Rectal Prolapse Exercises – How to Exercise and Improve Rectal Support

Rectal Prolapse Exercises

This information teaches you how to improve rectal support with rectal prolapse exercises along with rectal prolapse exercisesexercise  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:

  1. Mucosal prolapse which involves only the rectal mucosa (membrane) protruding through the anus;
  2. Full thickness rectal prolapse where the rectal wall protrudes through the anus; and
  3. 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: rectal prolapse exercises

  • Ageing
  • 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 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.

Inside Out by Michelle Kenway Pelvic Floor Physiotherapist and Dr Judith Goh Urogynaecologist teaches the essential exercise stages for effective pelvic floor exercises.

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 .

prolapse exercisesABOUT 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.

Comments

  1. I just found your site and have been trying to use your video on how to
    > have
    > a BM without straining the pelvic floor.
    >
    > I had a hysterectomy 7 weeks ago and have been recovering well except that
    > last week I had a pretty bad rectum prolapse. I have delt with chronic
    > Constipation for the last few years and off and on before that. I was
    > having
    > a bad bout with it and strained too much and enough came out that I had to
    > go to E. R. at the hospital. They got it back in. Now I am taking lots of
    > stool softeners and trying to be very careful how I go. So far am doing
    > not
    > too bad thanks to finding your video. No doctors or nurses that I talked
    > to
    > were any help at all.
    >
    > Have an appt. next Friday with a P.T. who specializes in pelvic floor. So
    > am
    > hoping she can tell me if I can work this out with P.T. or will I need
    > more
    > surgery. I am a strong healthy 56 year old with a tricky digestive system.
    >
    > I know you can`t give advice but if you could steer me to any of your
    > articles about rectum prolapse I would appreciate it. I think it was
    > brought
    > on by years of straining and the hysterectomy. I have never had children.
    > I
    > am wondering if my obgyn should not have made more sure that I did not
    > have
    > any of these problems already that might have needed repair before going
    > into surgery. (I had a abdominal with a 4 pound fibroid.) Now she seems to
    > not want to be bothered with me anymore. I just didn`t know much about all
    > this before the surgery. Didn`t know what to ask even. Now am wondering if
    > they couldn`t have done some repair work at the same time.
    >
    > Glad I found your video anyway. It saved me when I had no idea how I was
    > going to have a BM without the rectum prolapse again. (It was very
    > painful)And stool softeners have helped a lot too. Mirilax and ducosate.
    >
    > Thanks,
    >
    > Rachel
    >

    • Hi Rachel
      Thanks for your great comments. Yes we completely agree with you – it is possible that in many cases rectal prolapse can be prevented particularly by educating women like yourself who deal with chronic constipation and who therefore at increased risk of prolapse. Rectal prolapse is often the unforseen painful outcome of years of straining with constipation. If women understand; the risks associated with chronic straining to empty their bowels, how to empty their bowels correctly and relax their pelvic floor muscles, in addition to understanding how to keep their stool a good consistency through diet, exercise and appropriate medications if required then the incidence of rectal prolapse would be vastly decreased without a doubt. Following gynae surgery for prolapse repair and perhaps hysterectomy the risk of prolapse may be further increased, particularly in the early days when constipation may recur. The big thing to manage this long term aside from those factors already mentioned is getting the pelvic floor muscles functioning really well to support the rectum and anus, and prevent repeat rectal prolapse.

      Rachel you will find numerous article and videos on how to strengthen with pelvic floor exercises and for prolapse exercises. A great starting point is the free complimentary pelvic floor or kegel exercise video which you can access on our home page by entering your email address. Also watch this video on how to avoiding repeat prolapse.

      Hope this information helps you Rachel, best of luck with your recovery and health. Please let us know how you go, Michelle

  2. Marilyn Burns says:

    Hi Michelle:
    I’m so glad to be on your mailing list. The information you are giving us is critical to our well being. I have your book on my night stand for those awake minutes during the night.

    I’m glad to see the expanded subjects — I surely hope all the women in this world find your website

    Sincerely,
    Marilyn

    • Michelle Kenway says:

      Hi Marilyn
      How lovely to hear from you! I hope you are well. It’s been a while, my sincere apologies I have been flat out with my family and working (just like so many other women). I hope the changes help you find information more readily. I plan to be in touch with you on a monthly basis now that I am close to catching up so let me know if there’s anything you need.
      Best wishes to you Marilyn
      Michelle

  3. Will these exercises help reverse the prolapse, or just keep it from getting worse?

  4. Hi Michelle,
    I look forward to your monthly newsletter. It is good to reaffirm the pelvic floor exercises; especially how to modify those exercises in aerobic and pilates classes to make them safe for me I found that to be of enormous benefit, and I won’t feel self conscious now when I am doing something different to the others. Could you give me an alternative to doing squats when in a circle at the beginning of our aerobic class.
    Thank you,
    Kathy

    • Michelle Kenway says:

      Hi Kathy
      Why not do minisquats? Feet about hip width apart, butt goes back as trunk inclines slightly forward, a nice alternative to traditional wide deep squats. Let me know if you need further description on how to do this exercise. This can be combined with arm reach forward too. It’s a lovely exercise and you will feel like you are doing something similar to the others, and therefore less conspicuous.
      Cheers
      Michelle

  5. Hi Michelle!
    I’m a 26 year old female struggling with issues relating to a rectal prolapse. Before these issues, I was very active. I’m an avid gym goer, but I feel there is not much I can do anymore.
    I miss Step classes and boxing the most- is there any way I can get back into either of those forms of exercise without damaging myself more? :(
    I’ve been seeing a pelvic floor physiotherapist for a while now and I know which exercises are recommended, but the low impact and light weights are driving me crazy and I’m no longer getting any joy out of keeping active.
    If you have any advice, it would be greatly appreciated.
    Thanks!
    Bella

    • Michelle Kenway says:

      Hi Bella

      Yes I understand your frustration. Have you considered using a pessary to help you with your activity? This article on support pessary will give you a little more info – you would need to be assessed and fitted by your gynaecologist, some Australian Pelvic Floor Physios are also now fitting pessaries.

