Postpartum Prolapse Exercises for Fitness, Weight Loss, Strengthening and Toning Your Core After Pregnancy

Welcome to our 2 part series for safe postpartum exercise to help you get back in shape with prolapse problems. This episode teaches you the best postpartum fitness and weight loss exercises, how much exercise you need to do and how to safely tone your tummy and strengthen your whole body with prolapse problems.

Are your looking for safe postpartum exercises?

Are you suffering from prolapse after childbirth and worried about making your prolapse worse with exercise?

Safe postpartum exercises

Episode Part 1 – Safe Postpartum Exercises for Prolapse

Today’s podcast is all about safe postpartum exercise for women with prolapse.

In this episode I’ll be responding to this great reader question from Tracy who wrote to me asking about safe postpartum exercises for getting back in shape with her prolapse.

Tracy writes:

Hi Michelle

I have a grade 2 prolapse after 3 bubs. I’m very keen to start back exercising and flatten my mum tum but want to avoid prolapse surgery and making things worse. What can I do to get back safely? I’m seeing a Pelvic Floor Physiotherapist at the moment too

Thanks Tracy (Australia)

 

In answering Tracy’s question I’ll be discussing the following for women with prolapse:

  • How to regain your fitness after childbirth including the best types of low impact exercises to choose and those to avoid
  • The best weight loss exercises to choose and how much weight loss exercise you need to do to effectively lose weight
  • Core abdominal exercises that safely tone and flatten your tummy including Pilates and fitness ball exercises
  • Core abdominal exercises that potentially worsen prolapse symptoms and increase the risk of prolapase worsening
  • The best resistance exercises to choose for whole body strengthening and toning

How to Subscribe To Get Future Episodes

Our next episode in this 2 part series teaches you how to manage your pelvic floor and prolapse with tips to reduce your risk of prolapse worsening with postpartum exercises.

If you’d like to receive future episodes of the Pelvic Exercises Podcast, you can do the following:

  1. Subscribe on iTunes here https://itunes.apple.com/au/podcast/pelvic-exercises/id1401798687?mt=2
  2. Subscribe on Stitcher (for android, iOS or Web Player) here https://www.stitcher.com/podcast/michelle-kenway/pelvic-exercises-podcast?refid=stpr
  3. Subscribe to Pelvic Exercises monthly newsletter.

Once you’ve listened to today’s episode please give this podcast a quick rating on iTunes or Stitcher to help other women with prolapse problems find the podcast too.

Further Information on Safe Postpartum Exercises

PROLAPSE EXERCISES BOOK

prolapse exercises

with Pelvic Floor Physical Therapist Michelle Kenway

Learn how to exercise safely, strengthen your prolapse and reduce your risk of repeat prolapse.

Prolapse Exercises is a complete exercise guide for women after prolapse surgery seeking to exercise safely and protect their pelvic floor.

Also available to download now

READ MORE NOW

References

American College of Sports Medicine (2011) Position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Medicine & Science in Sports & Exercise, Jul;43(7):1334-59

Full Transcript Expand to view full transcript Compress to smaller transcript view

Welcome to Episode 2 of the Pelvic Exercises Podcast. My name is Michelle Kenway and I’m the Physiotherapist behind Pelvic Exercises, a website, series of safe exercise books, DVDs  and a podcast to help you exercise safely with pelvic floor problems. You can find all our free exercise videos and information at www.pelvicexercises.com.au

Today’s episode is Part 1 of a 2 part series on safe postpartum exercises for getting back into shape with prolapse problems.

You can learn more about today’s show, get a full transcript and leave your comments in our show notes at pelvicexercises.com.au/podcast/safe-postpartum-exercises/

Now I was prompted to make this series when I recently received this email from Tracy seeking information to help her return to exercise with a moderate prolapse and avoid surgery.

