Exercises for Pelvic Organ Prolapse
Pelvic organ prolapse is when weakened muscles and ligaments that hold up your vagina and support its surrounding organs cause pelvic organs (bladder, uterus, rectum, etc.) to slip down from their normal position and create a bulge or sense of pressure in your vagina. This diagnosis may sound scary, but it’s very treatable with physical therapy exercises that target your pelvic floor muscles.
You’ve likely heard of Kegel exercises. These strengthen the pelvic floor muscles, and are very effective at treating prolapse. But Kegels aren’t the whole story.
The exercises below engage the muscles responsible for supporting your pelvic organs, which can help reduce symptoms of prolapse as well as help treat it.
A key part of treating prolapse is managing abdominal pressure with proper breathing techniques. When you engage in activities that increase pressure (such as lifting, exercise, or having a bowel movement), avoid holding your breath or straining. Focus on breathing through your abdomen, which is known as diaphragmatic or belly breathing. This helps reduce pressure exerted on your pelvic organs. During exercise or lifting, exhale on the “hard part” of the lift or exercise. For example, when picking up your laundry basket, exhale when you lift the basket up.
Diaphragmatic Breathing with Elevated Pelvis
While lying down on your back, elevate your legs up the wall. (You could also place a yoga block or pillow under your pelvis.)
Place one hand on your breast bone and one hand on your abdomen near your belly button.
Slowly take a deep breath in. Try to get your hand on your stomach to rise while the hand on your breast bone remains still.
As you breathe in, the hand on your stomach should rise. When you breathe out, the hand on your stomach should lower.
As you fill your belly with air, your pelvic floor muscles will relax and lengthen.
Repeat for two to five minutes.
Note: This can also be done throughout the day in an upright position. Doing three rounds of belly breathing every time you notice you are “sucking in” your abdomen or bracing is helpful for managing prolapse.
Pelvic Tilt with Ball Squeeze
Lie on your back and do a pelvic tilt. Using your abdominal muscles, pull your hip bones up toward your ribs and press your low back into the floor/mat.
Hold this while squeezing a small rubber ball, rolled up towel, or folded pillow between your knees.
Relax your knees and your stomach muscles and then repeat.
Repeat this 10 times with smooth controlled motions.
Bridge with Kegel
Lying on your back, bend your knees and place your feet flat on the floor with hands by your side.
Tighten your abdominal muscles.
Pushing through your heels, raise your hips off the ground and do a Kegel at the same time.
To do a Kegel, gently squeeze the muscles around your vagina and anus. It might feel like your muscles are being gently pulled up and into your body as you hold this position.
Do not feel like you need to overextend your hips up.
Repeat this 10 times, holding for two seconds at the top.
There are many ways you can effectively treat pelvic organ prolapse, one of which is through targeted exercise therapy.
Engaging in these pelvic floor exercises, in addition to Kegels, on a regular basis will be an integral part of your prolapse management and recovery.
Many common habits, like “sucking your stomach in” or bracing your core can actually worsen prolapse. Learning how to manage your intra-abdominal pressure while doing things like lifting and exercising can help improve your prolapse and prevent it from worsening.
Iglesia, C. B. & Smithling, K. R. (2017). Pelvic Organ Prolapse. American Family Physician, 96(3): 179-185.
Pelvic Organ Prolapse: What is Pelvic Organ Prolapse? Pelvic Organ Prolapse Symptoms, Treatment, Diagnosis - UCLA. (n.d.). UCLA Health. https://www.uclahealth.org/womens-pelvic-health/pelvic-organ-prolapse
Cleveland Clinic. (2019). Diaphragmatic Breathing Exercises & Techniques | Cleveland Clinic. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing