Prolapse and Exercise – General Exercise Guidelines

prolapse exerciseProlapse and exercise-related worsening of prolapse can be avoided. How do you choose safe exercises, manage your weight and maintain your fitness if you’ve been diagnosed with a prolapse?

These Pelvic Floor Physiotherapist guidelines teach you how to exercise with confidence and protect your prolapse.

Read on now to learn about:

  • Prolapse and pelvic floor weakness
  • How some exercises can make a prolapse worse
  • How to choose safe exercise for prolapse
  • Prolapse and exercise for fitness
  • Prolapse and exercise for strength
  • Prolapse and core abdominal exercise
  • Prolapse and exercise classes.

Download this Prolapse and exercise information as a user friendly PDF (below).

Prolapse and exercise is by Pelvic Floor Physiotherapist Michelle Kenway to help women with prolapse stay active and exercise safely. Michelle is the author of Inside Out the internationally acclaimed guide to pelvic floor safe exercise for women.

Prolapse Exercises e-Book

International best selling prolapse exercise guide for women with prolapse and after prolapse surgery.

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

Prolapse and Pelvic Floor Weakness

A pelvic prolapse can occur with any of the pelvic organs including the bladder, urethra (urine tube) uterus and rectum. A prolapse occurs when the pelvic floor supports weaken and stretch allowing the pelvic organs to bulge into the walls of the vagina (vaginal prolapse) or from the rectum (rectal prolapse). The pelvic floor supports include the pelvic floor muscles and the strong pelvic floor tissues that hold the pelvic organs in place.

A prolapse usually occurs in women (and men) who have weakened pelvic floor support. The pelvic floor is commonly weakened and prolapse caused by:

  • Inappropriate exercise;
  • Pregnancy and childbirth;
  • Obesity and overweight;
  • Chronic straining with constipation;
  • Chronic coughing;
  • Menopause and ageing; and
  • Previous pelvic surgery.

How can exercise make prolapse worse?Prolapse and exercise

Some forms of exercise can weaken the pelvic floor and worsen a prolapse.

If you have a prolapse you are likely to have weakness in your pelvic floor muscles and supportive tissues. This makes your pelvic floor more prone to injury since it is less resistant to pressure and strain. Exercise places downward pressure on the pelvic floor (shown right) If the pressure is too great for the pelvic floor to withstand, the pelvic floor muscles becomes stretched, weak and floppy and less able to support your already prolapsed organs. This is how prolapse can become mere severe with inappropriate exercise that is not matched to the existing strength of the pelvic floor.

Prolapse and weak pelvic floor supports ⇒ inappropriate exercise causes pelvic floor strain ⇒ progressive stretch and damage to pelvic floor tissues ⇒ progressive weakness of pelvic floor ⇒ decreased prolapse support ⇒ prolapse worsens in severity

How to Choose Safe Prolapse Exercises?

The key questions to ask when choosing exercise with a prolapse are:

  1. How much downward pressure and/or strain does your chosen exercise place upon your pelvic floor?
  2. How strong and well functioning is your pelvic floor? How well can your pelvic floor provide support to counteract the associated downward pressure?

These following safe exercise selection principles apply to all forms of pelvic prolapse including;

  • Uterine prolapse;
  • Bladder prolapse;
  • Vaginal wall prolapse (cystocoele/rectocoele); and
  • Rectal prolapse.

Prolapse and Exercise for Fitness

High impact fitness exercise involves exercises with both feet off the ground at the same time. The impact of landing forcefully increases the downward pressure on the pelvic floor and prolapse. The pressure of body weight is transferred to the pelvic floor and lower body. This is why prolapse symptoms often feel worse inappropriate fitness exercises such as running and jumping. When repeated over extended duration, high impact exercise can progressively stretch and strain the pelvic floor supports.

High impact exercises that may compromise the pelvic floor: Unsafe exercise for prolapse

  • Running;
  • Jumping;
  • Skipping; and
  • Some dance exercises.

Fitness and weight loss/management exercise can be readily modified to protect the pelvic floor and remain highly effective. Low impact exercise is the key to reducing impact on the pelvic floor. Low impact exercise is exercise with at least one foot in contact with the ground at all times.

