Prolapse and Running Physio Guide to Avoid Prolapse Worsening

Prolapse and running Physiotherapist information teaches you how to run with a prolapse and reduce the risk of prolapse worsening.

This video guides you through:

  • 7 prolapse and running tips to reduce the risk of prolapse worsening
  • How to improve your prolapse support for running

Read on below to learn about running and 7 ways to avoid prolapse worsening

  • Prolapse and pelvic floor support
  • Running and prolapse
  • Prolapse and running tips to reduce prolapse worsening
  • Who’s most at risk with prolapse and running
  • Does prolapse get worse with running
  • How to improve your pelvic floor support for running with prolapse
Download Prolapse and Running PDF by scrolling down an

Prolapse Exercises eBook

The international best selling prolapse exercise guide for women with prolapse and after prolapse surgery

Prolapse Exercises e-book download

Prolapse Exercises eBook

Prolapse Exercises eBook teaches you how to:

  • Limit prolapse worsening
  • Reduce risk of prolapse after surgery
  • Strengthen prolapse supports
  • Exercise safely (resistance and cardio)
  • Lose weight and manage weight effectively

7 Ways to Improve Prolapse and Running

This running and prolapse information recognizes that some female runners want to run despite having a prolapse. 

This Physiotherapist information aims to lessen the impact of running on the pelvic floor and reduce the risk of worsening prolapse and running .

How to reduce pelvic floor and prolapse impact with running:

Prolapse running

1. Reduce running speed

Increased running speed requires more pelvic floor activation. 2 Therefore reducing running speed may lesson the impact of running on the pelvic floor particularly when the pelvic floor muscles aren’t working well (i.e. with prolapse).

2. Alternate running surfaces

Avoid constant running on hard surfaces such as roads and concrete pavements. Try to mix up running sessions to include softer running surfaces such as grass, gravel and sand.
Water running is an excellent form of low impact running.

3. Avoid downhill running

Running on flat surfaces reduces the physical impact when compared with running downhill. Downhill running increases impact and jarring on the pelvic floor.

4. Limit running distance

The longer the running distance, the more repeated the impact upon the pelvic floor. Try to avoid running long distances particularly on a regular basis.

5. Reduce stride length

Shorter stride length may help to reduce some of the physical impact associated with running. This may allow your heel to strike the ground less forcefully than with a long stride.

6. Mix up workouts

Alternate running workouts with other low impact forms of fitness exercises. These include cross trainer and elliptical machines, cycling and spin classes.

7. Manage your body weight

The more body weight you carry, the more you load the pelvic floor when you run. Pelvic floor strain is more likely in obese and overweight women with running, just as lower limb strain is more prevalent among overweight runners.

Running when overweight can increase the risk of prolapse worsening. This can result from the increased load abdominal and upper body weight places on the pelvic floor with impact.

8. Avoid running when fatigued or unwell

Pelvic floor muscles don’t work as well when the body is tired. Pelvic floor muscles and supports work most effectively when the body is well rested.

Who is Most at Risk With Prolapse and Running?

The risk of prolapse problems with running is increased with factors that weaken your pelvic floor OR increase the load.

1. Factors that increase the load of running:

  • Long distance running
  • Running speed 1
  • Road running
  • Running when overweight
  • Running with weights

2. Factors that weaken your pelvic floor:

  • Having a prolapse
  • Previous pelvic surgery including prolapse and/or hysterectomy
  • Weak pelvic floor muscles
  • Recent childbirth
  • Previous vaginal delivery
  • Previous traumatic vaginal delivery (forceps delivery, breech birth)
  • Multiparity (multiple births)
  • Menopause and beyond
  • Obesity and overweight
  • Chronic constipation and straining
  • Chronic coughing
  • Family history of prolapse

Unfortunately women with prolapse have accompanying pelvic floor muscle and tissue dysfunction.3

Does Prolapse Get Worse With Running?

Running with a prolapse can weaken pelvic floor muscles and tissues potentially making prolapse worse.

The degree to which running impacts upon your prolapse may be influenced by:

  • Your pelvic floor strength and how well it’s working
  • Your body weight
  • How far you run
  • How fast you run
  • Running surfaces
  • Recovery time between your runs

If you have a prolapse your pelvic floor already has some level of dysfunction.

The combination of repeated downward pelvic pressure and a lack of pelvic floor support can contribute to prolapse worsening.

Running and Prolapse

Running is a high impact exercise.

Pelvic Floor Descent

When you run or jog, every time your heel strikes the ground a force is transferred to your pelvic floor. Normally the pelvic floor activates with a reflex contraction after the heel strikes the ground when running.1

If your pelvic floor isn’t working well, the landing impact can force your pelvic floor and your prolapse to move downwards (shown right).

This is why some women feel prolapse symptoms such as bulging and heaviness associated with running. When the force is repeated or large for example long distance running or if you’re overweight respectively, there is a greater potential for pelvic floor strain.

When strain is placed upon the pelvic floor, the pelvic floor muscles and tissues stretch and weaken especially if the pelvic floor lacks the strength to withstand this strain.

