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PT Tuesday: Home Exercises for Pelvic Organ Prolapse

I'm very excited to introduce a guest author for today's post! Please welcome my good friend and pelvic floor physical therapist, Emily Pace! Take it away, Emily!

First, I want to say hi to all the Fierce Mamas out there reading this!!  Thank you so much for taking the time to read my post!  I’m Emily -- a pelvic floor therapist who lives and works in the Knoxville area.  I discovered pelvic health shortly before I started physical therapy school in 2009 and the nudge in my gut has turned into a full blown passion as I have learned more and more about how physical therapy can help pelvic problems.  I am the Pelvic Health Director for East Tennessee Spine and Sport Physical Therapy and I have primarily treated pelvic health since I graduated in 2011.  My goal is continue to grow as a provider every day and Alexis has been a huge part of my growth over the last several years. [Editor's note: Awww 😘]

If you follow this page, you have heard a lot about POP through Alexis, especially with her recent and AMAZING post about risk vs reward. Click the image below to read it:

So what’s next if you’ve found out that you have a prolapse or you’re suspicious that you might have one?  My first recommendation would be to find an OB/GYN that you trust.  My second recommendation is to find a pelvic health therapist in your area with knowledge of how to manage symptoms related to a prolapse to help you assess your specific situation.  My third recommendation is find a trainer like Alexis in your area.  She will rock your world and probably be the favorite of the 3! These three individuals need to work together to help you manage your symptoms and this team can help you figure out the risk vs reward piece of your life with a prolapse. 

Maybe your OB/GYN can’t get you in right away because a prolapse is a non-emergent situation.  Maybe you can’t get in with a physical therapist for a period of time--we’ve been known to have a waiting list! Maybe you found a trainer, but she wants you to be seen by both providers before diving into a workout routine. What can you do in the while you are waiting for these appointments?  What exercises provide the most reward with the fewest risks? 

The best part, but one of the hardest parts, about being a physical therapist is that I do not have a ‘one size fits all’ answer to treating problems of the musculoskeletal system.  I can’t just give you a generalized set of exercises and expect your problems to totally go away without assessment of your specific set of circumstances. What I can do is give you 3 exercises that can help get the ball rolling with minimal risk to your system. 

Please check with your physician before starting a new exercise program!  If you have an increase in your symptoms of heaviness, pressure, or feelings of "falling out" while completing these exercises or IMMEDIATELY afterwards, stop! An increase in these symptoms means that these exercises are not the best exercises for you at the moment, and you should seek care to find out what the best route is for symptom management.  Muscle soreness can happen as you start working weak muscles, but these exercises should not be painful.  This is not a “no pain, no gain” situation!

1. Diaphragmatic Breathing



Start lying on your back with your knees bent as pictured above.  Place one hand on your chest and one hand on your stomach.  Take a breath into your stomach, allowing your belly fill up like a balloon. When you blow the air out, you should feel your belly fall away from your hand.  The diaphragm and the pelvic floor are usually teammates, so when you take a breath in your pelvic floor should relax and lengthen just a little bit.  When you breathe out, your pelvic floor should gently draw in and up into your abdomen.  This is a very small and subtle movement which you might not feel! Just imagine that your pelvic floor is following along with your diaphragm as described.  Do 10 of these at a time to start waking up your brain’s awareness of the pelvic floor muscles.

I made the choice not to tell you to do Kegels (AKA pelvic floor muscle exercises) because most women, when just verbally cued, are doing them incorrectly.  In my opinion, until you have a provider who can make sure you are doing them correctly and can help guide you in how many of these exercises you should do a day based on your strength and endurance, you are better off using your breath to find these muscles.

2. Bridge

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After completing your breathing, you can move directly into a bridge.  While this seems like a simple move, it helps to build strength and uses gravity to decrease stress on your prolapse.  Again, you will use your breath with this exercise to help incorporate the pelvic floor, but do not directly activate the pelvic floor muscles unless you have been assessed by a provider who can help make sure you are doing this correctly.  Take a normal breath in, letting everything relax, to start and then blow the air out as you lift your hips off the floor as pictured.  The goal is to work up to 10 repetitions per set, 3 sets per session.  Quality is more important than quantity here!

3. Clamshells



These exercises help to work on the small muscles of your hip joint.  These are the muscles that not only help to support your hip joint, they also help to support your pelvic floor muscles.  There are not many activities in our daily life that make us use these muscles consistently, so they are often very weak even in very strong people!  You can add your breath into this exercise, but it is not required!  You will start on your side with your knees bent as pictured and lift just your top knee.  This seems really simple, but you will feel it in your butt before you know it! Keep your hips stacked straight up and down and don't let your top hip roll backwards as you lift your knee. Try to work up to 10 repetitions per set, 3 sets per session.

Thank you, Emily! If you're in the Knoxville area and in need of a pelvic floor physical therapist, definitely give Emily a call! She's an amazing therapist and human being and you'll be in good hands. You can find her at East Tennessee Spine and Sports (Oak Ridge location). I'm not affiliated with East TN Spine and Sport and this post was not sponsored by them in any way; I just love them to pieces.

Home exercises for pelvic organ prolapse
Alexis Helmrath