Prolapse Exercise – Physiotherapy Daily Prolapse Exercise Guidelines

Prolapse exercisePelvic Floor Physiotherapy Prolapse Exercise Guide

These prolapse exercise guidelines help you strengthen your prolapse support and alleviate prolapse symptoms.

Read on now to learn the answers to these prolapse questions:

  • What is prolapse exercise?
  • How can prolapse exercise help?
  • Who can benefit from prolapse exercise?
  • Can exercise fix a prolapse?
  • What is the correct exercise technique?
  • How many exercises to do per day?
  • Common exercise mistakes to avoid
  • How long will it take to notice prolapse improvements?

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

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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

What is Prolapse Exercise?

Prolapse exercise is pelvic floor exercise designed to improve prolapse support and protect a prolapse from worsening. Prolapse exercises are specifically for the pelvic floor muscles and are known as pelvic floor exercises. Pelvic floor exercises can strengthen and restore the pelvic floor muscles.

Research shows that pelvic floor exercise can improve prolapse support and reduce the frequency and how bothersome prolapse symptoms are in women with mild to moderate prolapse. 1

Prolapse occurs when the pelvic floor muscles and tissues weaken and stretch. This decreases support for the bladder, uterus and bowel (pelvic organs). When these organs lose support they can prolapse or bulge into the walls of the vagina (cystocoele, rectocoele), move down into the vagina (uterine prolapse) and/or protrude from the rectum (rectal prolapse).

How Prolapse Exercise Can Help Your Pelvic Floor

Many physiotherapists provide pelvic floor exercises for the treatment of prolapse. 2

Prolapse exercise involves training and rehabilitating the pelvic floor muscles.

Prolapse exercises aim to: prolapse exercise

  • Increase the strength and thickness of muscles for prolapse support
  • Lift the pelvic floor to sit higher within the pelvis
  • Increase the stiffness of the pelvic floor making it more resistant to strain.

Pelvic floor exercises can assist prolapse sufferers in a number of ways:

  • Reduce prolapse symptoms 3
  • Delay or avoid prolapse progression
  • Improve prolapse support following prolapse repair surgery
  • Improve bladder control
  • Improve bowel emptying.

Who can Benefit from Prolapse Exercise?

Pelvic floor exercises can help to reduce and in some cases overcome prolapse symptoms in women with mild to moderate prolapse. It may well be that improving prolapse support can delay or avoid a  prolapse from worsening.

Women with severe prolapse are prescribed pelvic floor exercises to improve the outcomes of prolapse repair surgery by improving pelvic floor support. Women with severe prolapse may benefit from strengthening their pelvic floor prior to prolapse surgery rather than waiting until after it has taken place.

Can Exercise Fix Prolapse?

No, unfortunately it’s not possible to completely fix a prolapse with pelvic floor exercise.

A prolapse is like a hernia of the pelvic floor tissues. The only way to completely repair a prolapse is via prolapse surgery. As stated above, pelvic floor exercises can improve prolapse symptoms and restore pelvic floor strength and support in women with mild to moderate prolapse.

Women with more severe prolapse usually require vaginal pessary or surgical management to eliminate prolapse symptoms.

Correct Prolapse Exercise Technique

Pelvic floor exercises for prolapse involve squeezing and lifting inside the pelvis using the pelvic floor muscles.

This feels like squeezing and lifting inwards all 3 pelvic openings (vagina, urine tube/urethra and anus).

Exercises for prolapse involve lifting and squeezing:

  • In and around the anus (back passage) as if trying to avoid passing wind
  • Inside the vagina
  • In and around the entrance to the urethra (urine tube) as if trying to stop or slow the flow of urine.

Physio Tips for Prolapse Exercise

  • Re-position your prolapse within your vagina before your pelvic exercises if it tends to protrude
  • Commence your exercises lying down and progress to sitting or standing when your pelvic floor strength increases
  • Attend to good posture for pelvic floor exercises since slumped posture decreases the effectiveness of pelvic support exercises 4
  • Practice your exercises at the start of the day when your prolapse will not be bulging as much as at the end of the day
  • Use a vaginal pessary to lift the weight of the prolapsed tissues making pelvic floor exercises easier to perform with a prolapse.

How Many Pelvic Floor Exercises to do Daily?

