What is Pelvic Organ Prolapse?
Pelvic organ prolapse (POP) is a condition where one or more of the pelvic organs (such as the bladder, uterus, or rectum) descend from their normal position into the vaginal canal due to the weakening of the pelvic floor muscles and connective tissue. This can result in symptoms such as a feeling of heaviness or pressure in the pelvis, urinary incontinence, bowel dysfunction, and discomfort during physical activity or sexual intercourse.
Did you know that 50% of women have a prolapse? We need better advise than just to stop exercising, and thankfully we now have better evidence and methods to support this.
Causes and Risk Factors
Several factors can contribute to the development of pelvic organ prolapse, including:
Childbirth: Vaginal deliveries can stretch and weaken the pelvic floor muscles.
Aging: The natural aging process leads to a decrease in muscle tone and connective tissue elasticity.
Hormonal Changes: Menopause and the associated drop in estrogen levels can affect pelvic floor strength.
Chronic Strain: Activities that increase intra-abdominal pressure, such as chronic coughing, constipation, or heavy lifting, can contribute to POP.
Genetics: A family history of prolapse and hypermobility can increase the risk.
The Role of Pelvic Floor Physiotherapy
Pelvic floor physiotherapy is a specialized branch of physical therapy focusing on the rehabilitation of the pelvic floor muscles. It plays a crucial role in managing and improving the symptoms of pelvic organ prolapse.
Key Benefits of Pelvic Floor Physiotherapy
Strengthening or relaxing Pelvic Floor Muscles: Pelvic floor physiotherapists teach exercises designed to connect to the pelvic floor muscles, improving support for the pelvic organs and reducing prolapse symptoms.
Education and Awareness: Patients learn about the anatomy and function of the pelvic floor, empowering them to make informed decisions about their health and activities.
Customized Exercise Programs: Physiotherapists tailor exercise programs to individual needs, ensuring that patients perform exercises correctly and safely to maximize benefits.
Improved Bladder and Bowel Control: Strengthening and/or relaxing the pelvic floor can alleviate symptoms like urinary incontinence and bowel dysfunction.
Pain Management: Physiotherapists can provide techniques to manage pelvic pain associated with prolapse, improving overall quality of life.
Exercise and Pelvic Organ Prolapse: Busting the Myths
Outdated Advice on Exercise
In the past, women with pelvic organ prolapse were often advised to avoid activities that increased intra-abdominal pressure, such as weightlifting or high-impact sports. This advice stemmed from concerns that such activities could exacerbate prolapse symptoms or lead to further prolapse.
However, new research and clinical practice have shown that avoiding exercise is not the solution. In fact, physical activity is crucial for overall health and well-being. Avoiding exercise can lead to weakened muscles, including the pelvic floor, potentially worsening prolapse symptoms over time.
Modern Perspective: Exercise is Beneficial
Current guidelines emphasize that women with pelvic organ prolapse can and should engage in physical activity, including weightlifting and other forms of exercise, provided they do so correctly and safely. Here's why:
Muscle Strength and Endurance: Regular exercise, including weightlifting, enhances overall muscle strength and endurance, supporting the pelvic floor and reducing prolapse symptoms.
Weight Management: Maintaining a healthy weight through exercise helps minimize the strain on the pelvic floor, preventing the progression of prolapse.
Improved Posture and Core Stability: Strengthening the core muscles, including the pelvic floor, enhances posture and stability, reducing pressure on the pelvic organs.
Mental Health Benefits: Physical activity boosts mental health, reducing stress and anxiety, which can positively impact pelvic floor function.
Safe Exercise Practices
To exercise safely with pelvic organ prolapse, consider the following tips:
Consult a Professional: Work with a pelvic floor physiotherapist to develop a safe and effective exercise plan. The addition of a pessary may be also be an option for you.
Focus on Technique: Ensure proper form and technique to avoid unnecessary strain on the pelvic floor.
Progress Gradually: Start with lighter weights and low-impact activities, gradually increasing intensity as strength improves.
Listen to Your Body: Pay attention to your body's signals and modify activities if you experience discomfort or worsening symptoms.
Conclusion
Pelvic organ prolapse is a manageable condition, and with the right approach, it should not hold you back from leading an active and fulfilling life. Pelvic floor physiotherapy offers significant benefits in strengthening the pelvic floor muscles, alleviating symptoms, and improving overall pelvic health. Embracing physical activity, including weightlifting, with proper guidance and technique, can enhance your quality of life and empower you to take control of your health. Remember, the key is to stay informed, seek professional advice, and listen to your body.
Liz is a sports (MSK) and pelvic health physiotherapist based at Alma Physiotherapy, 25 Lower Redland road, Bristol, BS6 6TB.
Email our PA Mei Lou pa@almaphysiotherapy.co.uk or call 07942 494506 for help booking.
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