Low impact exercises that are pelvic floor safe include:

  • Walking;
  • Cross trainer;
  • Road cycle;
  • Spinning or indoor cycle classes(stay seated and chose low gears);
  • Water based exercise;
  • Low impact fitball classes; and
  • Low impact fitness classes.

Prolapse and Exercise for Strength and Bone Health

Safe strength training with a prolapse is very feasible, however traditional strength training programs are designed for men and often fail to apply pelvic floor safe strength training principles

Pelvic floor and prolapse worsening is more likely with:

  • Heavy lifting and straining;
  • Specific strength training exercises; and
  • Unsupported positions when lifting (i.e. standing).

Strength exercises that increase pressure on prolapse:

  • Wide leg deep squats;
  • Smith machine squats;
  • Leg press (seated and incline); and
  • Weighted abdominal core strength exercises.

Women seeking pelvic floor safe strength exercises can access a complete physical workout in Inside Out Strength DVD workout for women with prolapse, designed and presented by Pelvic Floor Physiotherapist Michelle Kenway.

Core Abdominal Exercise and ProlapseUnsafe core exercises for prolapse

Scientific research shows that traditional intense core abdominal exercises increase the downward pressure on the pelvic floor and cause descent of the pelvic floor in women with pelvic floor dysfunction. The risk of injury seems to be increased with these exercises in women with previous vaginal delivery.

Some unsafe core exercises with a prolapse include:

  • Sit ups / abdominal crunches (shown right);
  • Fit ball sit ups and medicine ball sit ups;
  • The Hundred (Pilates);
  • The Plank;
  • Fit ball or Swiss ball sit ups; and
  • Abdominal exercise machines.

Prolapse and Exercise Classes

Some general exercise classes include exercises that may increase the risk of prolapse worsening with increased pelvic floor pressure. General exercise classes are designed for mainstream, not for women with pelvic floor prolapse. This means that exercises general exercise classes may be unsuitable for prolapse and require modification. The temptation in general exercise classes is often to perform intense and unsuitable exercises with the potential to worsen a prolapse.

Tips for exercise classes and prolapse:

  • High impact exercise classes – many of these exercises can be modified to be low impact.
  • Strength training/resistance classes can include inappropriate strength exercises and techniques. These can often be modified or alternative pelvic floor safe strength exercises performed.
  • Core training classes-intense core exercises will increase the likelihood of pelvic floor and prolapse strain. Core exercises can also be modified using techniques to reduce the intensity of the exercises on the upper abdominal muscles in particular.

If unsure about any exercise either leave it out or speak with your instructor for alternative exercises. Be mindful of the difficulty of catering to a large number of individuals with wide ranging abilities and expectations with pelvic floor safe exercises in group exercise.

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We Welcome Your Comments


  1. Hi
    I’mm 77 and an internal ultra sound has left me feeling as if razor blades are in my vagina. I cannot see the gyno for 5 days and am incredibly uncomfortable. I had to push hard a few times during the ultrasound and think it made everything worse. Is there danger in waiting for 5 days? It is a uterine prolapse I think. Would swimming laps be ok? I am scared and uncomfortable

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Adelina the ultrasound will be very unlikely to worsen your prolapse. It’s more likely that the vaginal walls are thin and possibly a little dry so there may be some mild abrasion inside the vagina. This should settle down over the next few days. Probably stay out of the pool until things have settled down which they will or if you’re very concerned phone the doctor’s receptionist and let him/her know what has happened since the ultrasound, all the best

  2. If you have a pessary to support your prolapse can you return to normal excersises? Or still avoid

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Sometimes women can return to more intense exercises when wearing a pessary – the presence or absence of prolapse symptoms usually tell you whether or not the exercises you’re doing while wearing the pessary are appropriate

  3. Hi

    I had a rectocele repair about 18 months ago after my third child was born. I am a very active boy mom, but I’ve tried very hard to stick to low impact exercises and use only weights 10lbs and below. I recently got some gluten resistance bands and started more HIIT style workouts. I modify the running and jumping exercises, but I’m curious if squats and glute resistance bands are truly safe post-repair? Thank you for your input!

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Felicia
      Post repair there’s no issue with glute resistance bands as far as I know, be sure to keep squats shallow – more like a minisquat rather than a deep squat. Lunges are a great alternative to squats too.