Currently there is little research into running and prolapse however studies show that women who perform high impact exercises more commonly experience pelvic floor problems such as bladder leakage compared with women who keep their exercises low impact.2

 Prolapse and Pelvic Floor Support

Prolapse and running

Pelvic prolapse results from poor pelvic organ support.

Lack of pelvic organ support is caused by weakness in the pelvic floor muscles and connective tissues. When the pelvic floor muscles and tissues weaken, they can’t support the pelvic organs (including the bladder, uterus and rectum).

This lack of support contributes to pelvic prolapse when the pelvic organs protrude into the vagina or from the rectum.

How to Improve Your Pelvic Floor Support for Running

Regular Pelvic Floor Exercises

Regular daily pelvic floor exercises will optimize the condition of pelvic floor support in order to withstand the pressure associated with a variety of fitness exercises.

A strong well supported pelvic floor will better withstand the pressure and impact associated with running when compared with a weak dysfunctional pelvic floor. Commitment to regular ongoing pelvic exercises is an essential to ensuring and optimizing long-term pelvic floor support.

Use a Vaginal Pessary

A vaginal pessary is a discreet pelvic floor support device that sits within the vagina and supports prolapsed vaginal tissues. A vaginal pessary is a useful device for women who want to continue running despite having a prolapse.

A well fitting pessary device can reduce prolapse and running symptoms and allow a woman with pelvic floor dysfunction to continue her regular exercise routine. Gynaecologists are usually trained to fit vaginal pessary devices for prolapse support and management and it can be worth discussing your suitability for a pessary.

Ensure Postnatal Recovery Before Running

Before recommencing running, ensure that your pelvic floor is well recovered from pregnancy and childbirth.

Strengthening for weak muscles can take 5-6 months. Pelvic floor muscles don’t function as well during breastfeeding owing to the lower levels of circulating oestrogen. Take this factor into account when planning your return to running after childbirth.

PDF  Download Prolapse and running article as a user friendly PDF


1 Leitner M, Moser H, Eichelberger P, Kuhn A, Radlinger L (2017).Evaluation of pelvic floor muscle activity during running in continent and incontinent women: An exploratory study.Neurourol Urodyn, 36(6) pps 1570-1576.

2 Fozzatti C, Riccetto C, Herrmann V, Brancalion M, Raimondi M, Nascif C, Marques L, Palma P.(2012) Prevalence study of stress urinary incontinence in women who perform high-impact exercises. IntUrogynecol J,23(12), pps 1687-1691.

3 Delancey, J (2016) What’s new in the functional anatomy of pelvic organ prolapse? Curr Opin Obstet Gynecol.29 (5), pps 420-429.

We Welcome Your Comments


  1. Hi, I am 39 yo, with three children. 2 csections and 1 vaginal (VBAC2). After my third birth, I started to feel a vaginal pressure that was very uncomfortable if I stood for a while. After about a 9 months, my doc confirmed cervical prolapse and I had a hysterectomy. It’s been 6 years since the surgery and I have been running very regularly over the past few years. Although recently I feel that same pressure again in my bowel area, and been dealing with a lot of leg swelling. I feel the pressure in my vaginal area too again after sex. I’m not sure what’s going on but my gut feels heavy and by the time the day is through my legs are really uncomfortable. I am wondering if there is prolapse again and the pressure is stunting circulation-but I can’t find anything on this. Would love your thoughts.

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Andrea
      Some of your symptoms do sound potentially prolapse-related but not so much the swelling. This really needs to be assessed by your Gynaecologist so that you know what you’re dealing with and the best way forward.

  2. Hi Michelle,

    Thank you for your website , it is very helpful.

    I am 33 and had anterior and posterior repair last year. Before children I was a 200m/400m runner and before that a netballer / triple jumper which I had to stop after a horrific knee injury/ surgery when I when I was 19 caused from netball .
    So far everything is going well recovery wise. I got the surgery as I was told that it will enable me to run again however, after doing some reading I am a little concerned that I will be unable to sprint again due to risk of prolapse re-occurrence. I have not done any running since surgery and have done all prolapse safe fit ball work to date . My question is have you have anyone being able to return to sprinting again ? I am feeling a little deflated to be honest as the reason I went for the surgery was to be able to feel “normal ” again and run with kids etc .

    Look forward to your thoughts


    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Nicole

      Yes I completely understand, being active and then trying to deal with protecting your pelvic floor is challenging. The problem is that being so young, your prolapse has to last a long long time. Unfortunately many women believe that surgery fixes the prolapse and that they can go back to previous high impact activities. The risk of repeat prolapse is very real after surgery with high impact activity, just refer to the previous comment (lady who has returned to running after surgery and the outcome). You can still exercise vigorously however it needs to be doing to appropriate low impact activities – you might like to take a look at this exercise video I recently posted on YouTube for some inspiration and I hope this helps a little in your decision making best wishes

  3. I just want to thank you for making all this information available to us.
    I am 64 and have had 4 children.
    9 months ago I took up running to train for a charity 5km. never having run before. I loved it and completed the challenge and made friends at the same time.
    Soon after that I realised I had a prolapse and wasn’t sure what to do about it.
    I bought your dvd and am enjoying it. Don’t think I’ll run again but am still doing 5k brisk walking with an understanding friend.
    Best wishes

