (hands on a ball against a wall)
• Kneeling women’s push ups (shown here)

How to do Kneeling Women’s Push Ups?

1. Place your hands directly under shoulders and your knees directly under your hips, keep both feet in contact with the ground.
2. Lower your nose towards the ground between your hands or slightly in front of your hands as you breathe in and then breathe out as you return your body back to starting position.

4. Resisted Core Abdominal Exercises

There are many forms of resisted and potentially unsafe abdominal core exercises in women’s gyms and fitness classes. Resisted core exercises are usually promoted as tummy flattening exercises – and most of us now know that these exercises won’t flatten your belly.

Resisted abdominal exercises can increase the downward pressure on the pelvic floor. When the  pelvic floor can’t withstand this pressure it is forced downwards potentially worsening prolapse conditions.

Resisted core abdominal exercises for women include:

• Abdominal resistance machines (shown here)
• Weighted sit ups or crunches (dumbbell/weighted plate/medicine ball)
• Incline sit ups (where the head down position increases the effort required by the abdominal muscles)
• Hanging leg raises (knees to chest)
• Abdominal rollout exercises (with roller or barbell)
• Cable crunch (kneeling weighted rope pull down)
• Exercise ball roll in (body forwards over the ball in push up position and ball is rolled into body as the knees are bent towards the chest)

How to Modify Core Abdominal Exercises

Modify resisted core abdominal exercises to protect your pelvic floor by eliminating the resistance in favour of more appropriate abdominal core exercises for women. The type of abdominal core you choose will vary according to the strength and support provided by your pelvic floor.

Pelvic floor safe abdominal core exercises include:

• Seated exercise ball abdominal core exercises (shown right)
• Appropriate floor-based Pilates style exercises including – Bent Knee Fall Outs, Heel Slides (shown in this pelvic floor safe core abdominal exercises video)
• Modified Full Plank by kneeling with weight on forearms and toes down (suited to some but not all women)

5. Dead Lift Exercise

The Dead Lift is one of the strength exercises for women you will often see in barbell strength training classes. The Dead Lift strengthens a number of areas of the body including: back, shoulder, leg and buttock muscles.

When performed with the heavy resistance the Dead Lift exercise can increase pelvic floor loading.

Dead Lift technique typically involves:

• Holding a weighted barbell in front of your hips with your legs in wide leg stance position
• Leaning forwards and lowering the barbell along the thighs and shins towards the ground
• Returning back to upright standing

How to Modify Dead Lifts

Dead lift can be modified to reduce pelvic floor loading by using the pelvic floor safe strength training guidelines and the following modified technique:

• Stand with feet under hips
• Hold a light dumbbell to the sides of the legs
• Lower the dumbbells to just above the outside of your knees by bending your legs. Keeping the inward curve in your lower back and sticking your bottom out behind your body
• Breathe out as you return back to stand upright

6. Leg Press Exercises

Leg press exercises strengthen the thighs and buttocks. Leg press machine involves moving a load or resistance by bending and extending the legs. Leg press machines are commonly found in women’s gyms, circuit classes and fitness centre.

Leg Press exercises can increase load on the pelvic floor and cause straining during deep press and return to standing, particulary with heavy loading.

Leg press machine exercises for women commonly include:

• Standing leg press (the load is placed on the shoulders and a weighted squat is performed)
• Seated leg press (the load is moved by extending the hips and legs)
• Incline leg press (the load is moved by extending the hips and legs)

How to Modify Leg Press Exercises

Leg Press machine exercises can be modified by using manageable resistance and avoiding breath holding especially during the press return to standing.

Alternative strength exercises for legs and buttocks include:

• Bridging exercise (shown here)
• Ball to back wall squat with dumbbells
• Mini squats with dumbbells
• Lunge with dumbbells

7.  Burpees

Burpees are often included in Boot Camp exercises for women for whole body strengthening and fitness.

Burpees involve these repeated exercises:

• Squat down to place hands on the ground
• Thrust both of the legs out behind the body
• Perform a Men’s Push Up
• Jump the legs forward towards the body
• Jump vertically to complete the exercise

Alternative Exercises to Burpees

In a class situation where you feel unable to avoid Burpees, pelvic floor friendly alternative exercises for some women can include mini squats and modified push ups.

Key Points on Exercises for Women

Unfortunately attending a women’s gym or fitness class doesn’t assure pelvic floor safe exercises for women with prolapse problems.

Pelvic floor safe exercise alternatives or modifications to heavy loading or high impact exercises are desirable for some women, especially after prolapse surgery.

Choosing pelvic floor safe alternative exercises you can improve your ability to keep exercising long-term, decrease prolapse symptoms and may reduce the risk of pelvic floor overload.