  4. Hi, im 33 and have been doing Hiit and some weighted bootcamp sessions a couple of times a week to 6 days a week( including at home sessions) for about 3 years. I recently found out i have a bladder prolapse (ive never been pregnant). I was wondering if this exercise could of caused my prolapse as i was doing alot of high intensity exercise when i first noticed the symptoms. Id love to still be able to do a couple of sessions a week that include jumping movements and wondering if you can do exercises to strengthen the pelvic floor so can still do these workouts? I am noticing atm they are causing a heavy feeling and discomfort.

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Emma

      There’s no saying what caused your prolapse, there are many causes. I think the best way to move forwards is to be diligent with your kegels, see a pelvic floor physio if you can for guidance, consider a vaginal support pessary if you want to continue high impact exercises. Also manage your bowels/chest conditions/avoid heavy lifting all the things with potential to worsen the condition too.

  5. Great article on what Not to do.
    Anything on what exercises we can do other than walking, cycling swimming and low impact fitness classes

  6. Miss Doreen says

    Is yoga a safe exercise to do with prolapse?
    My yoga teacher knows which are not suitable, but wanted confirmation the rest are safe to do?

  7. Anonymous says

    I have recently started learning swimming. Teh day I learnt the dog paddle technique, I experienced light bladder leakage. Is it possible that the dog paddle causes vaginal muscle to weaken?

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      It’s more likely that the pressure associated with the action used when you paddled was greater than the pressure your pelvic floor muscles can withstand. Best short term solution is to do your pelvic floor exercises.

  8. Hi Michelle,

    I’m 32 years old and 21 weeks pregnant with my second child. I found out I have a prolapse of the cervix at 20 weeks (well it basically started to bulge out). It is back Inside now but still visibly at the “doorway”.

    What safe excercises can I do to help lift everything back up while pregnant? And how much? What type of progress can I expect while pregnant and do u suggest bed rest considering the pressure with a growing baby may increase in that area?

    I would greatly appreciate Ur advice as my gynecologist just said ” do kegels” and nothing more or less.

    Thank u so much

    • Michelle Kenway Physiotherapist says

      Hi Tesneem
      Thank you for your question. Yes Kegel or pelvic floor exercises are really important for you at this stage. Most pregnant women with prolapse can still perform seated ball exercises such as those shown in this simple core exercises on the ball. Water-based exercises are also usually comfortable such as water walking forwards, backwards and sideways. A physiotherapist (physical therapist) can also provide you with appropriate deep abdominal exercises to help support your baby, spine and pelvis too.
      I hope this gives you somewhere to start Tesneem.

      All the best

  9. Hi

    I have been diagnosed with stage 2 front wall prolapse. i am 33 had 2 kids 6 and 4 and totally freaked out by it all. i have right hip pain also which i cant get rid of. physio says my pelvic floor is actually quite strong.
    ciuld my tight hip muscles be making prolapse worse? and if pelvic floor is already strong cant i even make the prolapse any better or am i stuck with stage 2?

    • Michelle Kenway Physiotherapist says

      Hi Jo
      Your hip shouldn’t impact on your pelvic floor however having said that we know that low back and pelvic pain both impact on the pelvic floor. You would need to clarify with of the hip pain is coming from hip or whether it’s related to your lower back or pelvis. If your problem is entirely hip related then it will be unlikely to make your prolapse worse.

      • hi.
        it actually does travel up my back and into my side. physio actually said he has not felt a psoas so tight in a long time.

        have been doing the bridge to try and engage my glutes.

  10. hi

    i have been diagnosed with a front wall prolapse stage 2. I am miffed as my physio says my pelvic floor is strong. what can i do?? im 33 and freaked out. i had 2 kids naturally but 6 and 4 yrs ago.


