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If you’re trying out this fitness thing or you’re already a seasoned gym life vet, you might be wondering about how exercise can affect your prolapse  pre or post-surgery.

In this article, we’ll talk about four exercises that you should definitely avoid if you suffer from prolapse or have undergone prolapse surgery. We’ll also discuss why they aren’t safe, whatyou can do instead and some things to bear in mind moving forward.

Pelvic Organ Prolapse

Pelvic Organ Prolapse , or POP for short, is a condition where the muscles and tissue of the pelvic floor that is responsible for supporting the pelvic organs become loose or weak. Because of this, one of these organs, for example, the uterus (uterine prolapse ), bladder(cystocele ), intestines (enterocele ), or rectum (rectocele ), drops and presses into or out of the vagina. The vagina itself can also drop in what is known as vaginal vault .

This condition is most common in postmenopausal women but can happen as a result of childbirth, obesity and even after a hysterectomy. This can cause considerable pain and discomfort during sex or physical activity and in some cases, the prolapse is visible and causes a bulge.

It is treated with pelvic floor muscle therapy to strengthen muscles, pessaries to support pelvic organs, diet changes to address bowel issues and surgery to support the uterus or vagina, and in some cases, a colpocleisis , which involves surgically closing the vagina.

Why it isn’t safe to do certain exercises

When you are diagnosed with Pelvic Organ Prolapse your doctor will advise you to stay away from strenuous activity before and after surgery. This should be a given since you’ll likely feel discomfort whenever you exert too much force.

Before surgery, doing exercise can put you in immediate or future pain. It can also worsen your condition if you are not careful.

During surgery , the pelvic floor is lifted by cutting and removing loose tissue and by stitching together what remains to hold the pelvic organs in place. Over time as it heals, the stitches will dissolve in your body and the new tissue will help to lift the organs higher.

This is all internal so there isn’t any outward indication of whether the wound has healed or not. You may feel all good to go, and your trainer may encourage you to go ahead with exercise after some time, but this is a decision only your doctor can make.

If you disobey your doctor and go too hard in the gym before you are given the green light you are actually doing yourself a huge disfavor.

For instance, you can cause newly healed tissues to overstretch. When this happens they will heal loosely, and not as firm as they could have. This means that not only will they be weak, but the pelvic floor will sit too low. This could cause a prolapse to happen again in the future.

It could also cause immediate prolapse, where the stitches that were used to repair the pelvic floor come apart and cause prolapse to happen again.

How long till you can exercise

As we said before, only your surgeon/doctor can give you the greenlight.

Typically, women are allowed to resume exercise about 6-8 weeks after their prolapse surgery, but this isn’t always the case since circumstances vary.

Some women make the mistake of staring at 6 weeks because they expect to be fully healed by that time but during this time, all that has happened is that the stitches may have completely melted. The tissues are still too weak to withstand strenuous activity and exercise and can cause strain and re-injury. To heal completely, they need at least 3 months, and maybe even more.

Some factors that contribute to how long you will have to wait for includes:

The type of prolapse repair surgery and technique used- There is not only one pelvic floor prolapse surgery. For instance, some surgeries can use permanent stitches to suspend sagging muscles and some use your own tissue to fix the issue. Others use mesh to hold up the organs.
Anything complications that happened during or after surgery- If there were complications that happened as a result of your surgery, then you will have to wait until those issues are resolved to go ahead with exercising. These include constipation, painful intercourse, damage to pelvic organs, incontinence and even complications with the mesh.
The condition of your pelvic floor muscles- After something like childbirth or menopause, the pelvic floor muscles are more likely to be strained or thin. This can increase your exercise wait time.

Your weight – The more weight you have around your gut area is the more pressure that is exerted on your pelvic floor. This means that it will take longer for you to heal.

Top 4 exercises to avoid

Exercise is generally a good idea, but not when it puts you at risk, you might want to reconsider.

Avoid exercises that put stress on the pelvic floor and can cause it to strain or repeat prolapse.