  • Pelvic floor exercises for prolapse support should be performed regularly aiming for at least 5 days of the week
  • Perform up to 8 pelvic floor exercises in a row
  • Try to maintain each exercise for up to 10 seconds
  • Relax and rest your pelvic floor muscles for around 6 seconds between every attempt
  • Repeat this up to 3 times daily for a maximum of 24 daily exercises.

When starting out

  • If your pelvic floor is weak it is unlikely that you will be able to initially perform this quantity of exercise.
  • Focus upon using the correct technique and maintaining your pelvic floor muscle contraction for as long as you are able to do so. For some women this will initially be for 1-2 seconds a time.
  • Gradually build up the duration of your pelvic floor muscle exercises and the number you can perform in a row as your strength improves over time.

Common Mistakes to Avoid

There are a number of common mistakes to avoid when doing pelvic floor exercises. These include:

  • Pushing the pelvic floor down rather than lifting it up
  • Breath holding during pelvic exercises – breathe normally throughout your exercises
  • Squeezing the buttocks and thighs instead of the inner pelvic floor muscles.

How Long to Notice Prolapse Improvements?

It can take up to 5-6 months of regular exercise to strengthen weak pelvic floor muscles.

Some women start to notice that their prolapse symptoms start to improve 3-4 weeks of daily pelvic floor exercises.

Pelvic floor exercises for improved prolapse support will only benefit women with intact pelvic floor muscles. Women with prolapse who do not notice any improvement in their pelvic floor strength and those who are unable to contract their pelvic floor muscles should seek pelvic floor rehabilitation treatment from a Pelvic Floor Physiotherapist.


1 HoffBrækken I,Majida M, Enge E, Bø K.(2010) Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial. American Journal of Obstetrics and Gynecology. 203,2, pps 170.e1-170.e7.

2 Hagen S, Stark D, Cattermole D (2004) A United Kingdom-wide survey of physiotherapy practice in the treatment of pelvic organ prolapse. Physiotherapy, 90, pps. 19-26.

3 Hagen S. et al (2014) Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial The Lancet
383, 9919 (1–7, pps 796-806.

4 Sapsford R, Richardson C, Stanton W. (2006) Sitting posture affects pelvic floor muscle activity in parous women: An observational study. Australian Journal of Physiotherapy. Volume 52, Issue 3, Pages 219-222.

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  1. Is the Figure 8 dance exercises from Bodyfx safe with prolapse? I see it advertised online. I am looking for replacement exercises for HIIT and plyo. They move fast, and do standing crunches while tilting the pelvis under…which has me questioning whether to purchase or not. Thank you

    • Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Charlene
      I took a look at the YouTube clip and it’s difficult to say just from that short glimpse. There are 2 things worth mentioning; it’s not possible to spot reduce fat from a specific area so while it’s an appealing idea for many women to be able to flatten the tummy with abdominal exercises or movements this is all well known to be a myth. The other issue is that the safety of abdominal exercises for that woman really depend largely on how well her pelvic floor is working and whether or not she has a prolapse. Yes I can see the standing pelvic tilts in the video – whether this exercise when repeated will aggravate pelvic floor conditions is really very individual. Wish I could be more help regarding this workout – having said this it would be preferable to many hiit and plyo moves. If you do proceed I’m keen to hear how it goes for you. Thanks for your enquiry!

  2. Question
    Do you have hip pain with vaginal prolapse.

  3. I’m 48 years old. I’ve had 10 vaginal births most of them 9 lbs more or just under. I’m suddenly having problems with prolapse. My youngest is almost 5. I have not been to the Dr about it. I feel a heavy pressure inside.I have very uncomfortable feelings in my pelvic floor. I just started having this yesterday. I’ve had little problems here and there over the years. But this is the worst so far. I’m having my period right now, I’m past the heavy bleeding part.I was using a diva menstrual cup. For 3days prior to this. My questions are these, is it bad for prolapse problems to use a menstrual cup? Is sex beneficial or will make it worse? I think I should see a Dr. I actually avoid doctors, they usually are not that helpful. I’m usually disappointed with them. But I thought a doctor could at least tell me the extent of my prolapse and pelvic floor integrity. I would like to try to remedy this problem with exercise. I am a little over weight. I would like to loose at least 10 lbs. My other question is, will this problem be something that will affect me the rest of my life? Will I have to constantly do special exercise and monitor my activities? Thank you in advance for your help and advice.

