What exercises are safe after a prolapse repair surgery?
When is it okay to start?

The answer is a little more complicated but lets dive in...

So to understand when it's safe to get back to exercises, its first important to understand how the pelvic floor works when we are exercising. When they do a bladder lift surgery, they are surgically “tacking” your bladder back up and off of where it was falling down into the walls of the vaginal canal.
Now, the fail rate of these surgeries are a little higher and can make returning to exercise and activity after surgery a little more nerve racking. We want to make sure that…
1. Your pelvic floor is strong enough
2. Your pelvic floor is coordinated with your core
3. You know how to use that coordination with exercise

So it’s not as simple as a one size fits all list of exercises to do and not to do…Let's go through these in more detail. These concepts also apply to someone with a prolapse who wants to exercise. 

Most people know how to do a Kegel or have heard of Kegel’s, but… they are not enough to get you back into exercise! Kegel’s are a way to contract the pelvic floor muscle in a still position. Yet… returning to exercises certainly isn’t sitting still! We need to incorporate movement into our pelvic floor to challenge it more and show it how not just to work when we are sitting still, but when we are moving.

We also need our pelvic floor to work with the rest of our body. When we exercise we add load, force, lift, push, pull, jump etc. Our pelvic floor needs to know how to work with us as we move to handle these things. Our pelvic floor is also an anticipatory muscle, meaning that when we go to jump, lift, push, pull, etc- our pelvic floor should automatically contract along with your transverse abdominal muscle to stabilize your spine and pelvis, keep us continent and to protect our pelvic organs. It prevents that unwanted pressure from our abdomen from pressing down and pushing down your organs.

Now let’s talk about how to do this with exercise. Let’s try a test- can you do a Kegel? Think about stopping your flow of urine midway through, or lifting a marble up into your vagina. You shouldn't be squeezing your bum or legs together. Now can you push down gently like you are pushing out a fart or a bowel movement. If you feel your belly- you should feel it pushing out into your hand slightly. If you put your hands over your pants where your vagina is, you can likely feel that area pushing into your hand slightly as well. Now if you do a Kegel, and then do that little push down- can you get a sense that your pelvic floor is lifting up, then pushing down- so they are basically the opposite of each other.

Now if you do something like a sit up, or a heavy lift, or whatever it might be, and your core and pelvic floor are not coordinated properly, you often do the opposite and end up bearing down, or pushing down through your pelvic floor. Can you see how this can be detrimental to a prolapse or a prolapse repair surgery? What is supposed to happen, is that your pelvic floor and lower abdominal contract to protect the extra pressure from pushing down. It should do this for us automatically, but if it isn’t, that is when we can get into trouble. BUT… All you need to do is start to practice!

Here are 2 things to start doing now: 

1. Practice exhaling while you Kegel. Blow out like you are blowing through a straw to make it even more efficient while you are thinking about stopping your flow of urine or imagining lifting a marble up into your vagina. This will both help to strengthen your pelvic floor as well as coordinate your core

2. Once you get the hang of that, practice doing this as you add a movement or load. For example, do this while you are lifting a light weight into a bicep curl and relax on the way back down, or lifting your bum up into a bridge exercise while you are lying down. 

The next thing you can do is watch my free webinar for prolapse. It is geared towards exercises and education for women who want to reduce their prolapse, but all the same exercises and education apply for someone with a prolapse repair who wants to strengthen and prevent the repair from failing.