Tracy writes:

Hi Michelle

I have a grade 2 prolapse after 3 bubs. I’m very keen to start back exercising and flatten my mum tum but want to avoid prolapse surgery and making things worse. What can I do to get back safely? I’m seeing a Pelvic Floor Physiotherapist at the moment ...

Welcome to Episode 2 of the Pelvic Exercises Podcast. My name is Michelle Kenway and I’m the Physiotherapist behind Pelvic Exercises, a website, series of safe exercise books, DVDs  and a podcast to help you exercise safely with pelvic floor problems. You can find all our free exercise videos and information at www.pelvicexercises.com.au

Today’s episode is Part 1 of a 2 part series on safe postpartum exercises for getting back into shape with prolapse problems.

You can learn more about today’s show, get a full transcript and leave your comments in our show notes at pelvicexercises.com.au/podcast/safe-postpartum-exercises/

Now I was prompted to make this series when I recently received this email from Tracy seeking information to help her return to exercise with a moderate prolapse and avoid surgery.

Tracy writes:

Hi Michelle

I have a grade 2 prolapse after 3 bubs. I’m very keen to start back exercising and flatten my mum tum but want to avoid prolapse surgery and making things worse. What can I do to get back safely? I’m seeing a Pelvic Floor Physiotherapist at the moment too.

Thanks Tracy (Australia)

Well Tracy, in responding to your question today, I’ll be talking about:

  • The best exercises to choose and what to avoid to regain your fitness
  • The  importance of managing your body weight with prolapse problems
  • The best exercises for you to choose to lose weight after how much exercise you need to do
  • Exercises to safely tone and flatten your tummy
  • Some core abdominal exercises you should avoid
  • And then finally we’ll look at the right exercises for strengthening and toning your whole body.

I’ll  start out today by acknowledging that it can seem really challenging to know how to get back to exercise safely after childbirth especially when you’re dealing a prolapse and trying to avoid prolapse surgery.

I also believe that you can feel positive as in my experience it is possible to return to fitness and get back in shape with a prolapse – it’s really a matter of knowing what to do, what to avoid and then of course getting into a good routine of regular appropriate exercise. In my experience most women find that their ability to exercise with prolapse issues usually improves as their fitness and overall pelvic floor condition improve over time.

I’m really glad to read that you’ve already been so proactive and taken the step of seeing a Pelvic Floor Therapist, this really is the best place for you to have started to help you manage your prolapse really well.

It’s also reassuring great to know that now you’re ready to get back into exercise you’re thinking about how to do this safely.

I don’t know some of the important details of your history aside from the fact that you have Grade 2 prolapse. I’d really like to know details like how recently you delivered your baby, your current body weight, your fitness history, your general health and the current condition of your pelvic floor so this is general information to help you out.

Now for the benefit of those of you listening today who don’t know what a Grade 2 prolapse is, I’ll explain this condition briefly.

A prolapse after childbirth involves one or more of the pelvic organs such as the bladder, uterus or rectum moving out of place down into (or out of) the vagina. Health professionals measure and grade a prolapse according to how far it has descended or moved down into the vagina. Having a Grade 2 prolapse means that Tracy’s prolapse has moved down inside the vagina and is bulging near the entrance. This is what we classify as a moderate prolapse.

If you want to know more about prolapse after childbirth I’ve posted a link in the further reading to some more information on prolapse after childbirth you can find it in the show notes at www.pelvicexercises.com.au/podcast/safe-postpartum-exercise/

As always before starting this discussion today, I’d like to remind everyone listening that when it comes to exercising with a prolapse everywoman is different. Many different factors influence how much exercise you can manage and the types of exercise you can do including how severe your prolapse is, how well your pelvic floor muscles are working, your body weight and how long since your delivery so please treat this as general information to help you get started.

Let’s start out today talking about the best exercises to choose for general fitness and weight management with prolapse problems.

The topic of cardiovascular fitness exercises and weight loss is important for new mums with prolapse.

