Yoga Prolapse Poses to Choose and Poses to Avoid

Yoga Exercises

Yoga prolapse guidelines are designed to help women with pelvic prolapse or having had previous prolapse surgery to exercise safely and minimise the risk of pelvic floor injury.

This article teaches you the Yoga exercises and techniques that improve prolapse support, and Yoga poses with potential to worsen prolapse and pelvic floor problems.

Read on now to learn:

  • Can Yoga fix a prolapse?
  • Yoga prolapse poses to alleviate and strengthen prolapse;
  • How can yoga worsen a prolapse; and
  • Yoga poses to modify or avoid with pelvic prolapse.

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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

Can Yoga fix a Prolapse?

No, the only way to completely repair a pelvic prolapse is via surgery. Appropriate exercise can however alleviate and in some cases eliminate prolapse symptoms in women with mild to moderate prolapse.

Prolapse occurs when the supportive tissues within the pelvic floor and around the pelvic organs (bladder, uterus and bowel) stretch beyond their limit and lose their elasticity. When the supportive tissues lose their elasticity they become thin, floppy and weak. While pelvic floor muscles can often be rehabilitated with exercise, the pelvic floor connective tissues having once failed and stretched beyond their normal limits, cannot recover with exercise.

Yoga Prolapse Exercises to Promote Support

These Yoga exercises and poses may assist women with prolapse by improving pelvic floor support and alleviating prolapse symptoms:

  • Mula bandha (“the root” or pelvic and deep abdominal core muscle exercise) If performed correctly this exercise in should promote improved support for the pelvic organs. Mula bandha can be practiced on its own or incorporated into other poses such as Mountain Pose for improved prolapse support. Avoid strong abdominal muscle in draw particularly if the pelvic floor is at risk. The abdominal activation in this exercise must be gentle, if forceful it may have the capacity to force the pelvic floor and prolapse downwards, particularly with pelvic floor muscle weakness.
  • Pranayama (breath exercise) can be valuable for women with prolapse. Breathing is closely integrated with the function of the pelvic floor, in fact the pelvic floor moves up and down in coordination with the breath. Some women with pelvic floor dysfunction need to attend to the breath before they can contract and relax their pelvic floor muscles.
  • Tadasana (Mountain pose) may be a beneficial posture exercise for women with prolapse and pelvic floor dysfunction. Posture affects the pelvic floor with slumped posture increasing pressure on the pelvic floor. The pelvic floor and deep core abdominal muscles that support the pelvic organs (and prolapse) work most effectively when using the postural muscles effectively and maintaining a natural slight inward curve in the low back. Mula bandha in Tadasana (Mountain Pose) is an ideal combination of exercises to promote pelvic support.
  • Inversions (Upside down/incline positions) may help to alleviate prolapse symptoms such as bulging and dragging however not all inversions are appropriate.
  1. Wall Flower Stretch will take pressure of the pelvic floor by elevating the legs. Wall Flower Stretch has potential to aggravate low back conditions in some individuals and should be either modified using cushion support to elevate the pelvis off the ground or avoided by those with or at risk of low back pain.
  2. Sarvangasana (Shoulder stand) may also provide prolapse relief by simply revering the effect of gravity on the prolapsed tissues. Shoulder stand has the potential to place force upon the neck and should be undertaken with caution and avoided by individuals with or at risk of neck pain and neck dysfunction.

Can Yoga Worsen Prolapse?

Some Yoga poses may have the potential to increase pressure on the pelvic floor and prolapse. Women can often be guided by their prolapse symptoms; increased prolapse symptoms during and/or following Yoga may suggest that the exercises performed increased pressure on the prolapsed tissues. When repeated over time, symptom producing exercises may worsen a prolapse.

Yoga prolapse

Yoga Prolapse Poses to Modify

If your pelvic floor is at increased risk of injury, there are some Yoga exercises to be mindful of that may need to be modified or avoided depending upon how well your pelvic floor is working.