    • Michelle Kenway Physiotherapist says

      Hi Sherri

      Really good questions, thank you for submitting them. Yes first and foremost it will be a good idea to have your condition assessed by a doctor or a pelvic floor physiotherapist. Prolapse symptoms are often worse immediately before and during menstruation. Some women find that they have a cyclical nature to their prolapse symptoms. A menstrual cup shouldn’t be a problem. Intercourse will be neither beneficial nor worsen a prolapse in most cases. Extra body weight will place an increased load on the pelvic floor and can worsen prolapse symptoms particularly if the weight is in and around the abdominal organs. Yes unfortunately if this is a prolapse this will be something you will need to be mindful of for the rest of your life both in terms of regular pelvic floor exercises to maximise the support for your pelvic organs along with avoiding exercises and activities most likely to worsen prolapse. The other issue that’s worth mentioning is that many women notice that their prolapse becomes more symptomatic with menopause (sorry all the bad news!). The good news is that for many women weight management and regular pelvic floor exercises can make a big difference.

      All the best

  4. Hi….I have first grade cystocele….I love to play batminton….will that affect the prolapse.

    • Michelle Kenway Physiotherapist says

      Hi Bonnie

      I’m not sure how much jumping and high impact activity is involved in badminton, it’s only the jumping that could be an issue, particularly if your pelvic floor muscles are weak. Ideally try to do your pelvic floor exercises regularly and enjoy your sport keeping it low-impact i.e. at least 1 foot on the ground for the most part.


  5. Hi Michelle,
    I was diagnosed with a ‘stage 1′ anterior prolapse (presumably that’s a bladder prolapse?) just yesterday when I was immediately asked if I want to be referred for surgery or try pelvic floor exercise for a few months. I had no idea!! I really wanted time to take it in and more information so I said I’d try exercise first & searched the internet for info. Some sites seemed to just paint a negative picture of sufferers’ conditions getting worse so I am VERY pleased & encouraged to have found your site with so much helpful advice and I’ve just ordered your book & signed up for newsletters.
    I’ve had 4 vaginal births & I’m post menopausal.
    I’ve read some of your advice regarding Pilates-I’ve been going to classes for 2 years following lower back muscle spasms. The instructor is very good at tailoring the exercises to individuals with muscular & skeletal problems and has helped me to improve my posture. My back is so much better but I have been doing the plank and some exercises with both legs raised, which you advise against. Gladly though, I’ve sometimes not raised both legs at the same time because I found it a strain on my back. I hope that means I haven’t done as much damage as I might otherwise! I’ll speak to my instructor about my diagnosis at my next class.
    I also play badminton for an hour once a week It’s by no means a competitive group-just a group of friends aged over 50 playing for fun & I really enjoy it. I tend to step around the court rather than run around and I wonder if I might still be able to play if I sit out for a few minutes every now and again. Have you any comments on that?
    Having felt very despondent about my diagnosis at first, I feel much more positive so thank you for your excellent website & videos.

  6. I have a stage 2 uterine prolapse and bladder prolapse. First diagnosed 7 years ago, uterine prolapse has worsened over time. I am an active 66 yr old. I managed quite well with pelvic floor exercises until 6 months ago, now getting more discomfort. Am embarrassing problem has arisen with the acquisition of a partner in that my bladder leaks during sex! Is this common? Would a pessary help or do I have to go the hysterectomy route? Also, would the prolapse cause constipation or is this separate?.

    • Michelle Kenway says

      Hi Cathy
      Yes bladder leakage during intercourse is a reasonably common occurence. It is usually caused by the pressure within the vagina pushing upon either the prolapsed bladder or stress urinary incontinence (SUI) owing to a patent urethral sphincter or hypermobile urine tube. Pelvic floor exercises are the main stay of conservatice management for SUI. Other ways to assist include ensuring complete bladder emptying prior to intercourse using this bladder emptying technique in addition to positioning for intercourse where sidelying back to partner may be less provocative for bladder leakage.

      Before considering surgery it would be wise to have urodynamics to determine the actual cause of your bladder leakage; if it is resulting from a hypermobile urethra, a hysterectomy will not help the situation. There are some pessaries designed for SUI with hypermobile urethra and prolapse support. Once again the success will depend on the reason for your SUI.