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Mary
      Thank you for taking the time to comment. It’s such a shame that running can have this type of impact on the pelvic floor isn’t it. It’s great to read that you’re brisk walking with a friend – physical and social along with your strength exercises you’ve got your bases covered. All the best for your health and well being

  4. Hi Michelle
    Thanks much for your advice am from Kenya Please can you send the book to me. Thanks

  5. Hi Michelle
    Am 32 years with four children when I got my fourth child I got vaginal prolapse I don’t know which exercise I can do I can’t run because I have a plate on my right leg at the ankle, am still breastfeeding I also don’t enjoy sex this days. How can I get your book for prolapse exercise? Please help

    • Michelle Kenway says

      Hi Rachel

      So you have 4 kids, breastfeeding, tired, vaginal prolapse, carrying added previous injury which probably makes your ankle swell up when you’ve been standing too long and you think you should be enjoying sex? I am hearing you and I think many other women will too!

      Have you thought about getting a stationary cycle that you could use at home for exercise, protect your pelvic floor and allow you to exercise without leaving the house and having to move all the kids or arrange for care? There are plenty available second hand.

      Prolapse Exercises book is available worldwide – we send daily Air Mail to US, Canada, Europe, Asia and of course locally in Australia.

      Thanks for sharing your story & thoughts Rachel – helps many other women in similar situations to yours too.

      Best wishes

  6. I’ve just read all of these posts, sometimes nodding with vehement recognition, othertimes welling up. I had my babies vaginally yonks ago (13 year). I started running 7 years ago and initially had no problems with incontinence, despite a family weakness. I run ultra marathons and also do triathlons. But about 4 years ago the problem started to emerge, often a lot worse on the week before my period, often worse later in the day, somewhat linked to coffee. I’ve been round the NHS route and been offered a TVT which I declined as the potential complications sounded horrendous. The senior physio I managed to finally see wants me to give up running in favour of pilates and I think I’m about ready to take that decision.
    I’m 42 and would welcome any ideas and suggestion you have,

    • Michelle Kenway says

      Hi Maria
      Agreed it’s awful that women are forced into these decisions about running because of usually unexpected pelvic floor problems. Especially someone such as you who obviously relishes the challenges of distance running.

      During the week before your period your oesterogen declines as you probably know, so that your pelvic floor muscles are less effective for support and control – so this suggests some issue with your pelvic floor muscles which may worsen with menopause when the hormones decrease for good. Aside from pelvic floor exercises there are devices for women that help them manage beladder issues with running – these include the Incostress (like a silicone tampon available in the UK) and Contiform ring (contact me for more details if you need them). Both devices are slightly different to each other, both work to support the urethra to address stress urinary incontinence and I have seen both work with varying efficacy for different women with the same issues as yours.

      My other suggestion is that you perhaps consider cycling which is an excellent form of cardiovascular exercise, low impact and kind to your pelvic floor. Pilates can actually have an adverse effect on the pelvic floor if the core exercises are too intense and overwhelm the pelvic floor which they often do in Pilates class situations, you may like to read more about Pilates and pelvic floor issues here.

      Alot here to consider, I hope this gives you some options to help you stay active and well Maria.

      Best wishes

  7. Hi Michelle
    I have found this site so useful. I feel completely devestated that yesterday after training for 5 months for my first half marathon, I went out after lunch to do 7 miles, about 3 miles in things felt a bit strange and I felt lile I need the loo (not to wee!). I had to walk the last mile home as felt so uncomfortable. When I showered at home things didn’t feel right so I took a peak and nearly had a heart attack as it was all swollen and I was sure I had suffered a prolapse. I got an emergency gp appointment who wants me to go back on friday to ‘GRADE’ it. I am 2 weeks away from my run and have another scheduled for May. I have been running for years and has been my saviour through a hectic life caring for 2 children and keeping low moods at bay. I am so upset. Do you think I could still do the run? (Things look and feel a lot more settled today). Will I have to give up running? I don’t think I could bare that. Thank you.

    • Michelle Kenway says

      Hi Helene
      Thank you for contacting me – yes I hear exactly what you are saying and I feel for you. When you are an avid runner, I don’t think that others can really comprehend what it means to have your ability to run (& cope with life’s stressors) threatened.

      Whether or not you can run in the future will depend on the severity of your prolapse and your pelvic floor support. It may be possible to organise to have a pessary fitted to help you to stay active and this may or may not include running. It is worth mentioning that some women undergo prolapse surgery in the mistaken belief that this will allow them to run again – nothing can be further from the truth since after prolapse surgery the risk of repeat prolapse is actually increased. Most women who have prolapse have some kind of deficit in their pelvic floor which has allowed this to happen. Then with repeated high impact exercise like running, the passive supports weaken and prolapse occurs. Having a repair fixes the passive supports but not the active ones (the pelvic floor muscles).

      So I suggest that you speak to a gynaecologist, undertake pelvic floor rehab., discuss the possibility of using a pessary with your gynae as well as modifying your exercise program to include pelvic floor safe exercises too.