Here are the top 4 exercises you should avoid:

1. Intense weight lifting

You can use weights, but this should be under the supervision of a physiotherapist who knows your condition.

Avoid any exercise that requires you to lift heavy weights, especially over your shoulder as this can cause you to strain down and strain your pelvic floor.

This means no:

Shoulder press
Pushups
Deadlifts
Crossbody curl

Lateral raises

2. High impact exercise

High impact exercises are those that cause one or both of your feet to be off the ground for a certain period and require you to exert a lot of energy.This can include running, jumping, skipping, dancing and sports such as football, netball, basketball, and tennis.

3. Intense core workouts

Intense core workouts put excessive strain on the pelvic floor and should be avoided at all costs.

Some of these exercises include:

Sit-ups/abdominal crunches
Planks
Russian twists

Curl ups

4. Certain leg exercises

Any leg exercise that involves you bending or crunching should be avoided. These can also cause strain on the pelvic floor  muscles.

Some of these include

Leg press
Squats
Bicycle legs

Leg raises

How to exercise safely

If you are ready to exercise, then your regular workout routine will have to be modified.

Instead of doing high intensity and impact exercises, try walking, yoga , pilates, swimming or low impact dancing and aerobics. Avoiding walking for long distances and stairs if you can.

When using weights, go light. You should not feel any discomfort in your pelvic region. If you do, stop immediately and speak to your doctor and/or trainer.

Do not hold your breath when exerting any form of effort and maintain good posture. You can do cycling, but avoid hills that will cause you to do knee lifts. As it relates to your abdominal region, try to avoid crunching as much as possible. Instead, try bridging, balls sits or pelvic rocking.

If you are given the go-ahead for sports, you don’t need to go all out. Just enjoy the game. For instance, if you play basketball, don’t try to dunk all the baskets. As a matter of fact, play for only one or two quarters and avoid overexerting yourself.

You will also need to extend your rests and decrease your reps for a while.

Pelvic Floor Exercises/Treatments To Try

While you worry about looking good on the outside, there are some exercises you can do before and after surgery to strengthen your pelvic floor.

These should, of course, only happen with the go-ahead from your doctor. These include:

Kegels

Kegels are exercises that involve contracting and relaxing the pelvic floor muscles themselves. There are many versions of the kegel, but they pretty much accomplish the same thing.

These include the basic kegel, squatting kegel, quick kegel, long kegel, bird dog kegel and bridge kegel.

Biofeedback therapy

Biofeedback therapy is a technology-aided type of pelvic floor exercise. Here, pelvic muscle activity is monitored using sensors and a computer when they are contracted and relaxed. With the help of a therapist, persons can locate the correct muscles that are to be exercised and a tailored regimen consisting of diet and exercise is prescribed.

Electrical stimulation (E-stim)

Electrical stimulation is a nonsurgical procedure that involves sending low-grade electrical currents to the pelvic floor. These currents cause the muscles to contract, similar to what happens during kegel exercises and helps to strengthen the pelvic floor.

Summary

Pelvic Organ Prolapse (POP) happens when pelvic floor muscles become loose or weaken
Pelvic floor muscles can weaken because of menopause, childbirth, and pregnancy, obesity, intense exercise, or surgery.
Many exercises aren’t safe before and after pelvic floor surgery since they can cause repeat prolapse, or can cause the pelvic floor to not heal high enough.
Women are advised to wait 6-8 weeks before  they resume physical activity but it can take more than 3 months for the tissue to heal completely.
Avoid intense weight lifting, high impact exercises, intense core workouts and certain leg exercises after surgery.
Always inform your trainer about your condition and adjust exercise accordingly to avoid straining the pelvic floor.
Kegels, biofeedback and electrical stimulation can be useful in strengthening the pelvic floor before and after surgery.

Always consult your doctor before going ahead with any form of physical activity or treatment and update him/her if you feel any pain or discomfort.

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