Rectal Prolapse Exercises
This information teaches you how to improve rectal support with rectal prolapse exercises along with exercise techniques to reduce rectal prolapse symptoms and strain.
Read on now to learn:
- What is a rectal prolapse
- What causes a rectal prolapse
- Signs and symptoms of rectal prolapse
- How to do rectal prolapse exercises
- How to exercise safely with a rectal prolapse.
Rectal Prolapse Definition
A rectal prolapse is a condition where the inside of the rectum protrudes out through the anus (shown right). This condition is not the same as a rectocoele or prolapse of the back wall of the vagina.
There are 3 types of rectal prolapse:
- Mucosal prolapse which involves only the rectal mucosa (membrane) protruding through the anus;
- Full thickness rectal prolapse where the rectal wall protrudes through the anus; and
- Internal intussusception where the rectum collapses but stays inside and does not protrude.
If you suspect you have a rectal prolapse seek prompt medical advice.
What Causes Rectal Prolapse?
A rectal prolapse results when the supportive tissues that hold the rectum in position become weakened.
Some causes of rectal prolapse include:
- Chronic constipation and straining to empty the bowel
- Chronic diarrhoea
- Pregnancy and childbirth
- Anal intercourse
- Cystic fibrosis
Some Signs and Symptoms of Rectal Prolapse?
Signs and symptoms of a rectal prolapse may include:
- A red protrusion may be visible from the anus especially after a bowel movement
- This anal protrusion may be evident with squatting & heavy lifting
- Mucous discharge from the anus
- Staining of underwear
- General discomfort around the anus often worse after activity and towards the end of the day.
Initially the rectal prolapse may retract (move back inside the anus) after a bowel movement. As it becomes worse it usually will become more apparent with everyday activities such as walking and prolonged standing and may cease to retract.
How to do Rectal Prolapse Exercises
Your pelvic floor provides support for your your rectum (shown right blue arrow). Your pelvic floor muscles work with other strong tissues to withstand the forces of everyday activity on your pelvic floor to support and hold your rectum in the correct position.
Rectal prolapse exercises involve the following 3 stages to achieve your best possible pelvic floor strength and support:
Stage 1 – Find your pelvic floor muscles for rectal prolapse exercises
- Position yourself sitting or lying down
- Imagine you are trying to stop wind from passing from your bowel, and urine passing from the urethra (urine tube)
- Slowly lift and squeeze the muscles in and around the anus, vagina and urethra
- You should be able to see your anus pucker with your contraction if you use a mirror
- Keep breathing as your buttocks and thighs stay relaxed
- Relax the muscles in and around your anus.
To progress your rectal prolapse exercises:
- Gradually try to increase the length of time you can maintain your muscle contraction as you lift up inside; and
- Gradually try to increase the strength with which you contract your muscles;
- Attempt to perform your exercises in upright positions (i.e. sitting and standing).
Stage 2 – Exercise your pelvic floor muscles
- Position yourself where you can best feel your pelvic floor muscles working (lying, sitting or standing)
- Slowly activate your pelvic floor muscles by lifting and squeezing them for up to 10 seconds at a time
- Relax your pelvic floor muscles back to their normal resting tone and rest to recover
- Repeat your extended pelvic floor muscle holds up to 10 times in a row
- Next practice lifting and squeezing your pelvic floor muscles with a brisk strong technique for up to 10 times
- Try to repeat these exercises (long and short muscle holds) 3 times every day
Stage 3 – Train your pelvic floor muscles for everyday activities
Training for everyday activities involves using your pelvic floor muscles:
- In upright positions;
- Before and during every cough, sneeze and lift; and
- When you sense an urgent desire and need to defer the urge to empty your bladder or bowel.
Tips for Successful Rectal Prolapse Exercises
- Choose positions such as lying down where your prolapse is more supported for your pelvic floor exercises when starting out
- Perform your pelvic floor exercises (kegels) when your muscles are less likely to be fatigued (e.g. early in the day)
- Always draw up your pelvic floor muscles after using your bowels
- Progress your pelvic floor exercises into upright positions when you are able.
How to Exercise With a Rectal Prolapse
1. Practice good bowel habits using the correct technique for bowel emptying and never strain with bowel movements
2. Choose supported positions wherever possible (for example sitting will be more supportive than standing)
3. Spread out your activities during the day and take time to rest and elevate your legs in the afternoon to reduce pressure on your pelvic floor if you have time
4. Avoid heavy lifting which increases pressure on your pelvic floor
5. Manage your weight well and avoid unnecessary weight gain which increases the load on your pelvic floor.
Safe Exercises and Rectal Prolapse
1. Choose appropriate pelvic floor safe fitness exercise (low impact) for prolapse protection where at least one foot remains in contact with the ground at all times (e.g. cycling is usually ideal to minimise pelvic floor strain).
2. Adhere to the prolapse protection principles for strength training to exercise for strength and reduce pelvic floor strain. These include choosing supported positions, exercising with light weights, gradual progression and avoiding specific strength exercises that increase pressure on the pelvic floor.
3. Avoid unsafe abdominal exercises that increase pressure on the pelvic floor. Some specific abdominal exercises such as sit-ups and plank as well as many Pilates-style exercises increase the downward pressure on your pelvic floor and your prolapse. Choose seated fit ball based core exercises to support your pelvic floor and exercise your core muscles.
For more information about how to choose safe fitness and strength training routines that reduce pelvic floor strain refer to Inside Out – the essential women’s guide to pelvic support by Michelle Kenway (Physiotherapist) and Dr Judith Goh (Urogynaecologist). Inside Out provides you with expert guidelines and advice for choosing safe general fitness and strength exercises and minimising the pressure on your pelvic floor as you exercise.
Rectal prolapse exercises are one important aspect of rectal prolapse management, and these exercises should be undertaken with a commitment to long-term practice for ongoing prolapse strength and support .
ABOUT THE AUTHOR, Michelle Kenway
Michelle Kenway is a Pelvic Floor Physiotherapist and author of Prolapse Exercises Inside Out. Prolapse Exercises is a complete exercise guide for women with prolapse and after prolapse surgery seeking to exercise safely and protect their pelvic floor.