    • Michelle Kenway Physiotherapist says

      Hi Jo
      Yes it is disappointing when this is happened despite your strong pelvic floor. The doing the best thing possible in seeing a pelvic floor physio. She will guide you in how to maintain your pelvic floor strength and avoid potential risk factors in your life that may impact on your pelvic floor and prolapse long-term. Having a strong pelvic floor is actually a really good thing for standing you in good stead long-term.
      All the best with your long-term management

  11. Hi Michelle, thanks for your reply. Would pain caused by pelvic floor muscle tension be felt by the entrance to the vagina? the pain is low down. it does relieve the pain when I lie down

    • Michelle Kenway says

      Hi Theresa

      Musculoskeletal pain (conditions related to muscles/tissues) commonly ease with rest when the tension is taken off them. Pelvic floor muscle tension is a possible cause of pain near the entrance to the vagina. This really needs to be assessed by pelvic floor physio or gynaecologist to ascertain the real cause.


  12. Hi Michelle, thanks for the work you are doing – it is such a relief to find someone who can offer advise. I experienced a prolapse two years ago and went to two specialists who were not particularly bothered. They said it is very mild.. I experience pain on a daily basis, usually at the end of the day I have to lay down on my side to relieve it. It is a sort of burning pressure pain if that makes sense. Fine when I get up in the morning but as the day goes on it get worse. There is a pressure and bulge that I am very aware of and my vagina looks different with bits visible that were not previously visible. The gynae eventually gave me gabapentin (?) for pain relief and it did work but I dont want to be taking pain killers on a permanent basis so I stopped. He seemed really baffled as to why I am sore and he said that I must just be ‘unusually sensitive down there’ as according to him I should not be experiencing pain. What are your thoughts? I have seen a physio and she said I have a strong core. I do kegel exercises daily and walk a couple times a week, as well as some home based weight exercises (from your book). I want to prevent it getting worse and am sick of being made to feel like I am complaining about nothing. perhaps I should try a lady gynae?? Theresa

    • Michelle Kenway says

      Hi Theresa
      Thanks for your comment. Yes I understand your desire to get this sorted out and get off pain killers.

      Theresa burning pressure pain can have a variety of causes and not necessarily prolapse.

      One cause that often goes undiagnosed is pelvic floor muscle tension. Women with prolapse can have pelvic floor muscle spasm where the pelvic floor muscles are unable to relax. Did your Pelvic Floor Physio examine your pelvic floor muscles to assess possible painful trigger points and/or spasm? here is an article to read on pelvic floor tensionfor more information if you are interested.

      Keen to hear how you go if you have time.
      Best wishes

      The nerves in the pelvis can also cause burning pelvic pain too. Yes good idea to get a second opinion if you haven’t received a good explanation to date.

  13. Michele M. says

    I am so glad I stumbled upon your video & website. I am a little more than a week post op and I wondering what other exercises are safe to do that would not hinder or impede the healing process in my abdomen. Are there any safe arm, leg, back exercises that you can recommend to me?
    I greatly appreciate all of the information and resources that you provide during this difficult time of recovery.
    Michele M.

    • Michelle Kenway says

      Hi Michele
      After prolapse surgery, wait until you have seen your surgeon for your 6 week check up before commencing strength training. The first 6 weeks is really a time to rest, recover and prevent physical deterioration with walking, gentle deep abdominal activation exercise and some ladies are given approval form their surgeon to commence a graduated program of pelvic floor exercises from around 4 weeks post op.

      When you do have approval to recommence strength exercises they need to be pelvic floor safe while your healing continues for the first three months, and thereafter to avoid recurrent prolapse. You will find many pelvic floor safe strength exercises on this site and in my exercise books and DVD’s.

      Hope this helps, all the best for your recovery

  14. Hi Michelle I am embarrassed to also ask but will intercourse harm my body after having bladder rectal and hysterectomy. I am afraid during and it worries me and although he dosent say I can tell it’s a concern for my husband. I like having a sex life but I don’t want to harm my body either. Are there positions that are off limits?

    • Michelle Kenway says

      Hi Shannon
      Yes this is a commonly experienced concern for ladies after prolapse surgery so you are not alone. When you are given approval to return to penetrative intercourse the surgeon, your surgeon has established that you are sufficiently healed and injury is not likely (often after the 6 week check up but this can vary for some ladies).

      There are quite a number of things you and your husband can do for your sex life and I think this article link on sex after hysterectomy surgery applies to prolapse covers this comprehensively in terms of positions, comfort and reassurance.