Speak with your instructor about those intense core Yoga exercises and poses that increase pelvic floor pressure if you feel concerned about your exercises and require modified exercise or alternative exercises. The following Yoga exercises and poses may increase pelvic floor pressure:

Yoga intense core abdominal poses and exercises

Intense core abdominal Yoga exercises should be avoided or modified with a prolapse. Strong activation of the upper abdominal muscles increases downward pressure on the pelvic floor (and prolapse). If the pelvic floor cannot withstand the associated pressure it is forced downwards. If repeated with intense force or repeated often this can result in weakening of the pelvic floor muscles and connective tissues.

This is why prolapse symptoms can feel worse after performing some intense core abdominal Yoga poses.

Yoga prolapse poses to avoid or modify include:

  • Double Leg Lift (modify by raising one leg only)
  • Boat Poses (modify raising one leg only)
  • Plank (shown above- modify by weight bearing through knees rather than through feet)
  • Uddiyana bandha (“belly lock”) – this bandha should be avoided by women seeking to avoid increasing pressure on their prolapse. The action of drawing the abdomen in strongly and simulating an in breath increases pressure within the abdomen which is transferred directly down onto the pelvic floor.
  • Deep squat poses – avoid poses involving deep squats to reduce pressure on the pelvic floor including Garland Pose and Noose Pose.
  • Forward bends with wide legs – avoid or modify wide leg forward bends which increase downward pressure in a vulnerable wide leg position such as Forward Bend with V-Legs
  • Upper body weight bearing – weight bearing through the upper limbs increases downward pressure on the pelvic floor with poses such as Crane Pose

This Yoga prolapse information is designed to help you continue your Yoga practice with confidence even if you do have pelvic floor problems.

The strength and function of your pelvic floor muscles is ultimately the major determining factor of which Yoga exercises your body can withstand. If you remain unsure about Yoga prolapse exercises having read this article, seek the assistance of a Pelvic Floor Physiotherapist for assessment of your pelvic floor strength and for appropriate exercise prescription.

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  1. I don’t know what the “wall flower stretch” is. Does it have another name? Is it the same as legs up the wall? I have looked online but can’t find it named as such.

    Thank you for the very informative and useful article!

  2. Hi..I have uterus prolapse 3 stage
    At the moment doing yoga ,wanted to ask if in this stage will yoga work or have to go for surgery ,and which yoga poses is best to do

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Insaya
      Unfortunately Yoga won’t fix a prolapse however there may be other options to discuss with your doctor such as using a pessary

  3. I found your advice very helpful with the yoga poses.

  4. Yes your artical is very helpful
    I have have moderate bladder prolapse; Sury wasnt sucessful so I manage my prolapse with pessaery and yoga.
    Your information has helped me to avoid some yoga poses, which my teacher regonizes.

  5. I am so confused to how the Mula Bandha works, everything I have read says to essentially exhale then draw up the pelvic floor and release on inhale, however with the Mula Bandha you draw up on inhale and release on exhale… is this correct? I just want to make sure and if it is, how is this beneficial? I want to make sure I understand this in its entirety before trying it. Don’t want to make things worse thanks so much

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Randi
      In my mind the key is to use this technique for pelvic floor training. It’s very difficult for many to draw up the pelvic floor muscles on the breathe in. I like to train ladies to breathe normally with their pelvic floor exercises however if the pelvic floor is weak it can help to exhale with the lift and then try to resume normal breathing throughout. What you need to avoid is breath holding during the exercise; your diaphragm and pelvic floor muscles work together in a coordinated manner and the only way to train this is to practice regular normal breathing with pelvic floor exercise. I hope this helps you, all the best

  6. Thanks Michelle Kenway .Wonderful article and great knowledge. Some of my students needed guidance.I am yoga instructor, not therapist .Pelvic floor exercises to strengthen the area with yoga is really great. Blessings and have a wonderful journey of life helping others.

  7. Please add my email to your mailing list. Also…is Yoga’s Bridge pose good for prolapsed-bladder?

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Cindy
      Unfortunately there’s no evidence supporting bridge pose as beneficial for prolapsed bladder however the pose can probably be considered a pelvic floor friendly one that can be done without incurring damage or strain to prolapse. Yes your name’s been added to the newsletter list, thanks for making contact.