      I hope this gives you some direction Helene
      All the best

  8. Juaune Thompson says

    About an hour ago, I tried to insert a Tampon. It didn’t go in all the way so I assumed I had forgotten to take one out. Well after “searching” I realized its NOT a tampon, it feels more like a soft ball. Maybe my cervix. Anyway, I’m freaking out because I have my first marathon on Sunday. I can’t miss it. I’m supposed to run 4 miles tomorrow and now I don’t know what to do. I’m going to the Dr tomorrow to know what’s really going on. But I know something isn’t right in there. I’m only 35 and I had my twins 10 yrs ago. Why is this happening now? Is this going to prevent me from running my race? I’m not in any pain or discomfort. It’s just something is lower than its supposed to be.

    • Michelle Kenway says

      Hi Juaune
      Thank you for your question. With a uterine prolapse it does become difficult to insert or retain a tampon in place and this is how some women notice their prolapse. Obviously your doctor will assess and diagnose accordingly. If it is diagnosed as a prolapse, long-distance running is a form of exercise you will need to assess as we know that high impact activities like running contribute to pelvic floor dysfunction in women. It may well be that if you have been doing alot of running training, your pelvic floor supports have weakened. Uterine prolapse can happen at any time in a woman’s life from after childbirth through to menopause and beyond.

      All the best

  9. Hi Michelle 3 months ago had prolapse/posterior repair need your advice on strength/toning exercise,running I feel is to risky walking doing at the moment,swimming/biking which would you suggest for overall results.
    Cheers Vicki

    • Michelle Kenway says

      Hi Vicky

      Thank you for your good question, I think you spot on to suspect that running is risky after prolapse surgery. It is concerning that women aren’t warned about the possible risks associated with high impact exercises like running after prolapse surgery in particular.

      Low impact exercises like walking and cycling are indeed the most appropriate exercises for women who have had prolapse surgery. High low interval exercise with cycling is a great combination for women who are accustomed to higher intensity exercise, seeking weight management and the natural high that goes along with running.

      Research tells us that high impact exercise increases the load on the pelvic floor. Women with a weak pelvic floor are at increased risk of pelvic floor problems like prolapse with high impact exercises. After prolapse surgery the risk to the pelvic floor is increased further and the risk of repeat prolapse increases. This places your pelvic floor at increased risk, regardless of how strong your pelvic floor is.

      The other issue is that women with prolapse are known to have pelvic floor dysfunction. So put the combination of weak pelvic floor, prolapse surgery and high impact exercises together and you’ve got the trifecta – a combination very likely to contribute to repeat prolapse.

      I hope this helps your understanding Vicki, let me know if there is anything further I can answer for you.

      Best wishes

  10. Hi Michelle,

    I am 48 and live in the UK. I have had 5 vaginal births and have been told by my doctor that I have a ‘very mild’ prolapse of my bladder. I run on road and off road about 4 times per week and am training for my third marathon. I took up running 4 years ago to lose weight and help combat recurring severe bouts of depression. It worked! I’m toned, fit and have never felt better mentally. However, I am sick of peeing myself on my long runs. I’m fine coughing, sneezing and bending all the time but find the leaking of urine during runs is getting worse. Sometimes, on a long run I have to change my pad as I have totally drenched it.

    My doctor has sent me for physio to make sure I am doing my pelvic floor exercises correctly. The physio has discharged me after 4 sessions as she said there is nothing more she can teach me as I am already doing them correctly and more regularly than the usual patients she sees.

    I am also pretty sure that I’m pre-menopausal as my periods are so erratic and random.

    Please don’t tell me to give up running as it has saved me and I can’t imagine what I would do without it.

    The doctor is now suggesting a ring pessary. Do you think it will help? Can I still do my pelvic floor exercises whilst wearing it? Can I run with it in?


    • Michelle Kenway says

      Hi Sarah
      Thanks so much for your comment – you state exactly what many women feel worldwide – frustration at not being able to run as you would like to because of your pelvic floor. No I won’t say stop running that’s not what you’re after.

      Yes there are other options for women to help them run without leakage:
      – Support pessaries are manly designed for prolapse management and a standard pessary won’t stop the bladder leakage. There are some pessaries available for women with prolapse and bladder leakage that have a small support for the urethra so you may like to follow up this option if considering a pessary
      – Incostress is a product readily available specically for stress urinary incontinence that is like a silicone tampon inserted into the vagina to support the urethra and can be reused and is readily fitted, I hear varying reports regarding its efficacy
      – Contiform is another product designed for stress urinary incontinence that is a circular ring with a support for the urethra, also inserted into the vagina and readily reused, again varying reports on efficacy
      – Some women choose to test out a super tampon to see if these urethral supports will help, the tampon is positioned not as high as usual as it will have no effect at all if this occurs, more like about 75%. If the tampon reduces the leakage then one of the devices mentioned may also assist. It may be worth trying out, but do this only as a test not as a regular practice.

      Best of luck, always keen to hear feedback Sarah!

  11. Hello Michelle

    Thank you for creating this site and allowing us to ask you questions. I have had a mild rectocele for about 2 years. I have had one vaginal birth but kept up crossfit throughout pregnancy as well as running. Thus, I did some damage. I don’t want surgery but as a former pro triathlete, I am really struggling with the reduced intensity of my exercise. I continue to swim a lot. I can bike but I live on an island now and there are very few places to ride. I love running but know of the issues associated with it.