      I would suggest that good lubrication with a natural (rather than petroleum based lubricant) and lying on your side with your back to your husband will help you to control the depth of penetration rather than traditional missionary position which can make you feel quite vulnerable to injury after prolapse surgery.

      Let me know if you have any questions.

      Kindest regards

  15. Dear Michelle,  there is a steep hill that is paved behind my work.  Climbing the makes anybody’s heart pump wildly, even the kids.   I used to climb the hill allot and got do I could do it without stopping.   I had prolapse surgery on December 3,  it’s now April and the snow is starting to melt.   Would it harm me pelvic floor or rectal surgery to start attempting the hill again?   I would have to work up to it as I haven’t done much since my surgery besides work.   My Dr asked that I continue not to lift as for the degree of repair she did and what she called my young age.  I’m 43.  She stitched both the front and back of my vagina to hold back my rectum and bladder and she took my uterus because it was prolapse too.   I was thinking of starting by walking the track behind my work as the snow disappears,  working up to climbing the paved steep hill again.   I like exercise to relieve stress but have refrained since the surgery.   I really like wii fit yoga but have refrained from it too.  Before my surgery people often told me I was the strongest girl they knew.  I’m still that girl I’m just unsure how to use my strength wisely. 
    Thank you

    • Michelle Kenway says

      Hi Shannon
      First and foremost are you doing regular pelvic floor exercises to support your repair? If your pelvic floor is strong and supportive you will be able to do more exercise.

      I am not sure if you are planning on pushing a pram up the hill – I would suggest you avoid this. Start with flat walking and gradually increase the distances you walk and the speed over time. The issue is not so much walking up the hill – rather it is stepping down heavily walking downhill which is more likely to impact upon your pelvic floor and repair.

      You will also find many basic strengthening exercises with videos and information on this site that can help you with basic pelvic floor safe strength exercises, let me know if you cannot find this information and I can assist you.

      Hope this helps you get started to rebuilding your strength Shannon

      Best wishes

  16. Hey , im 22 yrs old with no medical problem im a fitness freak and never had problem with my body recently i started doing skipping and after it i noticed i had pain in uterus ,is it muscles ? Or something else and also a little back pain of that uterus side.

    • Michelle Kenway says

      Hi Vatsala

      This abdominal discomfort could be one of a number of things – this needs to be checked out by your medical caregiver.

      All the best

  17. Hi Michelle,
    I had prolapse surgery about 17 weeks ago, I am 54years of age. I use to go to the gym and do a lot of running, but since my operation I have just started cycling and walking, this is my second op and quite afraid of it happening again. I have started cycling to work, it is slightly hilly and wonder if this will bother my second operation.

    Many thanks

    • Michelle Kenway says

      Hi Julie
      I would agree you do need to be really careful – we know that after one prolapse repair the risk of recurrent prolapse increases and after mare than one the risk increases further. Cycling using low gears and sitting in the seat on a slope where you don’t strain is the best option for pelvic floor protection. Heavy gears, standing riding out of the saddle and riding steep hills does increase pelvic floor pressure. If you can keep the hills to a minimum great as well as strengthen your pelvic floor and keep it in best possibloe shape long term are both important for you.

      This information on prolapse and cycling may help you too Julie

      Thanks for your question!
      All the best

  18. Hi Michelle,
    I am a 48yr old mum of 3. I have had a uterus prolapse since last June. I haven’t been to have it diagnosed as I don’t want any surgery. I was wondering if it is ok to climb hills and mountains with a prolapse as I don’t want it getting any worse. I can push the prolapse back into place but it gradually drops down again during the day.

    Many Thanks,

    • Michelle Kenway says

      Hi Maria

      Thanks for your message. It would be a good idea to get this diagnosed by your GP or a Pelvic Floor Physiotherapist so that you know what you are dealing with – this doesn’t mean that you need to have surgery, there are alternatives to surgery including pelvic floor exercises and support pessary which can be a great alternative to keep the prolapse supported and stop it dropping down during the day or when you go trekking. You can read more about support pessary here.

      As for mountain climbing and prolapse, best to avoid carrying a heavy pack when climbing with a prolapse. The pelvic floor will be loaded by any extra weight carried when trekking. How much trekking that can be done and the most appropriate slope will in part be determined by the strength of your pelvic floor and the severity of the prolapse. Steeper descents will be most likely to increase pressure due to the impact with stepping down (rather than climbing). Obviously the longer the trek, the greater the pressure on th pelvic floor.