      Hope this helps you along Cathy
      All the best

  7. I have had a hysterectomy and rectal prolapse repair (mesh rectopexy) in the last few years. I also suffer with piles and have been told I need more surgery to fix that too! I really don’t want that surgery and so am looking for alternative ways to improve the situation. I have young children who i no longer lift (bit sad) and am determined to lose weight (surgeon said BMI needs to be below 30, which isn’t far off, but I want it to be 24). I also really enjoy cycling and wondered if there was any reason I shouldn’t do it? If I can are there things I need to be careful of?

    • Michelle Kenway says

      Hi Claire

      Yes cycling is ideal for weight loss and minimising pressure on the piles. This article on cycling and prolapse is relevant to you will answer all your questions – the same information applies to pelvic floor protection for piles as well as prolapse/post hysterectomy.

      You may also benefit from reading this recent article on management of hemmorhoids which outlines safe exercises with hemorrhoids along with other useful information.

      Hope this helps you out Claire!

  8. I have a grade 2 recotcele and a grade 1 cystocele, I am 2 years post-partum. I have had success relieving the discomfort and pressure that I was having all day long with pelvic floor exercises. I really miss working out but I am afraid to be active because so far even small amounts of any activity like walking aggravate my condition. Is discomfort acceptable if tolerable? The last thing I want is to worsen my situation but I would like to know if perhaps I need to continue despite the discomfort and eventually with gentle progress could allow me to regain other muscle strength? I just hate to ignore it if my body is warning me to stop.

    • Michelle Kenway says

      Hi Sandy
      Thank you this is a good prolapse exercise-related question. I beleieve that discomfort is a sign that the pelvic floor and/or prolapse is being overloaded. This indicates to me that the pressure of that particular exercise is overwhelming the capacity of the pelvic floor tissues to provide adequate support and should be modified or avoided. I am not sure what type of strength exercise you are referring to and would be interested to know.

      I completely understand your reticence to perform exercises that might worsen your prolapse. I do believe there are many ways of modifying strength exercises so that they are pelvic floor safe and these are outlined in my books, DVD and many online exercise videos. The bridge exercise for example is a wonderful exercise for strengthening the buttocks and lower back and places minimal pressure on the pelvic floor even when performed with weights. Have you tried this type of anti gravity strength exercise Sandy? I am interested to know.

      All the best

      • No real strength training, just taking a leisurely stroll with my kids for 10-20 minutes causes discomfort for 2-3 days. I was hoping that maybe if I continued to walk a few times per week that eventually the other supporting muscles could offer more support. I have mostly focused on pelvic floor exercises, not a lot of anti gravity strength training. I was thrilled the other day when I found some of your lunge, squat and arm weight activities online because I didn’t think I would ever be able to do any of these again. I was concerned that those might be too much for me if simple walking is difficult. Maybe I am just trying to do this in the wrong order assuming that the walking is a gentle activity. Are those OK for a ‘beginner’?

        • I have one other sort of related question…my desire for increased activity is party for weight management. In your experience does weight loss help POP, particular for a cyctocele or rectocele…I have read conflicting information online.

          • Michelle Kenway says

            Hi Sandy

            There is no doubt that abdominal fat/weight loss in women who are overweight will reduce pressure on the pelvic floor and POP


  9. I just found out I have a prolapsed bladder. How do you know what grade I am at? Is there different symptoms with different grades? The doctor did not tell me she just told me that I should do kegal exercises. I am 43 years old. I workout about a one and a half hours a day. I do HIIT (high intense interval training), boot camp and weight training. Will I not be able to do these workouts anymore for rest of my life? or after I strengthen my pelvic floor will I be able to go back it? How long does it take to strengthen your pelvic floor and can you put your bladder to where it belongs from these exercises? Thank you so much for your time and advice

    • Michelle Kenway says

      Hi Sue
      There are a number of prolapse grading systems – one that is commonly used is the POPQ which was developed by the International Continence Society. This prolapse grading system grades the prolapse according to how far the leading edge of the prolapse has moved down within/out of the vagina. The stages are as follows in lay terms:

      Stage 0 – No prolapse is evident
      Stage 1 – The prolapse sits higher than 1 cm above the hymen (which is about 1 cm inside the vagina)
      Stage 2 – The prolapse sits within 1 cm above or below the hymen
      Stage 3 – The prolapse sits more than 1 cm below the hymen but descends no further than 2 cm less than the total length of the vagina
      Stage 4 – Complete eversion or outward prolapse of the vagina (known as a procidentia)