  8. Hi,
    I am 55 years old, had 3 vaginal births and one (the last pregnancy) was a C-section. I have a cystocele and a slight rectocele, and I have been using a pessary for the last 3 years which has helped greatly.I love that it works and is still working.

    I am 5’7′ and weigh 135 lbs. I eat a very healthy diet, lots of veggies and fruits, good fats, healthy grains, yogurt, some cheese and butter, some fish, a little chicken, very rarely pasta, potatoes and refined carbs, and no red meat at all,

    I work out daily (on average 1 -1.5 hours each day), doing a combination of HIT aerobics 3 times a week, free weights 3 times a week, and try to do 50 minutes of yoga at least every other day if not daily. I also walk outdoor quite a bit. About 6 months ago I started concentrating more on exercises to strengthen my core, including boat and plank poses and various kettlebell exercises. My core strength has greatly increased, and my prolapse symptoms have not gotten worse.

    Do you think it is ok to continue what I am doing, or could it one day backfire on me? I feel and look great, and feel so much better with a stronger core. I am hesitant to stop doing the poses which I have read are detrimental to women with organ prolapse, because they seemed to have really helped strengthen my core without any negative effects.

    I look forward to your opinion.
    Thank you,

    • Michelle Kenway Physiotherapist says

      Hi Pamela

      It sounds as though you’re very healthy and really looking after yourself well. My guess is that the pessary is supporting your prolapsed tissues really well so that you’re not noticing symptoms with your intense core exercises. You don’t mention the pelvic floor strength and this is also a factor-the stronger your pelvic floor and the better it supports your pelvic organs, the more exercise your body will be able to tolerate. I can’t say exactly you need to do in terms of exercise other than to suggest that you maintain a moderate approach to your core training and always avoid any exercises that cause you symptoms. I definitely wouldn’t recommend increasing the intensity of your core poses and I would suggest you take care with kettle bell exercises that involve squats and forward bends.

      All the best

  9. As part of physiotherapy for knee and SI joint issues I have been told to do the bridge pose to strengthen my glutes. Part of this is engaging the core strongly to protect my hypermobile SI joint. Afterward it feels like my pessary is slipping down.Is there anything I can do to protect my prolapse AND my SI joint while doing this exercise?

    • Michelle Kenway Physiotherapist says

      Hi Abby
      The issue will be likely be intense core activation which has the potential to increase pressure downwards on your pelvic floor. Maybe try to bridge without activating your core so strongly and notice the result. The bridging exercise will still help support your SI joint by strengthening your gluteal muscles.

  10. Hi Michelle, I had surgery last week for a stage 2 rectocele and bought your book inside out which is very helpful. I attend yoga classes regularly so your advice on yoga modifications would be very useful especially for those teaching Yoga.
    I see that you have a daily workout CD but would be keen to have a video that I could download to my iPad that has daily workout kegel exercises, no more than 10 mins that would enable me to progress my pelvic strengthening. An app that could enable you to view video, perform the exercises and then record your progress would be invaluable. Do you have anything in the pipeline ? Is there any 5 -10 min videos that I can currently download to my iPad that will enable to build a recovery programme ?

    The advice I got from the Physio is pretty basic, so this is really useful.

    Regards Maria

    • Michelle Kenway Physiotherapist says

      Hi Maria

      This is a great suggestion and I really appreciate you taking the time to tell me this. I base almost all the information I distribute including books & DVD’s on requests & feedback like yours. Leave this with me. I do have a short online series of pelvic floor strengthening videos that you may find helpful to start with while you’re waiting for me to produce this, here’s the link Maria you will see Episode 4 is the video for beginners which is where to start when you have your surgeon’s approval to commence your pelvic floor exercises.

      This video might assist you too for post operative pelvic floor exercises when starting out after surgery.

      Many thanks once again, all the best for your recovery

  11. Hi Michelle,
    After four years of practising Bikram yoga I have recently started doing some Astanga and I am loving the change. Since having my son (almost 3), I’ve noticed that my pelvic floor was not the best but it is becoming more clear now as I practice Ashtanga yoga. Whenever I am doing an inversion posture whether it’s bridge or shoulder stand and I come out of it, there is an enormous farting sound. This is so embarrassing I am actually finding that I am wanting to sit out of these postures. I know that this is supposed to relieve the pelvic floor but what (if anything) can I do to reduce/eliminate this sound? Are there some specific exercises I can do? Is this about the pelvic floor muscles or something else?