      In summary with a prolapse best to avoid carrying a heavy back pack and steep mountain climbing in favour of less steep terrain, particulalry if the prolapse if moderate and the pelvic floor is weak.

      All the best

  19. Hi Michelle. I am a 32 yr old mother of 5 and have been diagnosed with a stage 2-3 uterine prolapse after my last baby. Thank you for your information. It has all been very helpful and gives me hope of staying active. I wondered if a 3 lb weighted hula hoop is OK… and also are the waist trimming exercise belts safe to wear with a prolapse? I know they push in on the stomach, but can this damage pelvic floor muscles, or is it OK? Also, in your experience how often does post partum prolapse repair itself, to what extent, and how long does it take? Thank you!

    • Michelle Kenway says

      Hi Elisa
      Thanks for your comment – I don’t see an issue with hoola hoop and prolapse. I have never seen a weighted hoola hoop that you describe so it is difficult to comment however I cannot forsee this straining the pelvic floor with the rotation of the pelvis. In my experience post partum prolapse does improve and this takes a number of months along with pelvic floor exercise and overall recovery. While you breast feed your pelvic floor strength and capacity will be reduced so take this into account with your overall recovery. Breast feed by all means of course, it’s just sometimes helpful to know that the pelvic floor can return to full strength when feeing ceases. This article on prolapse after childbirth may help you too.
      Best wishes

  20. Hi Michelle
    i am 34 and had my first baby 10 weeks ago a vaucum delivery and i have a csytocele. i was very active before and during my pregnancy heavy weight lifting running high impact exercise etc. I am wondering whether pilates and yoga are safe to do with prolaspe? i already do sun salutation yoga routine with down ward dog . are full press ups ok as am currently doing these .As regards weight training can i still lift heavy weights should i be seated are lunges ok with weights ? So sorry for all the questions am fairly shocked about having prolapse dont know how to get rid of it

    • Michelle Kenway says

      Hi Aisling
      Yes I think it is a shock to be diagnosed with a prolapse and most women feel this to some degree or another, especially after having a baby. It is important at this early stage of recovery from pregnancy and childbirth to give your pelvic floor time to recover and strengthen and many women find that this helps with their prolapse management and symptoms which often decrease markedly. In terms of postnatal prolapse management women need to consider: regular daily pelvic floor exercises (feeding is a great time), avoiding heavy lifting where possible, good bowel management and avoiding constipation and straining, appropriate rest (with fatigue the pelvic floor muscles become fatigues too especially towards the end of the day).

      Intense core abdominal exercises should be avoided with prolapse especially in the postnatal period. Remember these exercises are often performed in Pilates classes (eg tabletop &variations, The Hundred) and some Yoga classes (eg Plank/hover). So the focus should be upon gentle deep core muscle activation and training, definitely not intense core as this may have potential to compromise an already weakened pelvic floor. Weight training should be light, you will find many vidoes and articles for pelvic floor safe strength training on this site and many exercises and techniques in Inside Out strength training DVD. Lunges are usually ok for women postnatally who don’t have issues with their pelvic stability or SIJ dysfunction/pubic symphysis problems. I tend to start with modified squats you can watch in this how to squat video and then progress for safety. Yes sitting is far more preferable to standing upper body, especially seated on a fit ball.

      Let me know if you have any further questions Aisling
      Take care

  21. Aloha Michelle, thank you so much for all the information. At 29 I had all organs prolapse after a vaginal birth. After three surgeries, I ended up with a hysterectomy, bladder sling and full repair. Surgery was successful. Now at 43, I prolapsed again. Bummer. I am a surfer, is going to make it worse? I am also a interior designer so I sit at a computer alot. What is the best way to sit for long hours? And finally, I love to be intimate with my husband. I worry at times that can weaken the vaginal walls. Can it? Thank you for your advise. Mahalo, Jennifer

    • Michelle Kenway says

      Aloha Jennifer
      Great questions – I have often wondered about the impact of surfing on the pelvic floor with many family members being surfers (I am not quite so courageous as you!). Do you notice any symptoms with surfing? I think that on the whole it is a great low impact exercise, probably take care as you pull your feet quickly through to standing as I see some surfers do this almost in on movement and jump into standing. If your upper body is already really strong I would think that there is not too much strain with paddling, would you agree?