As we’re all aware, there are often completely unrealistic and inappropriate appearance-based social expectations and pressures on new mums to lose weight and get back in shape. I’m not a supporter of placing pressure on any woman to lose weight rapidly after childbirth especially for cosmetic reasons. Rapid weight loss isn’t appropriate for new mums and can be dangerous for the health of both mum and bub (that is if the baby is breastfeeding).

Despite this, I think it’s important to recognise that body weight management is a very important part of prolapse management, especially for new mums who gain on average around 12 kilograms or 26 pounds during pregnancy and who usually have pelvic floor weakness after delivery. If you’re carrying extra weight in and around your belly, this weight is transferred to your pelvic floor. In other words it’s an added load for your pelvic floor to carry around all day.  This is why being overweight is a known risk factor for pelvic organ prolapse. Carrying too much abdominal weight can worsen prolapse symptoms and will possibly worsen the prolapse too, especially with the wrong kind of exercise. If you’re overweight after pregnancy, this is how weight management with sensible gradual weight loss and appropriate weight loss exercise after pregnancy can assist prolapse management, reduce prolapse symptoms and reduce the risk of prolapse worsening.

I think it’s also important for new mums to realise that it’s just not possible to spot reduce fat or a flabby tummy, this is an myth. Unfortunately some women still believe that doing abdominal curl exercises will flatten their tummy after childbirth. In reality, to flatten your tummy you need to lose weight from your tummy and to do this, you need to lose weight from all over your body, there’s no natural way of targeting weight loss from your tummy.

Many women mistakenly start to do core abdominal exercises such as sit-ups or abdominal curl exercises to flatten their tummy after pregnancy. Not only are these exercises a waste of time  and effort, there’s a good chance they can make your prolapse a whole lot worse. I’ll talk more on this issue when we discuss tummy toning exercises a little later in this episode.

So which exercises should you choose to lose weight from your whole body and therefore your tummy and improve your fitness?

The best exercises to choose for your fitness and weight loss are low impact fitness exercises.

Low impact fitness exercises increase your breathing and heart rate and they minimise the pressure on your pelvic floor (and of course your prolapse). You can usually pick a low impact exercise because at least one foot stays in contact with the ground at all times. It’s vital to avoid high impact weight loss and fitness exercises like running, especially repetitive treadmill running, jumping or high impact aerobics as these exercises will force your pelvic floor downwards and they’re likely to make your prolapse symptoms and your prolapse condition worse when repeated over time.

One of the best forms of low impact exercise for weight loss and fitness after pregnancy is stationary bike or cycle. Cycling is low impact, it places minimal pressure on a prolapse and it’s unlikely to damage other joints in your body compared with high impact exercises like running. Sitting on the bike seat helps support your pelvic floor and prolapse while you workout. Cycling is a great way of using your large leg muscles that burn fat and improve your fitness. One of the most effective ways of losing weight and improving fitness fast is alternating high and low intensity workouts on the bike. You wouldn’t start out with alternating high and low intensity bike but it’s definitely something worth aiming for over time.

Having a stationary bike at home can be a great exercise solution for new mums busy looking after other children too. The bike is convenient and  it’s quite easy to accumulate 2-3 ten minute sessions during the course of the day especially on those days you can’t get out of the house with the kids. You can usually find an inexpensive second hand bike online or you can hire one and see how you go if you prefer not to buy. Alternatively you might like to use a stationary bike at the gym or participate in spinning classes later on. There are some warnings for spinning classes and you can read more about these in the show notes.

Walking is also a great form of low impact exercise for women postpartum however when it comes to choosing effective exercises for getting back in shape with a moderate prolapse it may not exercise of choice. Tracy I’m mindful of the fact that you have 3 children so you’ll be pushing a heavy buggy or pram when you walk. This will increase the load on your pelvic floor and make it challenging to get a good fitness workout with walking at the moment. Some women with moderate prolapse find that walking causes their prolapse to bulge and drag more by the end of the day. When you start out walking, keep your walks short duration and stay on flat surfaces. You may find that as pelvic floor support starts to recover you can gradually build up the time spent walking however avoid pushing a heavy pram long distances or uphill with your prolapse just now.