      A prolapse is like a hernia in the vagina – it results from overstretched tissues and one it is there it cannot move back into place. Strengthening the pelvic floor has been recently shown in the research to move the prolapse to sit higher and reduce prolapse symptoms. Strengthening the pelvic floor is a log-term commitment and the time take depends on how strong your pelvic floor is from the outset. Much of what you will be doing is modifying your exercises – my book Prolapse Exercises outlines exercises to choose and avoid in detail and is way beyond the scope of what I can write in a comment. You will also find a large amount of information about pelvic floor safe exercises on this site this prolapse link is a good place to start.

      All the best Sue, hoping this helps you get started, feel welcome to comment/question further

  10. can i do surya namaskarams (yoga) with prolapse. 2 weeks back doctor said that i have first degree of rectoceal ,uteroceal and droping of blader.

    • Michelle Kenway says

      Hi Varija
      This Yoga routine, also known as “Sun Salutation” incorporates a series of Yoga poses. The poses will for the most part not place too much load on the pelvic floor. The one pose potetially requiring caution is Uttanasana or Intense Forward-Bending Pose since we know that bending forwards increases pressure on the pelvic floor – this is readily modified by just limiting how much forward bend occurs.

      This article on ” title=”Yoga Prolapse”>Yoga Prolapse exercises to avoid will give you some more information Varija

      Kindest regards

  11. Sue Probett says

    Hi, I am 53 years old and had surgery for a prolapsed uterus about 15 years ago. Recently bought a treadmill is it ok to use a treadmill and at an incline. Does how fast you walk affect pelvic floor. Is half an hour to start with too long. Thanking you.

    • Michelle Kenway says

      Hi Sue
      Hi Sue

      I think it’s best to keep the treadmill flat for walking so you can maintain good posture and maximise pelvic floor support. Everyone is different as far as km’s they can walk when starting out with a treadmill walking program, it’s really very individual – some women will start with less than 5 mins, some 10 mins. The key is to start and progress gradually while listening to your body – if previously inactive then 30 minutes would be quite taxing. Also remember the benefit of doing a couple of shorter (e.g.10 minute) sessions rather than one longer session, especially when starting out and building up your time walking.


  12. Hi I’m 28 years old and I have just been told by my GP that I have a mild prolapse of my cervix, (i gave birth to a 9 pound 2 baby 10 years ago but only felt this full feeling over the past couple of days which i dont understand why its so suddenly happened)
    how can I treat this problem so it can get back to normal?? Will pelvic floor exercises help? And how many should i do?
    My left side of my cervix is lower than my right and would like to correct this.
    Is there anything that I can do?
    Any reply would be much appreciated.
    Thank you in advance.

  13. Hi, not sure if this thread is still monitored but I have a question about whether prolapse gets worse at certain times of the month? I notice a lot of discomfort starting in the lead up to menstruation, which lasts until a few days after.
    I had a really traumatic birth with my first child and I’m scared about whether to try for another one-whether this will make prolapse a lot worse or if it could even harm my chances of carrying a baby?
    I’m only 33 and have been to GP & gynocologyst about this. Both were very unhelpful and said I did not have a prolapse but unless I have made a mistake about my insides bulge out on standing up (and now more commonly when sitting too), I think they are just fobbing me off. Since having my baby, I can no longer wear tampons and I often cannot empty my bladder fully but also suffer incontinence when coughing, sneezing or just feeling urgency. I’ve seen a pelvic floor physiotherapist who said my muscles are ok but I have a weakness at one side, probably due to episiotomy. I try to do Kegels but fail to contract for more than 3 seconds at a time and I’m also using a pelvic floor toning device but the problem seems to be getting worse. What do I do now? I just feel a complete lack of support.

    Thanks for your time if you get this and respond.