      As far as posture goes, the best sitting posture for pelvic floor support is to sit with the inward curve of the lower back maintained and to avoid slumping. This will involve a good ergonomic set up so that you don’t slump forwards over your keyboard. Sometimes a small towel roll or D shaped lumbar support pillow can assist with maintaining the lower back curve. Studies have shown that pelvic floor activity is promoted sitting away from the back of the chair, so it could be useful to spend some time during your working hours on an exercise ball or sitting forwards interspersed with resting your spine and using back support. You can read some more posture information here.

      Finally as far as intimate activity goes, this is usually not a problem in terms of worsening prolapse – with prolapse the pelvic tissues fall down, quite the opposite to what happens during intimacy. Once again you can read some more information on sex and prolapse.

      Hope this helps you along
      Best wishes

  22. Hi Michelle,
    I have had three vaginal births (second baby delivered with vacuum). My prolapse (cystocele and mild rectocele) was diagnosed after my second baby with a “middle of the road” by my ob/gyn. He said that the diagnosis is variable because I am breastfeeding. I was fitted wih a ring pessary between baby two and three, and continued exercising (boot camp, running, weights). I am still wearing the pessary and love the freedom it gives me to continue to remain active. However, I want to be more realistic as to maintaining a fit lifestyle that is conducive to supporting my prolapse. I am now six months postpartum and am just starting to get back to more regular exercise. Before children I would lift heavy weights (figure competition). I would love to get back to the definition I once had in my arms, back and legs. Is it possible to build a defined physique without compromising my pelvic floor? Can I still lift heavy weights? I’m reading contradicting information about weight-bearing exercises and pelvic floor health. Thanks :) Debbie

    • Michelle Kenway says

      Hi Debbie

      Yes I do think it’s possible to train definition without compromising the pelvic floor but it means being clever about how you train. You need to know and apply the safe strength training principles outlined in this article. As far as heavy lifting goes, upright heavy lifting will not help your prolapse so the idea is to use antigravity positions and those that place less pressure on your pelvic floor for example instead of standing triceps do them seated or better still triceps extensions lying on your back. Another big one is weighted deep wide leg squats which can overload the pelvic floor, much better to do weighted lunges or modified ball wall squats. It is difficult to outline this in a short comment as this is the topic of Inside Out book & DVD but I hope it gives you the general idea.

      Best of luck

  23. Diana Walker says

    I am a 58 year old who is just recovering from a rectal prolapse repair.(5 weeks ago) I have been doing a Pole fitness class for the last 2 years and have felt that this is good for the Pelvic Floor muscles. Do you think that this form of exercise is Ok and when do you think I could start again.

    • Michelle Kenway says

      Hi Diana
      Thanks for your comment. Pole fitness is very intense core abdominal work – double leg raises against gravity, raising the trunk against gravity and sustained holds. I would think that if the pelvic floor muscles are weak or not functioning well, this would be risky for someone with pelvic floor dysfunction especially post-op. Perhaps in women with strong well functioning pelvic floor muscles this type of exercise may even strengten the pelvic floor but not in women with pelvic floor problems. Gee I wish I could say otherwise – best thing to do is check with a pelvic floor physio regarding the strength and capacity of your pelvic floor to withstand such intense pressure. Remember that having had a repair the pelvic floor is already at increased risk of prolapse. Wish I could tell you better news Diana
      Best of luck

  24. Is it safe to use Leslie Sansome’s ‘Walk Slim’ or ‘Walk Away the Pounds’ programs when you have pelvic prolapse?  These exercises involve walking in place, side steps, kicks and knee lifts.   ‘Walk Away the Pounds’ also uses 2 lb. weights for part of the program.  Also,  can one walk for 2-3 miles using a medium pace (not too vigorous)?
    Thank you.

    • Hi Johanna

      Thanks for your great question. I haven’t seen these programs, I have just looked taken a quick look at the site but cannot see a full exercise list so I will have to keep my comments general to walking and the exercises you have described.

