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Pelvic Organ Prolapse and Exercise Part 3

The Barn KT9’s 3-part guide to understanding what pelvic organ prolapse is, where to start in managing symptoms, and how to continue exercising with prolapse written by our Instructor Tori.

How to exercise with POP

Typically the messaging surrounding POP and exercise focuses on what women “can’t do” - no running, jumping or lifting more than X weight - rather than uplifting. While pelvic organ prolapse may present challenges, it shouldn’t be the be-all and end-all of one’s fitness journey. The journey may just look a little different from time to time. 

So, here are my top 5 tips for exercising with pelvic organ prolapse.

  1. Learn to down-train your pelvic floor. 

For muscles to be able to effectively shorten and contract, they must be able to lengthen and relax fully. Gripping or guarding the pelvic floor is a very common response to POP. Mentally, we go into protection mode. Unfortunately, the constant gripping is hindering the pelvic floor's ability to strengthen because it’s in fact, too fatigued to function optimally. Positional breathing exercises can help down-train the nervous system and encourage relaxation and lengthening in the tissues of the pelvis. These are great to use post-exercise and/or when feeling symptomatic.

  1. Find the stack

Our bodies have an incredible way of compensating. If we want to do X, our bodies will find the willing muscles to help achieve that goal. However, when our body is in a period of postural change - such as pregnancy and postpartum - certain muscle groups can overcompensate and create unfavorable movement patterns. Orientating the ribcage over the pelvis allows for the core canister to have the best shot at working together as a system and managing intra-abdominal pressure. Tuning in to where your ribcage and pelvis are in space takes time, but this awareness and ability to adjust when exercising will give you the greatest opportunity to hit the target muscle groups for the exercise being done. 

  1. Intention now for intensity later

Taking the time to strip exercises back to their simplest form to find your symptom threshold may seem tedious, but will only help you in the long run. Find the right intensity at which you can do certain movements or exercises without symptoms and work within that range. You can then progressively begin to add more load or challenge to those activities to improve the endurance and strength of the muscles involved. When you begin to feel symptomatic, whether it's immediately or maybe the next day, you have found your new symptom threshold. Symptoms should not be feared or ignored. Rather symptoms can be used as feedback from our body to say that we may need to back off or try something different. 

  1. Find a supportive breathing strategy

As spoken about previously, our core acts as a canister and intra-abdominal pressure changes constantly. Exercise increases intra-abdominal pressure and if unmanaged, can impact one’s POP. We want to avoid breath-holding and bearing down (like when you’re trying to have a poo!). Instead, we can effectively manage pressure during exercise by finding a breathing strategy that helps “release” that pressure and creates support within the core.

Here are 3-options:

Exhale through whole movement: 

When first starting to exercise with POP, this is a great foundational breath strategy used to create coordination of the core system. Taking an inhale before the movement begins and exhaling through the whole movement allows us to marry that coordinated breath to a movement pattern. 

Exhale through exertion:

When one exhales, the diaphragm ascends, and the pelvic floor returns to its baseline. Therefore, it often feels most supportive to exhale during the hardest portion of an exercise when the slight lift of the pelvic floor can occur simultaneously. 

Brace breathing: 

This is a more advanced technique that can be used for more challenging movements. The key here is to be able to create tension in the abdominals, while still being able to breathe effectively into the ribcage and pelvic floor. This requires great awareness of one’s breath, tension, and positioning during that movement. 

  1. Become adaptable 

The goal is to find a way to support one’s long-term pelvic health and a lifetime of athleticism so we must control the controllables. We can’t change the fact that pelvic organ prolapse occurred. However, we can control how we choose to move, our mindset, and the support we put in place. As mentioned before, symptoms can fluctuate, so rigidity in a training routine or style can lead to disappointment and feelings of failure. Being adaptable with your training, knowing when to take a step back, and putting systems in place to keep you motivated during more challenging times will only support your athleticism in the long run. 

To sum things up, pelvic organ prolapse can present challenges and those challenges can vary over time. Finding the tools that help keep you positive, motivated, and empowered will ultimately help you regain strength and resilience after a POP diagnosis. At no point should anyone feel alone or ashamed of having POP - it is very common and there are effective treatments and supportive measures that are available to help manage and alleviate symptoms. Sport and exercise may look different for some time as you navigate what your movement threshold is, but over time and with the right support, you should be progressing in a way that is unique to you and your body. 

Finally, just to reiterate, nothing is ever TMI for our coaches at The Barn KT9, so please speak up if things don’t feel right so that we can help where possible.

Chat to an Osteopath, here at The Barn KT9 we recommend Laura Tilson Osteopathy.

Chat to a Women's Health Physio, we recommend:

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