    I am completely bored. I have a few questions. Is there any sort of weight training I can do? I have a lot of body weight stuff I do but it is not doing it for me. I run a bit but not much. q2) Is soft sand the best surface in which to run? (as safe as one can be running with a prolapse?), q3), what can I do?

    I have been very depressed about this for years and it has changed who I am. I can no longer push anything without fear of making it worse. I appreciate any ideas you may have.

    Thank you

    • Michelle Kenway says

      Hi Kristina
      I understand what you are saying and your furstration with wanting do the intense exercise but fearful of worsening your prolapse. First and foremost pelvic floor exercises, have you considered trialling a suport pessary to help you exercise? These can sometimes be difficult to fit correctly but often well worth a trial in young active women. As far as weight training goes there are plenty of options – upper body, legs, back, arms there is no limit to areas you can strengthen but this needs to be done in a pelvic floor safe manner – you can read more on pelvic floor safe strength training here as well as my Inside Out strength training DVD which explains the exercises and techniques for pelvic floor safe strength training.

      As far as running goes, the issue is with impact. The impact of landing forces the pelvic floor down (a bit like jumping on a trampoline). There are no studies to my knowledge on prolapse and running impact on sand however I would think that on soft sand much of the landing force would be absorbed by the quads and that the landing force would be less thn when compared with road running, would you agree from your running experience?

      I do think it is possible to exercise intensely with mild rectocoele, it is a matter of understanding pelvic floor safe exercise. Have you ever considered rowing/kayaking? Just a thought based on your background. There is no reason why you can’t forseeably do a program of spin, swim squad, occasional run if that’s what you choose to do, paddle and weights.

      Does this give you somewhere to start?

    • Kristina, my heart goes out to you. Bladder weakness is the pits. I’m just facing up to life as a former ultra runner after years of spoiled long run days, pads, soreness, repeated thrush episodes and sex just falling of my radar. I feel so sad at the thought of no more long days in the hills but the balancing thought is that its just been so thoroughly spoiled by all the other aspects of managing leaking urine. Good luck with your journey and hope you find a way to get real satisfaction from exercising again.

  12. Hi Michelle,

    I am a 32 year old mother of 2. I have had 2 vaginal births. I have a prolapse which causes me problems everyday, but even more so during excercise. I usually excercie and use tena lady pads, which isn’t normally much of a problem, but it’s not ideal. The problem is, I have entered the marathon for next year in April, but can’t seem to run at all without leaking urine. I have used the tena lady pads, but they are so uncomfortable and I’m worried about having to stop too much and also worried about drinking too much. Do you have any advice? I’m worried this problem is also going to get worse and not better during training. Please do you have any advice

    • Michelle Kenway says

      Hi Zoe
      Yes this is a common problem and there a a number of solutions for women like yourself seeking to run long distances and requiring alternatives to pads to manage bladder leakage. First and foremost I think yu recognise the improtance of not with holding water intake when running – good hydration before, during and after a marathon is essential. The pads become wet during long distance running, they can start to flood and the skin rubbing against the wet pad will irritate the skin and potentially cause discomfort.

      There are some devices available to assist women to exercise and prevent bladder leakage – they work by supporting the urethra (urine tube) since leakage often occurs when the urethra moves downwards as the heel strikes the ground when running. One device is called Contiform – it is a flexible ring device and comes in 3 sizes, is inserted into the vagina and supports the urethra (urine tube), women need to start with the New User Pack to get the right size. Another alternative is Incostress which is like a large silicone tampon which also supports the urethra. Some women choose to trial the use of a large tampon to assess the potential effectiveness of these devices since a tampon will also support the urethra to a degree – it shoudn’t be placed as high as a tampon would usually be placed – I would not recommend using this option all the time, just as a trial to see whether leakage is reduced using a urethral support as there is alwyas the potential for toxic shock with prolonged tampon use.

      I can’t emphasise enough the importance of pelvic floor exercises in women who run – to allow them to keep running by ensuring the pelvic floor muscles are strong and supportive.

      Best of luck Zoe

  13. Hi Michelle, I am a 43 year old mother of 2 children and 4 and a half weeks ago I had a colporrhaphy and perineorrhaphy to correct a rectocele. My symptoms weren’t too bad, but I decided to go ahead with surgery as my bowel felt uncomfortable in the evenings, the prolapse would come down when I was running (which was awful) and I felt very unsexy. I am hoping to be almost as good as new at the end of the recovery period; right now I still have pain and now have an unpleasant pressure in my bowel from mid morning til bedtime.

    I have my post op consultation in several weeks with the gynaecologist who did my surgery. I have just ordered your book and DVD.

    Now that I am regaining my energy, I would like to start exercising again soon, as I get quite down when I don’t exercise. I absolutely love running, I have run all my adult life and have been competing in half marathons and road races for the past several years. It is the easiest form of exercise to do, with limited time, and I prefer to exercise outside. In addition, running is the only thing that helps alleviate my chronic back pain (I’ve tried everything, walking makes it worse). I don’t want to have another prolapse, so if I have to give up running I will, but I’m keen to hear whether you think that will be necessary, if so, what you think I could replace it with. I guess swim or cycle training (perhaps a swim squad or spin classes) are the only options, in terms of getting my heart rate up, on a regular basis?

