Exercise With Pelvic Organ Prolapse: Staying Active Safely

Being told you have a prolapse can be frightening. Many women leave the appointment with one thought: “Does this mean I can never exercise again?” The honest answer is no. Most women can and should stay active. But exercise with pelvic organ prolapse does need to be done thoughtfully, and the person best placed to guide your plan is a pelvic health physiotherapist, not a trainer, an app or a forum.

I am a personal trainer, not a physio or doctor. This post is general information to help you understand the basics, ask good questions and feel less alone. Your physio’s advice always comes first.

What is pelvic organ prolapse?

A pelvic organ prolapse is when one or more of the organs in the pelvis, such as the bladder, bowel, womb or top of the vagina, slips down from its usual position and bulges into the vagina. The NHS page on pelvic organ prolapse lists symptoms such as a feeling of heaviness or dragging, a bulge in or coming out of the vagina, bladder problems such as leaking when you cough or exercise, and discomfort during sex. Some women have no symptoms at all.

It is more common after pregnancy and vaginal birth, and around and after the menopause, but it can happen to anyone with a pelvic floor.

If you notice a lump in or around your vagina, or any of the symptoms above, see your GP. If you have not been assessed, please do not self-diagnose and start a programme on your own.

Why a pelvic health physio should guide your plan

Prolapse is not one condition. It varies by which organ is involved, how far it has moved and how much it bothers you. Two women with the same diagnosis may need very different plans.

A specialist women’s health or pelvic health physiotherapist can:

• Check how well your pelvic floor muscles work and teach you to use them properly.
• Give you a pelvic floor training programme matched to you.
• Tell you which activities to limit for now and which are fine.
• Talk to you about support options, such as a pessary, if your doctor thinks one might help.

The NHS page on treating pelvic organ prolapse explains that pelvic floor muscle training is usually provided by a specialist women’s health physiotherapist. Ask your GP about a referral.

Exercise with pelvic organ prolapse: the general principles

These are broad principles based on NHS guidance. Your physio may tell you something different for your situation, and if they do, follow them.

Keep moving gently

The NHS recommends gentle exercise such as regular walking. Walking is good for your heart, mood and weight, and is usually well tolerated. It is a great base for most women.

Be careful with high strain activities

The NHS advises avoiding activities that put a lot of strain on the pelvic floor, such as heavy lifting, running and trampolining. This does not always mean “never”. It means these should only come back if and when your physio says so, built up gradually.

Manage pressure, not just muscles

Anything that repeatedly pushes down on your pelvic floor can make symptoms worse. Practical ways to reduce that pressure:

• Breathe out on the effort when you lift a shopping bag, a child or a weight. Do not hold your breath.
• Avoid straining on the toilet. More fibre, enough fluid and staying active help prevent constipation.
• Treat a long-lasting cough. The NHS notes that stopping smoking helps, as a smoker’s cough adds pressure.
• Lift your kids smartly. Get close, bend your knees, breathe out and lift with your legs.

Notice your symptoms

A useful rule I use with women who have physio-guided plans: if an exercise brings on heaviness, dragging, a bulge, leaking or pain, during or after, that is a sign to stop or scale it back and tell your physio. Symptoms often feel worse at the end of a long day on your feet, so you may find mornings are a better time to train.

Exercises that often suit women with a prolapse

With your physio’s agreement, many women do well with:

• Pelvic floor exercises, done daily as prescribed.
• Brisk walking, building up time gradually.
• Swimming or an exercise bike for low-impact cardio.
• Glute bridges, breathing out as you lift.
• Side-lying leg lifts and clamshells for hip strength.
• Supported squats to a chair, with light or no weight.
• Bird dogs and other gentle core work.

Things to check with your physio before doing: heavy lifting, jumping, running, full sit-ups and crunches, and anything that makes you bear down. My post on pelvic floor exercises for mums covers the basics of finding and working those muscles, and core exercises for beginners lists gentler core options you can run past your physio.

How I work with women who have a prolapse

When someone tells me they have a prolapse, I ask what their physio has said and build around that. I do not try to treat the prolapse. I help her stay strong and active within the limits her physio has set. In a class, that might mean she does a step-out instead of a jump, a lighter weight with a slower tempo, or a bridge while others do a heavier hip hinge. Nobody else needs to know why.

Where a bootcamp class fits

A small, low-pressure class can help you stay active and confident once your physio is happy for you to join one. With a maximum of 10 people, I can see what everyone is doing and offer an easier option at any point. My SYP Unlock hip and back mobility class is one of the gentler sessions and a good first choice. You may also find my post on pelvic floor and exercise classes helpful.

FAQs

Can I exercise with a pelvic organ prolapse?

Yes, most women can stay active. Gentle exercise like walking is usually encouraged. Get assessed by your GP or a pelvic health physio, who can tell you which activities suit you.

What exercises should I avoid with a prolapse?

The NHS advises avoiding activities that strain the pelvic floor, such as heavy lifting, running and trampolining. Your physio will tell you if and when any of these can come back.

Can pelvic floor exercises help a prolapse?

Regular pelvic floor exercises are recommended by the NHS and are usually taught by a specialist women’s health physio, who can check your technique.

Can I lift weights with a prolapse?

Some women do, but only with guidance from a pelvic health physio. Start light, breathe out on the effort and stop if you feel heaviness or a bulge.

Book your first class

If your physio is happy for you to join a group class, I would love to see you. SYP Bootcamp runs 45-minute small-group classes indoors in a church hall in Archway N19, with a maximum of 10 people and £15 a class, and every exercise has an easier option. You are welcome to message me first about any guidance your physio has given. Book my £15 class or call or WhatsApp me on 07301 512215. If you would rather have one-to-one support that follows your physio’s plan closely, see my injury-safe personal training in Archway.

About the author

Artem Olekhnovych is a personal trainer in Archway and the founder of SYP Fitness and SYP Bootcamp. He has coached clients in Archway, Highgate and across North London for over 10 years, and runs small-group bootcamp classes for busy mums and dads. Read reviews from his 1-1 clients.