    • Michelle Kenway says

      Hi Daniela

      This vaginal noise sound is usually an indication of laxity or looseness in the upper front wall of the vagina (often it occurs with upper anterior vaginal wall prolapse). It simply happens as air becomes trapped and the noise is made as it leaves the vagina, it is nothing to be alarmed about but agreed it is embarrassing especially in a class situation.

      The solution is to strengthen the pelvic floor muscles with regular pelvic floor exercises to increase the tone of your pelvic floor. It would also be advisable to avoid those Yoga poses such as those listed in this article that place pressure on the pelvic floor such as deep squat Garland pose, deep wide leg forward bends and intense core abdominal exercises as your pelvic floor strength improves.

      You may like to use this link to access guidelines and information for strengthening your pelvic floor with pelvic floor exercises

      Hope this helps you out Daniela

  12. Hi Michelle, I would love a yoga DVD and would be happy with a number of routines but would still be happy with I one routine of pelvic floor safe yoga. I use your Inside Out DVD and attend a yoga class but frequently have to modify postures, it will be great as instructors become more informed about this issue. Thanks so much for all the information. Sue.

  13. I had a total hysterectomy 6 months ago due to a uterine and cervical prolapse. The only advice my doctor gave regarding exercise is: no running and no quick, jerky motions. I have been walking 30 minutes a day but I started an exercise program on DVD and find I have to modify all of it. Based on what I have learned on your website, I have modified the planks, squats and lunges. I also march in place verses running or jumping in place. In the program I bought, there are a lot of standing knee lifts which I am unsure if those are pelvic floor safe. The workout asks you to tighten your core while standing and lift a knee above your waist, while crunching your abs. I modify it by not tightening the core or crunching and keeping the knee lift below the waist, but am unsure if even that is safe. I am just so terrified to create another prolapse but I want to exercise and tone because I am gaining weight and feel so flabby. I am not even sure if sitting, extended leg toe touches are safe or sitting or lying, spinal twists are safe for the pelvic floor. I want to enjoy exercising and not worry that each exercise I try might cause a prolapse. I would love to see a pelvic floor safe yoga routine as well as a pelvic floor safe tummy toning DVD that could be purchased in the US.

    • Michelle Kenway says

      Hi Jen
      Thank you for your comment. I think the modifications you are making sound excellent. I agree – keep your knee lifts below your waist, no need to lift your knees higher than this anyway, there is no really functional or weight loss benefit. Agreed also avoid drawing in your abs while lifting your knees. I would avoid sitting deep forward bend toe touches as these will increase the pressure in your abdomen which is transferred to the pelvic floor. Spinal rotations are not an issue, the feet need to stay flat on the floor avoid lumbar rotations with the feet raised – they are not helpful for the spine or the pelvic floor.

      Did you know I have a pelvic floor safe exercise DVD for the US for toning and strengthening? This was made for women with prolapse issues and after prolapse/hysterectomy surgery to help them exercise safely. I need to get to work with Yoga/stretching DVD in my spare time :)

      Anyway hope this helps you along. I have some weight management articles for prolapse coming out with the next newsletter you may like to read too, not sure if you are on the email list.

      Best wishes

  14. Hi Michelle,

    I would love to see a number of routines.
    Thank you!

  15. Prue gashumba says

    Hi Michelle,

    I have really found people’s comments, experiences and your information very helpful as I am having a prolapse and love exercising. I would love to buy one of those prolapse safe exercise DVDs once you have made one.



    • Michelle Kenway says

      Hi Prue
      Thank you for this feedback. Can I ask what you would like to see on this DVD? One person instructing a session of pelvic floor safe Yoga? One routine or a number of routines?
      Kind regards

  16. Dear Michelle,
    I have a stage 2 uterine prolapse. How can I modify the forward bend with wide legs? It’s one of my favourite positions!
    Also, I recently did a headstand as the physio said that would be OK with a prolapse, but when I came down, I could feel and hear my organs dropping back into place and after that, the prolapse came much, much lower :( I think inverted postures are to be avoided, I am certain this made mine worse.