    Would be grateful to hear your thoughts.

    Kind regards

    • Michelle Kenway says

      Hi Katherine
      Yes running after prolapse surgery has to be one of the big questions – I understand your desire to run and love of running. Basically it comes down to whether your pelvic floor can withstand the repeated high impact of running. Unfortunately one prolapse repair increaes the risk of recurrent prolapse even without the added risk of running on top of this. My advice is to see a pelvic Floor Physio regarding a pelvic floor assessment but really to keep your exercise low impact long term. All too often I have seen women with recurrent prolapse as a result of returning to heavy lifting or high impact. The high impact places stretch and starin on the pelvic floor over time, so it is often a gradual process. Bowel management is also vital for managing rectoceole as you probably are well aware.You may like to read this article on prolapse and running

      As a rule I advise women prost prolapse surgery to avoid high impact exercise and choose low impact exercises, yes spinning is great, stay seated in the saddle – avoid standing, spin fast and avoid the heavy climbing, high gear out of the saddle work. You may also be interested in LifeSprints – absolutely fantastic 20 minute workout, you can read further using this link. Fast seated spinning is ideal. Swimming is also a great low impact form of exercise.

      Best of luck, hope this helps and let me know if you need anything further

      • Katherine Slaney says

        Hi Michelle,

        Thanks for your reply. I must admit, I’m a bit depressed about it all. I don’t exercise to lose weight (my body mass index is 19 so i’m not too worried about my weight) – I just love training for events and being outside! I’ve tried power walking but find it very boring and I don’t feel like it’s doing anything. It’s difficult to go cycling outside on a daily basis (I live in Wellington, NZ where it’s very windy and very hilly!) but I guess I’ll have to try.

        Many thanks,

  14. Thank you for responding, Michelle. I’m so glad I can do “something” again!
    Rebounding on a mini tramp is putting G force on the body thereby every bounce causes a gentle squeeze of every cell in the body. The cells are literally juiced of toxins! The immune system is stimulated this way as well as the lymph system resulting in faster healing. The lymph system is stimulated by this rhythmic motion and all these toxins being released. The calf muscles act as a pump for the lymph system. In the down bounce they contract and bring the lymph fluid up through channels called vessels. These vessels have one way valves so lymph always moves in one direction. The main vessels run vertically up the torso, legs, and arms. This is why this up and down movement is so effective for the lymph system. It is said that lymph flow is increased 15 to 30 times by rebounding. NASA did studies on all of this for their astronauts!

    I hope this helps! May God bless you Michelle!

  15. Hi MIchelle,
    I have just ordered your book and DVD combo and am very much looking forward to their arrival! I have a grade 2 rectocele and a possible cystocele (sometimes I feel my bladder descend when having a bm, sigh). I have just begun using estriol cream vaginally to see if it will help strengthen my pelvic floor. Anyway, I’m a mother of 5 last baby weighed in at 9.5 lbs. and I’m only 4’11”. I have struggled with constipation due to hypothyroidism and celiac disease. I used to love aerobics and jogging! It actually would help me with regularity. My question is, is rebounding on a mini trampoline ok? I have toxic overload as well and rebounding helps to activate the lymph system for detoxifying. I hope I can do this as I need to do many things to get my health back on track….Sometimes all of this is so very overwhelming.
    Thankyou for all that you do and caring so deeply for all of us P.O.P ladies!

    • Michelle Kenway says

      Hi TJ
      Yes agreed managing health can feel overwhelming at times can’t it. I have had this question a few times about rebounder and lymph activation – I wonder how it activates the lymph system more than going for a brisk walk? I am not sure of the rationale for this, maybe you can fill me in. Anyway regardless, minitramp will have some impact on the pelvic floor if both feet are off the tramp simultaneously, if you need to use a rebounder then with a prolapse try to lessen the impact with one foot in contact with the surface of the rebounder throughout. This also means not lifting the knees too high and making it more of a sep than a high knee jog if this makes sense.
      Best of luck with your endeavours TJ!

  16. Hi,

    I was diagnosed with a mild bladder prolapse at my 6 week postpartum appt. My obgyn said that I would be okay to run. I was skeptical about that advice because of everything I’ve read says not to run. I am a distance runner and before I was pregnant I ran ultra marathons. I am almost 9 months postpartum now and have slowly been upping my mileage lately because I am preparing for a long trail race in October. I am so worried though that continuing running will worsen my condition. I would like to have at least one more baby too and I am so afraid that will worsen my condition also.
    L,ast week on a day I was working, I noticed that I could feel my bladder lower than usual. At that job I was always on my feet and frequently squatting (however that was my last week there and am transitioning to an office job in two weeks) and it was a particularly long shift that day. When I got home my prolapse was the worst it had ever been. However, I didnt run that day. Do you think my running contributed to that or was it the long hours on my feet? I would be very depressed if I had to give up running. I met my husband during an ultra marathon. Running is so important to us both.


