QUESTION: I WAS RECENTLY DIAGNOSED WITH A PELVIC ORGAN PROLAPSE AND AM SCARED TO DO ANYTHING THAT WILL WORSEN IT. I USED TO BE A WORKOUT JUNKIE, BUT NOW I’M SCARED TO WORKOUT FOR FEAR THAT I’LL MAKE MY PROLAPSE WORSE. IS IT SAFE TO WORK OUT IF YOU HAVE A PROLAPSE?

Answer: Yes! But as usual, it really depends on your own situation and the degree of prolapse you have.

Let’s first just back up a moment and explain what a pelvic organ prolapse is. Your pelvic floor is made up of a web of muscles that looks much like a basket and holds up some pretty vital organs in women: the bladder, the rectum, and the uterus. A prolapse happens when these muscles become weakened, and the pelvic floor is no longer able to completely hold the organ in place, causing one or more of the organs to fall into the vagina.

Pelvic organ prolapse can happen when too much pressure has been placed on the pelvic floor. Pregnancy and childbirth are two big causes of pelvic organ prolapse, in addition to things like chronic coughs, or exercises that place a lot of repeated pressure on the pelvic floor (like running).

There are different grades of pelvic organ prolapse. Some women with a minor prolapse may not even know she has one, or the symptoms may be so mild that they don’t bother her. Others may have a severe prolapse, where the organ starts to protrude outside of the vagina. Many women with prolapse report symptoms of discomfort – a heavy or aching feeling in the vagina, or the feeling that you’re sitting on top of a ball.

While a prolapse can never completely be reversed on its own, there are treatment options available that can help improve the condition. Because the pelvic floor is a muscle, the first and most obvious line of treatment is to improve the strength of the pelvic floor, which includes not only learning how to tighten the muscle, but also relax it. A physical therapist trained in women’s health can be a huge help here since they can tell you the degree of prolapse you have, show you how to properly strengthen the pelvic floor, and monitor your progress.

For women looking to get back into exercise, it’s best to start with a trained physical therapist who can get you going on a workout plan to strengthen your pelvic floor. They can also advise you on any other type of exercise you’re interested in and work with you as you build up to that. Many women find that by making their pelvic floor stronger, they’re able to do most of what they did before prolapse.

Your PT may also prescribe you a pessary, which is a device that is inserted into the vagina and helps to hold up your organs for you. For some women who like exercises such as running, which tend to put a lot of pressure on the pelvic floor, this device can help support the pelvic floor during the workout/run. A pessary needs to be fitted by a doctor, and you may need a couple of tries before finding the size that works for you, but after that, it can be a huge help for those more strenuous workouts.

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