    • Michelle Kenway says

      Hi Dtm

      Yes the level of pelvic floor muscle support changes during the female hormonal cycle. Some women notice their pelvic prolapse or bladder control problems worsen in the week prior/during menstruation. This is due to the effect of oestrogen on the pelvic floor which declines during this time. With regards to prolapse and standing up – yes you are correct sometimes a prolapse may not be visible lying down and become more evident standing up. Standing up is an excellent way to assess prolapse because the weight of gravity combined with the abdominal contents have an effect on revealing the extent of prolapse. Being unable to retain tampons in place is also a symptom of pelvic prolapse, since the descended tissues/organs force the tampon down/out. Usually most damage is done during the first vaginal delivery and it would be to your advantage to consult with an obstetrician regarding your concerns. I am not sure which country you reside in however if you can access a trained Pelvic Floor Physiotherapist, she may be able to asses you in standing and assist with your pelvic floor recovery to help you manage future pregnancy.

      Let me know if you have any further questions, I am happy to assist you

      Kindest regards

  14. I am 3 weeks post TVTO and posterior repair. I’m finding it so difficult to get good advice on how active I should be, I was just told to avoid lifting. I have only mild discomfort and I’m walking for about 30 minutes every day, I’m not lifting anything but I’m hanging up clean shirts in the wardrobe and doing things like dusting around the house and pruning shrubs outside. Does this sound a safe level? Is it ok to stretch up to reach something on a shelf and to bend down to pick up something light on the floor?
    I have been doing Pilates for some years but have been advised not to begin again for 12 weeks. I’m very flexible and missing doing my daily stretching routine, when could I begin these again?
    Your site is really helpful and I’m going to order your book and DVD.

    • Michelle Kenway says

      Hi Gilly
      During the first 6 weeks post op. is a major protection phase, then the following 6 weeks moderate protection to ensure full recovery over the 3 mths that it takes for complete internal healing. It sounds as though you are being quite safe in your approach to recovery, be mindful of keeping outdoor work light, and don’t overdo the walking, keep walking flat surface and even split into two shorter walks if you feel fatigued. Advice to avoid Pilates for 12 weeks is prudent, and then to take care to avoid intense core abdominal exercises upon returning using a graduated approach to resuming exercises. There is no reason why gentle neck, shoulder and upper back stretches cannot be performed post op for most women. Small range lumbar rotations (knee rolls with feet flat on supporting surface) being mindful of not rotating the legs too far to one side can also be helpful for lower back stiffness.

      Hope this helps you along

  15. Hi, I’m a 50 year old woman, medium build following a good diet and exercise plan. I recently started bike riding, it’s been 5 years since I rode. I love it but noticed more and more a heaviness below after riding. some months before I felt dryness and discomfort so I went to the doctor and she didn’t see anything then but prescribed a vaginal lubricant and suggested maximum estroven. last week I took a mirror to look after riding and shockingly there was this small buldge OMG frightened me. after I relieved myself it was somewhat gone. I’m afraid to have sex and afraid to take an Epson salt bath, so you see I have many questions; having sex, riding the bike make it worse, should I get a more appropriate seat, Epson salt baths good or bad, waking better than biking? thank you so much for anything you can suggest.

    • Michelle Kenway says

      Hi Dawm
      Best thing to do in this situation is to go to see your doctor for examination. Symptoms such as heaviness and bulge are consistent with pelvic prolpase however any unusual sympotms need to be assessed by a doctor or qualified Pelvic Floor Physiotherapist. Epson salts will make no difference to a prolapse. Gentle flat cycling, slow speed is usally not problematic. Some women with moderate prolapse find that walking long distances can aggravate their symptoms and so choose to walk short comfortable distances rather than long distance.
      Hope this helps

  16. Lynne Rubino says

    I have a 4/5 bladder prolapse. I am an avid horseback rider and have my own horse. I recently started jumping my horse over low (2ft) jumps. Is the riding and jumping
    going to make my prolapse worse?

    Looking forward to your repsonse!


    • Michelle Kenway says

      Hi Lynne
      Thanks for your question regarding horeriding and prolapse. It is difficult to answer as to the best of my knowledge there are no scientific studies into the effect of horseriding on moderate prolapse. I can tell you that jumps will involve high impact landing that may be transferred to your pelvic floor. I wonder if you notice worsening prolapse symptoms after riding and jumping? This would be an obvious indicator for you. We have had some discussion regarding horseriding and prolapse on site here is the link for you to read, I hope this helps you a little (scroll down through the comments and discussion on horseriding starting with this one)

  17. Thank you so much for this website and for the utube videos. I am recently diagnosed with moderate prolapse and am seeing a physiotherapist and she is telling me to do EXACTLY what you are saying. I feel so much better hearing someone else like you tell me the same thing. I want to avoid surgery and strengthen myself enough to relieve some of my symptoms and your videos and website give me great hope, thank you so much for sharing your in depth knowledge of this unspoken problem and for giving me confidence that I am doing all I can to try to fix my prolapse in a conservative manner. Best Regards!!!!!!!!!!!!!

