Pelvic organ prolapse is a condition that can evoke significant anxiety, especially for those navigating pregnancy and postpartum recovery. However, with the right information and support, it is possible to maintain an active lifestyle and manage prolapse effectively. In a recent episode of the MamasteFit Podcast, Gina and Roxanne were joined by Dr. Courtney Johnson, a pelvic floor physical therapist, to discuss how to exercise with prolapse during pregnancy and postpartum. Here’s a summary of the key insights shared during the episode.
What is Pelvic Organ Prolapse?
Pelvic organ prolapse occurs when the organs in the pelvic cavity, such as the bladder, uterus, or rectum, drop from their normal position and push against the walls of the vagina. This happens due to a loss of support from the pelvic floor muscles or the connective tissue that holds these organs in place. Prolapse is categorized into different stages depending on the severity and the extent to which the organs have descended.
While prolapse can sound alarming, it’s important to note that it is a common condition, particularly after childbirth. Dr. Courtney emphasizes that having prolapse doesn’t necessarily mean that it will be symptomatic or that it will limit one’s ability to exercise or live a normal life. In fact, many women can manage and even improve their condition with proper care and exercise.
Common Symptoms of Prolapse
The symptoms of prolapse can vary depending on the severity and type of prolapse, but some common indicators include:
- A feeling of heaviness or pressure in the pelvis: This is often described as a sensation of something falling out.
- Bulging in the vagina: Some women may notice a bulge or protrusion in the vaginal area.
- Difficulty with bowel movements or urination: This can include straining, incomplete emptying, or urinary incontinence.
- Lower back pain: Discomfort in the lower back can sometimes be linked to prolapse.
- Discomfort during intercourse: Some women experience pain or discomfort during sexual activity.
It’s important to note that some women with prolapse may not experience any symptoms, and the condition may only be discovered during a routine pelvic exam.
Reassurance and Early Steps Post-Diagnosis
One of the most crucial steps after being diagnosed with prolapse, particularly in the early postpartum period, is not to panic. Dr. Courtney reassures listeners that six weeks postpartum is still very early, and the body is still healing and adjusting. Prolapse diagnosed at this stage might not be permanent, and with the right approach, symptoms can improve significantly.
The first step is to focus on gentle core exercises, proper breathing techniques, and managing intra-abdominal pressure. These exercises help in re-coordinating the pelvic floor muscles and strengthening the core without putting undue stress on the pelvic organs.
Managing and Overcoming Prolapse Symptoms
While a diagnosis of prolapse can be daunting, especially if you’re an active individual, there are numerous strategies to help manage and potentially reduce symptoms:
1. Breathing and Pressure Management
- One of the key factors in managing prolapse is learning how to breathe correctly during various activities. Proper breath control helps in managing intra-abdominal pressure, which is crucial in preventing further strain on the pelvic floor.
- Exhaling during exertion, such as lifting or exercising, can help reduce pressure on the pelvic floor and alleviate symptoms.
2. Pelvic Floor Exercises
- Strengthening the pelvic floor muscles through targeted exercises can help support the pelvic organs better. Kegels, which involve contracting and relaxing the pelvic floor muscles, are a common recommendation.
- However, it’s essential to ensure that these muscles are both strong and flexible. Working with a pelvic floor physical therapist can help you learn how to engage these muscles properly and avoid over-tightening them, which can also cause symptoms.
3. Use of a Pessary
- A pessary is a device inserted into the vagina to help support the pelvic organs. This can be particularly useful for women who experience significant symptoms that impact their daily life or exercise routine.
- A pessary can be a temporary aid while you work on strengthening your pelvic floor, or it can be a long-term solution depending on your needs and preferences.
4. Posture and Body Mechanics
- Maintaining proper posture and alignment can significantly impact your pelvic health. Ensure that your ribs are aligned over your hips and that you avoid excessive tilting of the pelvis.
- When lifting objects or during exercise, it’s essential to use your entire core, including your glutes and deep abdominal muscles, to reduce strain on the pelvic floor.
5. Progressive Exercise and Resistance Training
- Contrary to some misconceptions, it is possible to lift weights and engage in resistance training even with a prolapse. In fact, strengthening your muscles, including those in the pelvic floor, can help alleviate symptoms.
- Begin with lighter weights and low-impact exercises, gradually increasing resistance as your strength improves. Time under tension exercises, where you control the movement speed, can also be effective in building muscle without exacerbating symptoms.
6. Symptom Diary
- Keeping a symptom diary can help you identify triggers that exacerbate your prolapse symptoms. Documenting your activities, diet, stress levels, and symptoms can provide valuable insights into what might be contributing to your discomfort.
7. Mindset and Emotional Support
- The emotional impact of a prolapse diagnosis can be significant, especially if it interferes with your active lifestyle. It’s essential to address any fears or anxieties you may have about your condition.
- Seeking support from a pelvic floor therapist, counselor, or support group can be beneficial. Remember that your body is resilient and capable of healing with time, effort, and the right strategies.
The Role of Strength Training
A common misconception is that lifting weights or engaging in strenuous exercise can worsen prolapse. However, Dr. Courtney and the MamasteFit team emphasize that with proper guidance, strength training can actually be beneficial. Progressive overload—gradually increasing the weight or resistance in exercises—helps in building muscle density and strength, which supports the pelvic floor and reduces prolapse symptoms.
It’s crucial, however, to start with lighter resistance and focus on time under tension, where muscles are engaged for longer periods even with lower weights. This approach can be as effective as lifting heavier weights and is especially important in the initial stages of postpartum recovery.
You can maintain an active lifestyle and continue to exercise without restriction even with prolapse! Our prenatal and postnatal fitness programs come with an education course that teaches you HOW to exercise to protect your pelvic floor.
We offer our fitness programs in two main formats:
Teambuildr App: these workouts are self-paced in a workout app delivered as a list of exercises with demo videos. Workout length varies depending on if you grab the mini (15-20 minutes) or full version (45-75 minutes).
Follow Along Workouts: these workouts are delivered as full length on-demand workout videos that you follow and workout with at the same time.
Explore our fitness programs here or take our quiz to figure out what program is best for you!
Mindset and Long-Term Management
Managing prolapse effectively isn’t just about the physical aspects; mindset plays a significant role too. Stress and anxiety can exacerbate symptoms, so working on mental resilience is just as important as physical recovery. Dr. Courtney encourages keeping a symptom diary to track activities that might trigger symptoms and adjusting routines accordingly.
For those who are pregnant and have prolapse, Dr. Courtney advises focusing on pelvic floor relaxation and pressure management throughout pregnancy. It’s also essential to debunk myths that prolapse can prevent a successful vaginal birth or cause complications during delivery. With the right preparation and mindset, many women with prolapse have healthy pregnancies and births.
Roxanne and I share our personal journeys with pelvic organ prolapse in this podcast episode! We each have a grade 1-2 prolapse with varying degrees of symptoms. Roxanne has used a pessary to help strengthen her pelvic floor as she returned to exercise, while I have had very minimal symptoms and issues with my prolapse.
You can absolutely live an active life with prolapse!!
Conclusion
Pelvic organ prolapse, while challenging, is a manageable condition with the right approach. By focusing on breathing techniques, pelvic floor exercises, proper posture, and gradual strength training, you can significantly reduce symptoms and regain confidence in your body’s abilities. Remember that you are not alone, and there are resources and professionals available to guide you through your journey to recovery.
For more information and support, you can find Dr. Courtney on Instagram at @thefemaleathletedoc, where she shares valuable tips and resources on pelvic health, fitness, and recovery.