Water based exercise is a great from of low impact fitness exercise after childbirth (when your doctor tells you it’s ok to return to water exercise, usually after your bleeding has stopped). Water-based exercises like swimming, water or aqua aerobics and water walking are all great forms of low impact exercise. Swimming laps probably isn’t the exercise of choice for weight loss as you need to be able to swim fast to achieve a good energy burning effect however it’s nice to include swimming in your postnatal exercise program for general  fitness and variety especially if it’s something you enjoy. I remember taking my babies to the local swimming pool with a group of girlfriends where we would take turns swimming and watching each other’s children. This way a great way to exercise and enjoy some social time too.

I’ve included a link to a helpful list of most effective low impact weight loss exercises for you to choose from in the show notes.

So how much fitness exercise do you need to do to improve your fitness and to lose weight?

According to the American College of Sports Medicine for general fitness healthy adults need to do at least 30 minutes of moderate intensity aerobic exercise on 5 days or more (this gives a total at least 150 minutes or 2.5 hrs/week). Moderate intensity means that your heart rate and breathing are increased but you can comfortably talk while you exercise. If 30 minutes a day seems too much at the moment, don’t worry. If you can break your exercise into 10 minute chunks, you can get to 30 minutes with three 10 minute sessions over the course of the day – 10 minutes seems to be the lower limit of how much exercise you need to do at a time. Start out with the amount of exercise you can comfortably manage, even if it’s 10 minutes a day and build up gradually over time.

To lose weight with exercise alone, unfortunately you need to spend much more time doing moderate intensity exercise. The ACSM guidelines state that to lose weight healthy adults need to do 45 minutes  to 1.5 hours of exercise on 5 days of the week and that doing more than 50 minutes a day, 5 days per week results in clinically significant weight loss of 5-7.5 kg.

So basically the greater the amount of time you spend exercising at a moderate intensity the more weight you’ll lose. This amount of exercise can seem well out of reach for a new mum, especially with prolapse problems and this is why if you’re looking to lose weight you’ll probably need to reduce your energy intake too to help out. Trying to lose weight with moderate intensity exercise alone is very time consuming and physically demanding.

The other effective way of exercising to lose weight and improve fitness is interval training. Exercising at a alternating high intensity and low intensity is a really efficient and scientifically supported method of losing weight and women can achieve weight loss and improve their fitness in as little as 15 mins per. This is an intense and vigorous way of exercising and it isn’t appropriate for most new mums to resume immediately after pregnancy and childbirth. High low exercise might be something to consider in time as your fitness improves and once again, stationary bike is a great way to do this type of interval training. For more information on cycling for weight loss just use the further reading link to cycling in the show notes for today’s episode.

Let’s now talk about doing the right core exercises to tone your tummy.

We’ve already talked about how it’s not possible to spot reduce tummy weight but it is possible to tone floppy tummy muscles and make your tummy appear flatter with the right core exercises. In fact core abdominal exercises are important for your recovery after pregnancy.

When it comes to core abdominal exercises, you need to be really careful about which exercises you choose and those you avoid. You need to avoid intense core abdominal exercises, more isn’t better when it comes to training your tummy. If your pelvic floor is weak (which it almost certainly is after childbirth and with a prolapse) intense core abdominal exercises will force the pelvic floor downwards and over time, they are likely to make your prolapse symptoms and condition worse.

Intense core abdominal exercises to avoid are abdominal exercises with both legs raised off the ground, core exercises like  abdominal curls, The Plank and some Pilates exercises like Tabletop or Yoga poses like V sit.