    • Michelle Kenway says

      Hi Miki
      Thanks for your question. Many factors can overload the pelvic floor it is often difficult to pick out one factor – many factors can affect the capacity of the pelvic floor: the physical effort involved in caring for a baby/young child, long hours on your feet, squatting, running (this is a high impact exercise), your general level of fatigue, time of your monthly cycle etc. Have you considered speaking with your gynaecologist about using a support pessary to help you to manage your pelvic floor in view of your work/family/exercise commitments? Pessary is not just something for older women and in my view is sometimes under utilised in women of child bearing age seeking to stay active and avoid surgery.

      I hope this helps a little. The other thing that I shouldn’t overlook is the need to ensure that your pelvic floor muscles are strong and supportive, especially if considering more babies. Please feel welcome to reply further should you have any more questions.

  17. Hi Michelle
    I am nearing 40 and have had 4 children (normal vaginal births). I run several times a week (8-12 km runs) and have now noticed that I sometimes leak urine during runs. I am normal weight and otherwise healthy. If I run first thing in the morning (which is most of the time) I am fine. I guess because my bladder is empty. It is when I run at other times of day that I notice it. I don’t have any incontinence problems otherwise. To be honest, I have only just pieced it together because, 99% of the time I do run first thing so have never thought i had a problem. Obviously, I need to strengthen my pelvic floor so will embark on doing the PF exercises. Do you think I should stop running until my pelvic floor strength increases or can I keep running in the meantime. Is there anything else I should be doing? Thanks for the advice…

    • Michelle Kenway says

      Hi Teresa

      Thanks for your question. There are a few things that come to mind here – having 4 vaginal births (and pregnancies) will undoubtedly impact upon the pelvic floor. Sometimes symptoms don’t start to emerge until a woman is a little older, many women find their symptoms really start to show as menopause approaches owing to changing hormone levels and the effect this has on pelvic floor. Other women notice symptoms in the lead up to their monthly period.

      First thing in the morning the pelvic floor will be less fatigued there is no doubt, and during the course of the day with fatigue the pelvic floor may become less supportive, plus you may be well hydrated, have had a coffee or tea – in other words different factors can come into play. For most women at risk of pelvic floor problems it is best to stick with the lower impact exercises (brisk walking) until the pelvic floor is strong enough to withstand the pressure of running if that is what you seek to do.

      Hope this helps!

  18. Hi Michelle,
    I have recently got your DVD Pelvic Floor Safe which I love, in fact I couldn’t get it here in Cape Town, but my friend ordered it in the UK and sent it to me. So it’s well travelled.
    I used to Gym 5 days a week an hour a day, I knew I had a slight uterus prolapse but it didn’t seem to bad, but then a few women got together and had a PT, which I loved I started to lose centimetres which I have battled with after Menopause, but then my prolapse got worse, I went to the doctor but it is still in the first stage so I stopped all my training with the PT, and have just starting doing your exercises, but I really need to do more cardio, I am writing to you to ask if spinning at the gym would be okay, and walking on the treadmill and I would love to get a bike would all of these be okay to do.
    Many Thanks
    Linda x

    • Michelle Kenway says

      Hi Linda
      Glad to hear you like the DVD and that it’s helping you out. Yes spinning is a wonderful cardio exercises and can be readily made pelvic floor safe. I have an article that includes information on how to spin for fitness and protect the pelvic floor, hope this helps you out!
      Best wishes

  19. Hi, I had a prolapse after the birth of my first child, with forceps etc, symptoms reduced/disappeared after 9 months. I’m currently pregnant and hoping to have a c section to avoid more damage to my pelvic floor (I know the damage has been done, but I just don’t want to take the risk of a second birth like that causing more damage – I’m short, my husband is tall, baby has big head, my mum has a prolapse). Before my pregnancies I used to run 3 times a week up to 3 miles outside. I don’t want to do anything to risk more damage, but I was wondering whether running on a treadmill is less damaging, since it is springy? This is a great article, thank you very much.

    • Michelle Kenway says

      Hi Jenny
      Yes unfortunately while a treadmill may be springy, the impact is still there on the pelvic floor and this high impact exercise is the type of exercise that can affect the pelvic floor (and therefore prolapse). The other issue is that treadmill lacks the natural surface variations you would expect to find outdoors like grass/gravel etc and this is why treadmill is also known to be the cause of lower limb musculoskeletal problems that stem from repetitive impact. Much kinder to the pelvic floor to walk briskly or spin in sitting with low gears for a good cardio workout with a prolapse. Sorry the news isn’t happier!

  20. elizabeth says

    Im 60 years young, mother of 4. I’ve always been a couch potato but in April I signed up for half marathon..been training 4 days a week..up to 5 miles some running and fast paced walking. Several weeks ago thought I had uti but test said no..took over counter meds and it went same thing. Went to uro gyn today. Have prolapsed bladder. Gave me 2 choices, surgery or try device that I would put in myself..she said I can still run..what I’ve read here doesn’t sound like that is smartest thing to do…your thoughts please.