    • Michelle Kenway says

      Hi Squirrel
      Thanks for your question on Yoga with a uterine prolapse. To modify Forward Bends to reduce pressure on the pelvic floor you will need to reduce the degree of the bending forwards movement. I am not sure whether you do this pose standing or seated however if for example you do this standing rather than forwards bending to touch your feet you might modify the exercise by forward bending to place hands on a block. In my classes we do forward bending facing a wall and placing both hands onto the wall- this reduces the potential strain on the pelvic floor and the lower back.

      Interesting to read about inversion and your pelvic floor – when inverted there is no strain on the prolapse, in fact the pressure is relieved off the prolapse when inverted however it may well be that the act of moving down from the inversion increases some pressure on the pelvic floor, it remains to be seen. Regardless it is best to avoid Yoga postures that aggravate prolapse symptoms and if this is one of them then leave it from your routine.

      All the best

  17. Very useful thank you very much.

  18. I’m in Australia and would be very interested in purchasing a DVD too as I too love my yoga but am worried I might do myself more harm than good.

  19. Just had laproscopic uterosacral vaginal vault suspension repair transoloturtor tape. anterior prolapse surgery Dec. 3, came hm with a catheter. Dec. 9 cath was taken out. I was sent home with self cath un able to void at dr’s office. Post – op dr. said that I had abdominal adhesion that were removed that the surgery it’s self went very well. I’m still inflamed in my vagina and bladder, ureatha. my ? is how do I urinate more on my own, when I get the urge to urinate only a little 25, 50, 75cc comes out. How do I relax the my pelvic floor.? I’m cathing between 250 – 400cc thank you.

    • Michelle Kenway says

      Hi TC
      Thank you for your comment and question – to void and empty your bladder there are a number of things that women can do to help
      – sit to void (don’t hover over the seat) and lean forwards with the inwards curve in the lower back
      – relax the pelvic floor muscles by bulging and relaxing the lower abdominal muscles forwards (i.e. the area below where your briefs normally sit)
      – avoid overfilling the bladder and schedule regular voids so as not to over fill the bladder
      – double void technique is also very helpful and this involves standing up after the first attempt at emptying the bladder, rotating the hips forwards, backwards and around in circles a little like hoola hoop action then sitting back down to empty further. This techniques can be done as many times as desired to improve bladder emptying
      – avoid bladder irritants like caffeine which increase the speed of bladder filling until the bladder is emptying well

      Best of luck TC, my apologies for the delayed reply I actually had a holiday break this year:)

  20. Hi Michelle,
    I was wondering if you had made a DVD yet?I have two children and mild prolapse symptoms and wanted to know which poses are safe to perform. I would love to go to my local class but seems silly if I have to stop and wait to do poses which are safe for me. Having a DVD would be great as not only could I practice at home I could also do the safe poses at the class

    • Michelle Kenway says

      Hi Lisa
      Thank you for contacting me – this is definitely on my to do list, hopefully in the New Year. Are you on the newsletter list? I will send out a message when this comes closer, and thank you for the reminder!
      Best wishes

  21. Hi Michelle,
    I am 45 yrs old. I yet to undergo Hysterectomy surgery soon. Now I can do all yoga postures(even advanced) very easily and do practice regularly. After surgery (not immediately, 1 yr later) can i do the same or should avoid some postures compulsorily? Pl. advice whether i can swim and ride bicycle one year after surgery?

    Thank you, Sudha

    • Michelle Kenway says

      Hi Sudhaa
      Thanks for your comment/question. There is usually no issue for women swimming or bike riding a year after hysterectomy. Most women are well healed by this time. The issue arises in Yoga with respect to intense core abdominal exercises (e.g. full Plank, V sits etc), to avoid placing too much pressure on the pelvic floor. Other positions and exercises to be mindful of after pelvic surgery are exercises such as deep wide leg squats. What you can do individually will depend ultimately upon the strength and support provided by your pelvic floor. Hope this helps, best of luck