  18. I have a bladder prolapse and it is hurting to much to stay physical. I love running, excersicing anyway and horse back riding, so I am going crazy not being able to do aroebic type activity. Whcih is better a stationary bike or recumbandt bike. I am currently waiting for you book to arrive!

    • Michelle Kenway says

      Hi Anita
      Whether or not to use a recumbent or upright bike is a very individual decision – I suggest that you go to a sports store and try out both styles of bike for comfort, and for the ability to adjust the resistance levels and set up to suit your body. Some women find that leaning forward in upright aggravates back problems, while others find various seating arrangements more or less comfortable. Both styles of bike are low impact and therefore good options for pelvic floor safe exercises. Some women with pelvic pain need to be cautious when it comes to the pressure of the seat on their pelvic floor but this doesn’t sound to be your issue.

  19. Carol Bisseling says


    Do you have exercise video appropriate for me? Easier motivation for me Here is my situation in brief. Thanks so much for your valuable time.

    I purchased your book and really got a lot of info. Bought in 2011. Had rectal tack, anterior bladder repair and lost uterus and cervix in surgery after visit to docter when felt prolapse after voiding. Placement of mesh also. After 3 years still have a little “wettness” on exertion. Constantly had setbacks with pushing clutch and yoga exercises- Surgeon (urogyn) advised do anything that felt OK and clutch not a problem in driving the Toyota. Exercises felt Ok then each many times I realized I hurt myself after activity. Got an automatic car finally. Surgeon said when asked abouth pelvic exercises “why would you want to do that you don’t have a vagina” . I stopped seeing him – he had no answers for me and eventually 1 year just as I was able to pick up more the bladder fell and was repaired by a urologist. Urologist read surgery report and said temporary stitches were used for the repair. I still have no idea why.

    After 2 years from last surgery, I am finally able to pick up gallon milk carton without pulling but still have wetness on occasions of too much activity. Bending is easier now. I am super careful and can’t stand long periods but can do lots more. I did physical therapy for last surgery and am faithful to kegels and swim. Still have little setbacks for a day or two when standing a few hours.
    Hopefully you have video appropriate for me or some suggestions on where to go from here or if you think full recovery is possible in time. I have been told the only way to find out what is going on is mri – but still might not tell what is happening in there- or exploratory surgery -( I am worried about possibly more adheseions or problems after another surgery). What would you do in my case? Limited ability to do my ususal profession has caused financial difficulty so MRI is out- high deductible and live in the US. I hope you have a suggestion and an exercise video appropriate to me.


    C Bisseling

    • Michelle Kenway says

      Hi Carol

      It sounds as though you are on the right track with your Kegels, swimming and understanding those activities that impact upon your pelvic floor.

      Upon reading your history my first impression is that you would probably benefit from seeing a pelvic floor physio to help you establish how well your pelvic floor muscles are working, and where to focus your efforts in terms of training pelvic floor muscle strength/endurance and using ‘the knack’ to pre brace your pelvic floor for specific functional activities. I will post a video on using ‘the knack’ in the next few days. This would also help to establish how appropriately you are training your pelvic floor at present and whether or not to your best possible advantage – you need to be training your pelvic floor as effectively as possible.

      Other factors that maybe impacting upon your pelvic floor also need to be considered; your body weight, your bowels, any respiratory/chest/allergies, medications, coexisting back/pelvic joint pain problems, fluid intake/type, bladder irritants, hormonal status etc as there are so many factors that can impact upon the pelvic floor, continence and prolapse recovery.

      With regards to safe exercise for prolapse, your best choices are low impact exercises and you can read all about these and perhaps start using this prolapse link. As far as exercise DVD’s go, I made Inside Out Strength exercise DVD for women with prolapse or previous prolapse repair seeking a pelvic floor safe strength training workout. It is based upon the Inside Out book you have already read, and goes further with additional strength exercises and a kegel workout. So this would be a good place to start if you are seeking to strengthen your whole body and protect your pelvic floor. If you are seeking to improve your cardiovascular fitness, then swimming, water walking, cross trainer and similar low impact exercises are pelvic floor friendly and appropriate for many women with prolapse.