To tone your tummy the first thing to do is to learn how to correctly activate your deep core abdominal muscles. These muscles are called your Transverse Abdominis muscles. Transverse abdominis wraps around your tummy like a corset and attaches to tissues at the back of your body. They often can become stretched during pregnancy and stop working well.

If you’ve done Pilates, you’ll know the correct action for exercising these muscles. Start with tall posture if you’re standing or sitting. Gently draw your navel and your lower abdominal wall beneath your briefs inwards towards your spine while you try to breathe normally and  hold this action. This is a very small movement, it’s really important to avoid contracting these muscles too strongly.

The best abdominal core exercises to start out with involve activating your Transverse Abdominis or deep abdominal muscles during exercises like alternate arm and leg raises (kneeling), and gentle Pilates-style exercises such as  single knee roll outs (also known as Bent Knee Fallouts). There are also some great seated ball core abdominal routines you can try too.

You can find links to videos to help you do these exercises at home in the show notes on the pelvic exercises website.

So last but definitely not least today I’m going to talk about strength training exercise and I’ll use the terms strength and resistance training interchangeably as they mean the same thing.

Strength training typically involves contracting your muscles repeatedly against some form of resistance.

Resistance training exercises include free weights that you can do at home or in the gym, machine weights in the gym, resistance bands, your body weight and even resistance exercises in the water.

Keeping your body strong can help your prolapse management. If your body is strong, then you’ll place less pressure on your pelvic floor during your everyday activities and let’s face it being a mum requires lots of strength with all the lifting and carrying activities that increase as your baby grows. It makes sense to keep your body strong to keep up with the ever increasing demands on your pelvic floor.

Resistance training helps you get back in shape. It  helps you tone up your whole body and this includes your tummy. Resistance exercise also builds lean muscle and the more lean muscle you have, the better you can manage your body weight. These are just some of the benefits of strength training for women.

Being a new mum and having a prolapse mean that you need to be careful with your resistance training and not simply returning to a regular strength training program in the gym. You really need to know what you’re doing to keep your pelvic floor safe. The key to safe resistance training with a prolapse is starting out with light resistance, progressing gradually and knowing the right exercises to choose and those exercises to avoid to protect your pelvic floor. It also helps to know the best positions and techniques for your strength exercises that help you minimise loading onto your pelvic floor.

Let’s talk about pelvic floor safe resistance exercises to choose and what to avoid.

Some of the best resistance exercises for legs include floor bridges (lying down with knees bent lifting and lowering your butt off the ground – most women with prolapse issues can use weights on their hips for this exercise).

Mini squats are a great safe alternative to deep wide squats which you should ideally avoid now and forever. Take care with weighted lunges after your baby as your pelvic girdle may be unstable after childbirth and lunges can cause pelvic instability problems in some women.

Seated low row is a great exercise for strengthening your back and shoulders and this can be done as a machine exercise or simply using a resistance band tied to a door handle at home.

Upper body strengthening exercises like biceps curls and triceps extensions using light dumbbell weights can be done at home ideally sitting on an exercise ball or a bench. Try to sit or even use lying down positions for your upper body weights rather than standing to reduce the load on your pelvic floor and your prolapse.

Now there is no one-fits-all pelvic floor safe strength training program for women. Just the same as fitness and core exercises,  you should avoid or modify any strength exercises that cause you to have prolapse symptoms.

How  much strength training do you need to do?

To strengthen your muscles aim to do strength exercises approximately 2-3 days of the week. Ideally every session you would do perform 8-12 repeated strength exercises, 2-4 times for the major muscle groups.

Once again you can find links to information on the best strength exercises to choose, unsafe gym exercise to avoid and a helpful 10 step guide to how to do your strength exercises in the show notes.

Let’s now take a moment to review some of the key points from today’s discussion so that you’re really clear on the best safe postpartum exercise for you to choose with prolapse problems.