  22. Thanks so much for all the good information…I had the prolapse surgery in 05…I was told it has come down some…..Also I noticed in April of this year after doing yoga class that I was in pain…now realizing it was some of the yoga poses I was doing…I love doing yoga and it makes me feel so good….I want to go back…but thinking I might try Silver Sneakers chair yoga. I love getting down on the floor but I guess the is the next best thing….Also the swimming was a great suggestion…I am a very active 68yr. old. Thanks and Best wishes Marita

  23. Hi Michelle
    I have an overactive bladder with urge incontinence. I’ve started doing yoga to try and keep my anxiety and stress levels at a manageable level. Can you let me know of any yoga or pilates poses/moves that place pressure on the bladder. I was recently doing a low squat and the pressure was very intense! Just so you know, this was brought on by a severe UTI and I’ve not had any children.
    Thanks for your help!

    • Michelle Kenway says

      Hi Amy
      Yes you are spot on with the low deep squat, this position will increase pressure on the bladder. Other exercises that come to mind include forward bends (especially maintained), and intense core abdominal poses like Plank. Also just thinking about your history of severe UTI and not having had children it’s probably worth mentioning the importance of pelvic floor muscle relaxation not just contraction. Pelvic floor muscle relaxation can be encouraged with your Yoga diaphragmatic breathing, gentle lower abdominal bulging forwards and visualisation of the pelvic floor relaxing during the meditation and relaxation if the class includes this. Otherwise this technique can be practiced at home lying down (maybe incorporated into a 5-10 min. whole body relaxation routine if you have time), a warm pack on the lower abdomen can help too.
      Best wishes

  24. What is wallflower stretch?

    • Michelle Kenway says

      Hi Maria
      Wallflower stretch involves laying on the ground with legs up against a wall. The position usually involves getting the buttocks as close to the wall as possible, upper body relaxed and head down, legs up. This position places stretch on the hamstring muscles at the back of the thighs and the lower back. It is not a position I would recommend for anyone who is prone to lower back problems. It can sometimnes be modified by placing a firm cushion under the lower back to lift the buttocks off the ground. This is an energy restoration position in Yoga.

  25. Hi Michelle

    I’m really grateful for all the advice you’ve given on pelvic floor safe exercises, and am now working with a personal trainer to put some of this into practice.

    Is downward dog a suitable pose?

    And I really have enjoyed sun salutation before prolapse (vaginal and bowel) – would this be suitable now? I haven’t had surgery, but am having physio to strengthen my muscles


    • Michelle Kenway says

      Hi Sarah

      I don’t see a major problem for the pelvic floor for most women with Downward Dog, the pelvic floor is usually not under pressure in this position. Downward Dog is definitely not for everyone, especially women with low back disc problems but that’s another story.

      Yes the Sun Salutation is a lovely Yoga sequence isn’t it. Is the Sun Salutation pelvic floor safe? I suspect not for everyone – the full Plank position lowering to Push Up position is quite an intense core exercise. For some women this will be too much for their pelvic floor to withstand espceially if repeated, for other women it will be fine, so it ultimately depends on the individual capacity of the pelvic floor. Sun Salutation can be modified by kneeling rather than full Plank on the toes to make it a less-intense core exercise. This doesn’t answer whether it is ok for you, as this unfortunately Ican’t answer but your Physio should be able to give you some feedback on your pelvic floor strength and capacity to resist the associated pressure with this sequence of exercises.

      Hope this helps you enjoy your yoga Sarah

  26. Hello Michelle, What a wonderful informative article you have written. My input is on Udiyana Bandha. I believe the only safe way is to teach it in stages slowly so they completely understand the workings of the three diaphragms, and many find cat breathe is successful for them.
    On the exhalation Jalandha bandha is executed, then uddiyana by gently drawing navel in and UP to lift central diaphragm and widen rib cage (as back is then bought down keeping natural curve in spine) then drawing up as in Mula Bandha and anal area of Aswini Bandha and we have three successful locks then gently releasing … a resting breathe …and repeat if we ..and they have felt the three locks especially pelvic floor. As Inderstand and I feel vwithin my self the chin locks starts off the vacuum with the mid diaphgram then as the pelvic floor in joining in the vacuum increase the drawing up. It often takes a lot of classes to teach this correctly and many teachers find it too hard to teach but I feeel it is so worthwhile that I persevere until the student and I am happy with the result. I can tell without asking the student if they felt it alletc however Iet them give me THEIR feedback. We teach very gentle style classes yet with awareness.
    I appreciate and welcome your input please?