      • Walking is an ideal low impact exercise for women seeking to minimise pressure on the pelvic floor. The key to low impact exercise is that at least one foot stays in contact with the ground at all times so this may help you assess some of the exercises in the program for their suitability.
      • Side steps are usually ok, jus avoid wide side step squatting action which is potentially more compromising
      • Kicks with one foot on the ground are again low impact.

      There is no benefit for women walking with hand weights. This doesn’t burn any extra calories or increase bone density and in fact increases the load ultimately carried by the pelvic floor. We do know that overweight and obesity are well established risk factors for prolapse. Body weight and weight carried are transferred to the pelvic floor so really there is no added benefit from carrying weights during walking and it may in fact increase the load on the pelvic floor.
      Walking tips

      • Support briefs or supportive exercise tights can help some women with prolapse to walk and minimise prolapse symptoms
      • Walk at the start of the day when you and your pelvic floor are not fatigued
      • Walk on flat surfaces
      • Wear well cushioned footwear when walking to help reduce impact

      Enjoy your walking Johanna and best of luck

  25. Hi,
    I'm 62 years old, have had two children naturally when I was 32 and 36, teach yoga and for the past few years have been working hard at contracting my abs (core work, yoga poses using mula bandha (root lock) and uddiyana bandha (belly lock).  Just the other day, I felt a bulge when wiping after urination and realized my uterus has prolapsed.  Not a good thing.  I can engage manually push it up with my finger and engage pelvic floor muscles to keep it "up" but it slips down between those.  And, worse yet, I run on hard surfaces regularly (have done 6 marathons in the past 10 years) and just recently took a boot-camp style fitness class that involved jumping rope, weight lifting and strong core plank type work.  So, now I have to figure out how to "back off" and prevent worsening and heaven forbid, surgery.  I thank you for your webpage and the information on what exercises are good and which ones are not good.  What about rebounding?  One article on the web said it helped with bladder prolapse.  Or is it contraindicated also.  I was going to purchase a Gyneflex device to use for Kegels exercises, but it looks like the Whole Woman webpage feels this is a useless device for uterine prolapse.  I look forward to hearing from you.  thanks again.

    • Hi Eileen

      Thank you for your comment/question. The risk factors for prolapse that immediately stand out from your story are:
      – High impact exercise (marathons and boot-camp jumping)
      – Intense core abdominal exercises
      – Weightlifting (I am not sure of the details from your comment however also a potential risk for prolapse)
      – Post menopause
      – Previous vaginal deliveries.

      Rebounding this will not help bladder prolapse at all, in fact the opposite is possible. The rebounder, while lower in impact than road running without doubt, will still create downward force on an existing prolapse.

      Spring loaded kegel exercise devices do not train the lift and squeeze action that is so vital for correct pelvic floor exercise technique. Rather these simply train a squeeze action which does not fully train the required pelvic floor action for prolapse support.

      If you suspect you may have a prolapse the steps to take are:
      1. Confirm the diagnosis and severity with your doctor
      2. Discuss the possibility of seeing a gynaecologist to assess your suitability for a pessary for prolapse support
      3. Commence daily kegel exercises
      4. Modify existing high impact exercises to low impact exercise, cease unsafe core exercises, modify unsuitable yoga exercises, address and modify running for prolapse.

      I hope this gives you somewhere to start and please feel welcome to comment further.

    • I just wondered if you have heard of the Whole Woman website? I had a hysterectomy in 2000 due to uterine prolapse. I did not know at the time that NOT having surgery was an option. I now am dealing with a rectocele and have refused surgery for the prolapse. I have found a lot of good information and many women suffering from prolapse!! I would rather deal with this prolapse than with the risks of surgery! Also, I do feel it was initially brought on from rebounding. I started rebound due to thyroid nodules and i did not have the bulge before that. I was rebound pretty good for long periods of time. I gave it up but was wondering if I could do very light rebounding by just lightly bouncing back and forth and not have my feet leave the rebounder? Thanks :)

      • Michelle Kenway says

        Hi Lori

        Rebounding needs to be kept very low impact with prolapse issues and yes with one foot remaining in contact with the rebounder at all times if you do choose to do it. If you notice prolapse symptoms then cease this exercise in favor of walking.

        All the best