      I hope this provides you with some direction Carol, and please feel most welcome to comment further with any further questions.


  20. Your articles are really very helpful, especially when the doctors tell me that its fine to excersize however I want to! Can you tell me if if is relitvly safe to take a Zumba dance class with prolapse repairs?

    • Hi Teri
      Zumba is usually low impact and therefore appropriate exercise when fully recovered post repair for most women however this can vary from one instuctor to another so it is wise to understand low impact versus high impact exercise. The idea is to modify high impact exercises that involve jump/hop and make them into a low impact step so that at least one foot stays on the ground as you exercise.

  21. Will dancing make my uterine prolapse worse? (swingdancing, hand dancing, ballroom dancing, etc.

    • Hi Renee
      Dancing is a great form of exercise and is usually (not always) low impact. You can estimate the load on your pelvic floor associated with dancing by judging whether or not at least one foot is in contact with the ground as you dance. This means that dancing with alot of higher impact jumping is best avoided. The speed will come into it too – in thinking about swing dancing probably the faster ther music the greater the impact? I may stand corrected on this but I would think that slower dancing would be more likely to be lower impact. Ball dancing as I understand it would seem an ideal form of low impact exercise and activity with a prolapse.

  22. Can you use a staionary bike if you have uterine prolapse? treadmill, etc.

    • Hi Renee
      With uterine prolapse it is advisable to keep fitness exercises low impact. Staionary bike is one such exercise that is pelvic floor friendly placing minimal impact on the pelvic floor. It is advisable that to keep cycling forces on the pelvic floor low, stay seated in the saddle and avoid using heavy gears. Better to use light gears and high revolutions for your fitness and weight management exercise.
      Hope this helps

  23. Can you do walking if you have grade 2 uterine prolapse, rectocele,, etc. How long can you walk?, how far?, Do you need special walking shoes?

    • Hi Renee
      Thanks for your questions!

      What any woman can do for exercise with a prolapse is really determined by how well her pelvic floor is functioning. The pelvic floor supports the pelvic organs with exercise and activity. Regular low impact exercise such as walking is usually suitable for most women with mild to moderate pelvic prolapse such as yours, however for some women with more severe prolapse find that even walking and standing becomes very uncomfortable.

      There are no hard and fast rules on the time/distance to walk with a prolapse since every woman is different. Based upon the ACSM guidelines for exercise for general fitness, aerobic exercise such as walking should be 30 minutes on 5 days a week for healthy adults.

      Well cushioned footwear, keeping walking surfaces flat and even wearing supportive briefs or gym pants may help to reduce impact and improve support a little. Some women choose to do shorter walks (3 lost of 10 minutes) plus walk when rested not fatigued may help too. Some women choose to use a pessary for exercise and this is an excellent option for some women to help them to exercise for fitness with a prolapse. A vaginal pessary needs to be prescribed and fitted by a gynaecologist for those women suited to using a pessary.

      Hope this helps you Renee

      • With advanced uterine prolapse surgery scheduled for May 24th ( 2 mos. from now)
        can I besides walking ride a stationery bike ? I notice that both these activities
        Improve how I feel and help me keep my bodily elimination as normal as possible.
        I am used to exercise and notice that just sitting seems to increase my discomfort.
        I also do stretching exercises as well as arcs to lift my pelvis. Are these also
        helpful before surgery ?

        Will welcome your answer. Thank you.

    • Christine says


    • Thank you for the response.
      I may wait until I have finished a little more therapy before giving this a try. I do have stage 2 and 3 prolapse, and I am not confident my pelvic floor is strong enough just yet to take this intensity on lol. I tried a few moves at the pace shown on the video clip, and things didnt feel very good in the pelvic area. I am not looking for spot reduction, as I am already my ideal weight. I am looking for alternative cardio to accompany my pelvic floor exercises for the time being. This workout looks intriguing though, I will give it a try in the future and report back
      Thanks again❤

      • Michelle Kenway Pelvic Floor Physiotherapist says

        I think that if is causes symptoms during or afterwards then it’s likely placing pressure on your pelvic floor. Have you tried any machines like stationary bike or elliptical machine? Many women find they can get a great cardio workout on a stationary bike without aggravating prolapse symptoms.