One of the challenges faced by many women who have prolapse is the ability to maintain some level of consistency in working out, given the inconsistent nature of prolapse symptoms. Yet basic exercise physiology states that you need to do a certain amount of exercise at a particular intensity and frequency to reap the benefits of improvement in that system. But what are you supposed to do when you feel like your insides are dropping down even more on a day that you were supposed to work out? What is more important? Keeping up with your exercise routine for consistency and to meet threshold for improvement or missing a day of cardio in order to rest the pelvis?
What should you do if you are symptomatic but want to participate in cardio?
To start off, we need to acknowledge that not every woman who has prolapse actually has any symptoms at all. However, If they do feel symptomatic, women will often describe a sense of heaviness, pressure and fullness in the lower pelvis and vagina. They may feel as though things on the inside are dragging, dropping, or falling out/down. If this is something you are feeling on a day you are scheduled to do cardio, take a moment to decide what you will do with the information your body is giving you. Use your symptoms as feedback to help you determine what kinds of exercise to engage in that day.
Here are some helpful ideas for doing cardio on symptomatic days
1. Doing cardio on a symptomatic days is still possible but you will want to be extra keen on keeping things “prolapse-friendly” that particular day. For instance, you may want to opt in for biking on a symptomatic day so that you can still get your cardio fix but in a way that won’t load the pelvic floor with gravity. Just remember to breathe and stay down on the seat! Another great option would be swimming which also unloads the pelvic floor.
2. If you really want to take part in cardio but feel symptoms of prolapse that day, try doing the lightest possible version of that exercise and spend less time doing it. For example, you can reduce how long you are doing it for by 50%.
3. If you were planning on going to a cardio class that day, it might be worthwhile to wait for another, non-symptomatic day before attending. Instead, try doing some of the exercises that would have been done in the class on your own. That way, you can control your pace, your technique, and can ensure that you use your Foundation Breath with each move. It would be a great to use that time to re- enforce proper activation of your deep core so that when you
return to the class, you'll feel even more solid with your core involvement.
You can learn all about your inner core and breathing techniques during exercise in our Foundations Series.
4. When you’re working out, especially on symptomatic days, use some form of internal support such as pessary or tampon which can help to block the vaginal walls from descending further during the session.
5. Another option is to hold off on cardio that day and switch your workout to resistance training instead. If you are symptomatic, take advantage of exercise positions that support the pelvic organs such as hands and knees, side lying, seated, supine, and forwards leaning. Exercising in these positions will help to keep your symptoms at bay while still allowing you to maintain some level of consistency in your workout when symptomatic, rather than not exercising at all.
For some ideas check out some of our prolapse friendly, and free, exercise videos on YouTube.
6. After the workout, spend some time in this position of pelvic rest which eliminates the downwards pull of gravity on your pelvic organs.
Click here for more details on using the pelvic rest position.
In the end, participating in cardio isn’t off the table even if you’re symptomatic but you really do need to listen to your body that day and weigh your options. The advice I often give to my patients is, if it is possible to switch out your cardio workout for a low impact option that unloads the pelvic floor, this would by far, be our first choice as it would still allow you to workout but in a prolapse-friendly way that won't add any extra downwards strain to an already symptomatic day.