I’d just like to review the main points we’ve discussed today:

  • We’ve discussed the fact that every woman is different with regards to the amount and type of exercise she can manage with a prolapse.
  • In my experience, most women with prolapse can do some form of exercise after childbirth and the capacity for exercise usually improves over time.
  • For your general fitness choose low impact exercises such as stationary bike and aim for 30 minutes of moderate intensity exercise on 5 days of the week
  • We’ve discussed the importance of body weight management for overall prolapse management and the fact that getting the quantity of exercise to lose weight is a lot for a new mum i.e. more than 45 minutes of moderate intensity exercise on 5 days of the week. This is why appropriate diet for weight loss must come into play too.
  • Core abdominal training exercises to flatten the appearance of your tummy should use the right gentle deep abdominal muscle exercise  technique and it’s very important to avoid intense core exercises after childbirth with prolapse problems
  • Finally we discussed the value of strength training exercises for new mums and how keeping your body strong may help to reduce the pressure on your prolapse with everyday activities.

Well Tracy I hope this answers some of your questions. Next week I’ll continue this discussion with some really important tips for how to best protect your prolapse during exercise to minimise your risk of worsening your prolapse and prolapse surgery.

I really hope you can join me then.

Thank you so much for listening today. If you’d like to receive this weekly podcast you can subscribe on iTunes or Stitcher. If you’ve enjoyed this show today it would be great if you could leave a rating or even a review. Your feedback really helps me get this information out to help other women with prolapse problems.

I always love to hear from you. You can post any questions or comments you might have in the comments section at the end of the show notes.

Once again if you need more information or you’d like to comment you can find today’s show notes at pelvicexercises.com.au/podcasts/safe-postpartum-exercises/ where there’s a full transcript and links to all the further reading.

I hope you enjoy an active and healthy week and I look forward to chatting with you next week. Bye for now.

 

 

 

 

 

 

We Welcome Your Comments

Comments

  1. Hi Michelle

    Thanks for this great podcast episode, it’s given me some good ideas for how to get back to exercise. I didn’t realise the importance of weight loss, especially since I’m still carrying an extra 15 pounds 4 mths on . I also have a grade 2 prolapse after having my second baby. What do you think about using a pessary? Jill (Canada)

    • Michelle Kenway Physiotherapist says:

      I think that pessaries are largely underutilised to help postnatal prolapse. They can really help improve symptoms and support. I discuss the use of pessaries for postnatal exercise in part 2 of this series (next episode)

  2. This was my question and I’m so grateful for such good information. I was really worried after noticing the prolapse that I wouldn’t be able to get back to the gym and I’d be stuck with my mum tum. So far these tips and your program have been great and I already feel stronger and more confident

    • Michelle Kenway Physiotherapist says:

      Great to hear your news Tracy, thanks so much for the update and that things are on the improve, all the best!

  3. Hi Michelle,
    I just wanted to thank you for your exercise video. I haven’t been able to do much for the last few months as per my pelvic floor physio but have just started your workout this last week. I have enjoyed it and can def feel the muscles working.
    But with the pushups I’m feeling pain to the right upper quadrant of my abdomen which made me have to stop, oblique region maybe?
    I did tear a stomach muscle during pregnancy. Would this be causing the problem? If so, what can I do?
    I really want to get rid of my soft icky tummy!

    • Michelle Kenway Physiotherapist says:

      Hi Rochelle
      Push ups (full mens) are not a pelvic floor safe exercise – they require strong abdominals activation and may thereby increase loading on the pelvic floor. Pelvic floor friendly push ups involve kneeling and the hands placed under the shoulders. The nose is then lowered towards the ground between the hands or slightly in front of the hands thereby using the chest and shoulders rather than the abdominal muscles. You’re wise to discontinue this exercise if it causes discomfort. You will require an assessment from a Physio to correctly diagnose and treat this condition. Gentle core abdominal exercises like the ones shown in this link are more appropriate for postnatal core abdominal strengthening. Hope this helps you out Rochelle, cheers Michelle