      Hope this gives you some help with this issue
      Michelle

  6. I have a full rectal prolapse. It is not due to constipation (I’m vegan). But is due to straining to fully empty my bladder. What exercises can I do to reduce this. Going to the bathroom now requires that I push my rectum back most of the time. Sometimes if I half stand up it will recoil back inside me.

    I’m new to this site and am interested in videos as well as books and advice.

    Thank you so much! I hate this!

    • Michelle Kenway says:

      Hi Lori
      Yes agreed rectal prolapse is a challenging condition to manage. I think it is worth mentioning that with a vegetarian diet there still can be challenges for the bowel since the high insoluble fibre content can make the stool bulky and a little difficult to pass at times, stool consistency is a key area to manage with this condition ensuring that it is well formed and soft to pass. If the prolapse does not return into the rectum upon standing this is a medical emergency and I think this is important to mention if this occurs.
      Best of luck with your management
      Michelle

  7. Thanks for your response, Michelle. Can a pessary be used in the rectum? I thought that was more appropriate for a vaginal prolapse?

    • Michelle Kenway says:

      Hi Bella

      Yes pessaries are for vaginal prolapse, you are correct. Support pessaries are not used in the rectum. The conservative management of rectal prolapse is usually primarily focused on bowel management (good bowel emptying technique, stool consistency) and pelvic floor strengthening. When this fails, or if the rectal prolapse is severe then surgery is used for management.

      Best of luck
      Michelle

  8. hello
    just on this site for the first time. Iam not sure of the problem i have but since 4 years i have been dealing with the problem of constipation with a lot of straining when having a bowel moving. and since then i have used a lot of stool softeners including enemas. so at the stage aim now even the soft stool takes long to come out. i have seen doctors i did a T-scan they still find nothing wrong with but within myself i know that i have a big problem. Please i need your help to have my normal life back. thanks

    • Michelle Kenway says:

      Hi Lizy
      Unfortunately I am unable to diagnose your problem however I can suggest that you watch this bowel movement video which may help you with your emptying technique. The critical thing is to bulge the abdomen forwards as this relaxes the external anal sphincter during the bowel movement. When women strain to empty their bowels they usually draw the abdomen in strongly which contracts the anal sphincter and actually makes the problem worse. You may also like to read this article on pelvic floor muscle tension, it may/may not apply to you.
      Hope this gives you some direction
      Michelle

  9. Iam a 51yrs women who had a total bowel obstruction 12 months ago had surgery which discovered i had malrotation of the bowel and had bands and adhesions which were causing the bowel obstruction, recovered well and bowel movements went back to normal for about 3 months then bowel stopped again the surgeon thought i had another obstruction had more surgery and not obstruction had been found. since then the only way i empty is by taking picalax medication every second day have had ..ct..mri..and barium orally and rectum which has discovered that i ave intussusception of the lower bowel just before the rectum so when i feel the need to go i sit an nothing happens….only with the picalax do i get movement this is since last may…. am only being referred to a pelvic floor center but have to wait till May for my appointment….my symptoms are not being able to empty or pass wind and everytime i have a meal no matter how small i get severe abdominal distention and colic like pain which will build all day and by evening i am completely debilitated , if i go walking i get abdominal pain … the position of sitting in the car causes abdominal distention and pain…can no longer ly on by sides in bed as it causes awful pain..will wake everynight …also take trmadol for pain…diet and fluid has all been tried with no results. my question is how is pelvic exercises going to cure me…have been doing my own pelvic exercises myself since being told about intussusception in december but am not getting any improvement am at wits end here….

    • Michelle Kenway says:

      Hi Angela

      Thanks so much for your comment and for sharing your experience here, yes I can see why you must feel at your wits end. Pelvic floor physiotherapy can help bowel management in a number of ways – teach correct bowel emptying position and technique (after assessment of your current emptying problems), assess and modify stool consistency with appropriate diet, and of course teach how to strengthen and relax your pelvic floor muscles according individual assessment. Your physiotherapist will assess you and then based upon this assessment implement appropriate treatment.

      Angela I would also recommend that you read some of this information which may also assist you – trying to reduce gas with diet and management, achieve a good stool consistency and overcome constipation and empty your bowels using the technique to avoid straining.

      Angela have you considered asking your doctor to phone the centre on your behalf to assist you towards an earlier appointment or perhaps contact the centre yourself and ask to list your name on a cancellation list if they have one?

      Please don’t hesitate to contact me further if I can assist you
      Kindest regards
      Michelle

  10. Hi Michelle, Thank you for you info….have been in contact with the centre and they cannot take me before april….so will have to wait..have view a few of your videos and will try and do the suggested exercises…will let you know how i get on…i was so relieved to find your page as it has given me so much information and answered so many of my questions.
    Again thanks,
    Angela.

    • Michelle Kenway says:

      Hi Angela
      All the best to you – please let me know if there is any other information I can help you with while you wait, and yes keen to hear how things go for you.
      Michelle

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