    We don’t teach the strong abdominal work but gentle with awareness of the lift.

    I do teach sitting correctly as taught by Judith Lasseter and have found it quite successful as well.
    Look forward to hearing from you.

    • Michelle Kenway says

      Hi Lesleigh

      Yes we do know that the pelvic floor is constantly moving with the breath. On the out breath the pelvic floor rises owing to the decrease in intra abdominal pressure, and then descends with the in breath, in doing so mirrors the action of the diaphragm.

      I would agree with you that breathing and abdominal muscle activation should be gentle not forceful and that breathing awareness is vital for women when it comes to pelvic floor contraction and relaxation. I think that problems come into play when the action is strong and forceful. WE know from research that while some women think they are activating their pelvic floor muscles correctly, in fact they are bracing and pushing down which can have the potential to worsen pelvic floor problems. So that if a woman is strongly activating her abdominals, we can’t be sure that she is also elevating her pelvic floor without a pelvic floor examination.

      In my experience, women who have practiced Yoga breathing often have a very good understanding of diaphragmatic breathing to aid in post operative ventilation and also to help pelvic floor muscle rehab and relaxation.


  27. I had bladder prolaspe surgery 3 mos. ago. Read your book “Inside Out”. Still some questions. What about the following postures: Plough, cobra, headstand. I’m guessing the headstand is not good because you use adominals to raise yourself up. How about sitting cross-legged? I would love a prolapse appropriate yoga dvd. I purchased a pelvic floor rehab dvd, but it includes wide leg squat positions which I am not doing.
    PS—thank you so much for “Inside Out”. It contains the best infomation I have been able to find on post surgery appropriate excercises.

    • Michelle Kenway says

      Hi Marlene
      Thanks you for your questions, I am not advocating these following exercises as pelvic floor safe but I will try to appraise them in terms of potential impact upon the pelvic floor. As always different exercises will impact differently upon women’s bodies, however with previous prolapse surgery I think it is particularly prudent to avoid potential risks with inappropriate exercises.

      The Plough is a little difficult to assess – it does involve double leg raise to get into position (this could be modified by raising one leg at a time to get into position). There is no research to my knowledge that assesses the pelvic floor pressure associated with these types of yoga exercises. I also wonder if by compressing the abdominal area when in the Plough position with legs backwards over the body, whether the pressure within the abdomen and transferred to the pelvic floor is enough to impact upon the pelvic floor? Again this will be a very individual thing and vary from woman to woman depending upon her pelvic floor capacity. Did you do this exercise prior to your prolapse surgery? Did you notice any symptoms with this exercise?

      I don’t see Cobra as an issue for the pelvic floor although I would not do full Cobra during recovery from pelvic floor surgery. I always avoid full Cobra to avoid compressing the joints of the low back, and I avoid extending the neck backwards (many necks are not happy in the hyper-extended position). I find when exercising with classes of mature women this helps to avoid discomfort or injury to those participants in class with more vulnerable low backs and necks.

      As for Headstand, once you are in the position I imagine there is actually very minimal pressure on the pelvic floor as there is no gravity, and no weight of abdominal contents on the pelvic floor either. It would be a matter of raising into headstand one leg at a time, which will use the back of your legs and butt. Abdominals are active in this position but not in a manner that would impact upon the pelvic floor.

      Sitting cross legged? Once again no research, I don’t see a major issue with it sitting upright, however I would avoid cross legged or legs apart lean foward exercises.

      Hope this helps a little!

  28. Maree Bentley says

    Hi Michelle
    You are right about confusing advice on exercises and yoga after prolapse surgery. I have just had my third stint of prolapse surgery so definitely have to look after this last attempt. I have avoided yoga since last surgery 3 months ago but would really like to resume. A DVD would be great; meanwhile I’ll send your advice above on what poses to do and what to avoid to my yoga instructor.