    • Michelle Kenway says

      Hi Elizabeth
      Your capacity to run with a prolapse really depends on how well your pelvic floor is supporting your pelvic organs (including bladder, uterus, rectum). Post menopause and with a prolapse the pelvic floor support is usually weakened making progressive prolapse a possibility with high impact exercises that load the pelvic floor (like running). It is not known whether pessary can prevent prolapse from progressing with running. After prolapse surgery, running is not advisable as the pelvic organs are at increased risk of prolapse. So the decision whether to run or not depends on a number of factors, and post operatively it is not usually an appropriate type of cardiovascular exercise.
      Hope this helps

  21. Hi Michelle. I am 7 weeks postpartum and have noticed that I am leaking urine when running and doing other high impact exercises. Do you recommend that I stop until my pelvic floor is stronger? I’m doing my kegals daily.

    • Michelle Kenway says

      Hi Janet
      Definitely stop your high impact, there is no question that your pelvic floor will not be strong enough for you to run yet and you are seeing the signs of pelvic floor weakness.
      If you are breast feeding, if you had a vaginal delivery and pelvic floor trauma, a big baby (>’r 4kg) then your risk of pelvic floor injury with high impact exercise just now is even further increased (and this is just to mention a few risk factors). Best to keep your exercise low impact there is plenty for you to do – my preference is cycling/spinning for women who have previously been runners, so long as your pelvic floor is not uncomfortable on the bike seat – start gradually and build up. This way you can get a great workout, recover your pelvic floor strength over the next 4-5 months and return to higher impact when your pelvic floor is recovered.

      • Thanks for the quick response. But once my pelvic floor is recovered, then I can go back to high impact exercises without any issues?

        • Michelle Kenway says

          Janet that remains to be seen – if your pelvic floor can withstand the loading associated with high impact exercises, then yes. It is ultimately a matter of your capacity to restore your former pelvic floor strength and function. There is no one correct answer for every woman – women differ with regard to their pelvic floor capacity and individual risks. your individual risks are unknown to me (?overweight?constipation?pelvic floor injury with childbirth for example). So the goal initially is to strengthen your pelvic floor to the best of your ability, if you have difficulty seek the expertise of a pelvic floor physio to help you along. I hope this helps a little

  22. Ruth dunn says

    Hi Michelle,

    Do you know how much a weakened pelvic floor is linked to hip joints? 6 months ago I went on a run ever since then I
    Have stage 2 uterine prolapse 1 bladder and 2 rectal my son was 9 pounds and I’m little got 2 children. I have had an extremely active life up untill now. I have been doing regular kegals but I can feel my pekvic floor is weaker late afternoon is this normal?? Also I am awaiting hip
    Diagnosis probable bilateral laberal tears of hips abd hip dysplasia so 2 major problems in very close proximity. The gynocologist says that this problem has nothing to do with hips and will not affect the recovery if any hip
    Surgery but im not so sure any tips please thankyou

  23. Hi Michelle
    Firstly, I’ve got your book InsideOut and find it very helpful for its exercise guidance. Thank you.
    Secondly, question for you … I’m a mother of a five year old and I’ve recently had it confirmed that I have a grade two uterine prolapse and a cystocoele (no incontinence though). I’ve always been very sporty and active but have given up running since the diagnosis and am only doing light work in the gym now as I don’t want to make things worse. Please can you tell me what you think of ski-ing for people with prolapse? I’ve skied a couple of seasons previously – still noviceish level, and am considering a family ski hol overseas. Keen to know whether its something that is likely to be bad or not. Many thanks.

    • Michelle Kenway says

      Hi Jo
      I don’t see any issue at all with downhill skiing at novice to expert level at all, so enjoy! You are probably best to avoid the big jumps, but it sounds as though I am similar level to you and there’s no way I’d be thinking about a jump. I have never been cross country skiing and while I know it’s a great cardiovascular workout I can’t comment on the abdominal muscle involvement when climbing uphill in particular and maybe one of our readers from the colder climates can help with this question. But again, cross country skiing on the flat would also be great low impact activity and exercise.
      Hope you have a great holiday Jo,

  24. I have been a Marathon runner for 40 yrS. recently had surgery for prolapse of mostly everything. No one knows what to do with us boomers (age62). They look at me as if I am crazy when I say running is imp do you know of anyone who has helped us boomers I know my problems were caused by running as I have no other problems but I deserve serious consideration. More of us will be in the future. Surgery went well but when I ask about running they
    Ey look at me like I’m crazy

    • Michelle Kenway says

      Hi Jane
      I’m hearing you loud and clear! And yes I agree with you there are more to come in the future. I too have been an avid runner, and having had children I am very aware of the impact of high impact exercises such as running on my pelvic floor. With marathon running, there is only so much repeated downward pressure the post menopausal pelvic floor can withstand.

      I guess the challenge for you now is for what you do in the future – your risk of repeat prolapse is unfortunately increased having had one episode of prolapse surgery. I will be interested to hear about alternatives you pursue, and how you manage the strong call running has to some of us. For me, cycling is a great alternative as I can still achieve that exercise intensity and duration that I love, as well as support my insides.
      Best of luck and thank you for your input!

  25. I love running and the freedom of getting away from the family just for 30 minutes a day. However recent events have prevented me from enjoying it, and I really miss that feeling you get from running. 
    Thank you for providing some great strategies and information, I now feel confident in getting back out there.
    Here's to a happier mum.