    I’m having trouble with a “jelly belly” since last surgery. I’d really like to restore some strength to my abdominal region without doing weights. Sadly, surgeon says I shouldn’t lift anything much for the rest of my days (including grandchildren). Do you have any recommendations for safe exercises?

    Many thanks for all your help to we prolapsed ladies.

    • Michelle Kenway says

      Hi Maree

      Lovely to hear from you. Are you interested in a pelvic floor safe yoga DVD or a pelvic floor safe tummy toning DVD? What would help you most?

      I really think that after three attempts, you need to be so very careful with your exercises now. Do you have access to a pelvic floor physiotherapist to help you Maree? This is my first thought.

      I really like gentle seated ball core exercises, I have some shown in this core exercise video I made for post hysterectomy but they also apply to women after prolapse surgery. There are many seated variations you can use but the nice thing is that they involve sitting and supporting your pelvic floor. Let me know if you’d like to see some more and I’ll set about making another online video of these types of pelvic floor safe core exercises.

      Swimming is also a great gentle tummy toner. Swimming freestyle will not overload the pelvic floor, but involves the core abdominal muscles working gently.

      This article on pelvic floor safe core abdominal exercises may also assist you too.

      Does this help a little? Let me know is you need more information Maree

      Kindest regards

  29. I have had prolapse surgery and rectum also but specialist didnt tell me not to do yoga, pilates of gym. I was thinking of going to crossfit but after reading thses comments I am wondering what you think. I have probably already undone the good of the surgery.

    • Hi Moira
      The pelvic floor risk can be with intense core abdominal exercises in Pilates and Yoga along with some Yoga positions combined with specific exercises such as wide leg bend forwards.

      Cross fit suitability will depend on your instructor and the exercises incorporated. Cross fit can involve intense workouts, and some inappropriate exercises for women after prolapse surgery. You will know even when you start about the class suitability by whether or not the instructor enquires about any history of pelvic floor surgery. If there is no screening it will be highly unlikely to be a pelvic floor friendly class.

      I hope this helps you a little with your future exercise program, best of luck

  30. I have had surgery to correct prolapse of bladder and rectum…I really like yoga and am getting my core stronger. But, I am concerned what yoga poses pose a risk for future prolapse. I am in favor of a DVD that ya’ll put together for us lovers of yoga!!

  31. margaret says

    thank you for this information. I love doing warrior pose, triangle, downward dog…and have often wondered if they’re ok. recently bought a yoga tape and started some new exercises which aggravated my prolapse (uterine). But the above warrior pose, etc. don’t seem to bother me. I, too, would love to have a dvd especially with prolapse in mind!

    • Hi Margaret
      Thanks for your comment! Yes these are nice exercises- which Yoga exercises do you think have recently been aggravating for your prolapse? Always interested to hear. And yes, I need to get busy with a DVD lased along these lines.
      Best wishes

  32. I’m a 60 year old Yoga instructor and I’ve begun to notice some symptoms of “inner slackening” in my own pelvic muscles. Have recently discovered your site. THANK YOU for this information in particular!! Bandha is, of course, commonly taught to instructors, but the idea of avoiding the “downward thrust” of some of these other poses is news to me!! (oh, dang, and just when I (thought) I was getting really strong in Navasana!)

    • Hi Nanna
      So glad this information has helped you a little towards safe Yoga (and hopefully your female Yoga class participants too).
      Best wishes

  33. I have a mobile bladder neck which has caused stress incontinence. How can I strengthen and flatten my stomach without making things worse. I am due to have a tension free tape fitted.

    • Hi Sue
      Great question regarding flattening the stomach after a TVT. You are undoubtedly aware of the potential for intense core exercises to place downwards pressure on your TVT so best to avoid these types of exercises. Also too, you can further relax in the knowledge that intense core exercise will never flatten the stomach, this is a myth. A flatter looking is achieved with weightloss which usually occurs all over (unless surgically assisted!), we can’t spot reduce with exercise. We can however gently tone the core abdominal muscles with exercises such as those shown in this safe core exercises video, hope they help you along with a safe recovery post-op and long-term.
      Best of luck

  34. victoria hattemar says

    Would you consider putting together a yoga routine on DVD for strengthening the pelvic floor?