Exercise following prolapse - fitness professionals, advise?

[supergolden88]

Finally had my urodynamics test at Kings today. Mildly unpleasant/embarassing but the staff were all very nice and professional.

Turns out I have the holy trinity of prolapses(bladder/womb/bowel) - described as a mild prolapse so could be a lot worse. Have booked private physio appointment for next week. According the lovely NHS lady most women who have given birth suffer from some kind of prolapse even if they are not aware of it. It frequently improves a couple of years after the birth or when breastfeeding stops.

If any fitness professionals read this post can you advise re: exercise/fitness? Running and any other high impact exercises are out as are abdominal crunches (anything putting direct pressure on pelvic floor). I would still like to keep up my fitness regime. Walking is obviously an option but any way to make it more aerobic/carorie burning? And what are the options for tightening the abs when crunches are out? (including Pilates core exercises etc)

[Princess]

I'm not a fitness professional but am in a similar situation to you. I have been advised to walk, swim and try pilates. Nothing that will work off my mummy tummy though! If any sort of excersise doesn't feel right I have been told to stop immediately! Good luck with the physio. Mine is working but I accept it's going to be a long road to any sort of normality

[Convex]

Hi super golden.

Do you mean that Pilates counts as crunching and so is not allowed?

I also read somewhere that you have to be careful lifting so I suppose body pump for example would be out.

Power walking would be ok though and if you keep the pace up it's good for fat burning.

Nb I'm not a fitness professional but will be watching this thread with interest!

[supergolden88]

yes sorry I realise it was not clear - pilates exercises that bear down on pelvic floor (such as the pilates 100) are also out. Heavy lifting is bad as you say. I find deep squats uncomfortable although they are part of the Hab-it DVD which is all about pelvic floor rehabilitation (although after you have strengthened the PF muscles)

The aim is to strenthen the TA muscles (transverse abs) and not the rectus abdominals (your six pack). Strengthening the bum/core/thigh muscles is also good for PF weakness. I believe planks are ok and they strengthen the abs but I find them a bit limiting in terms of exercise.

this is a good resource

http://www.hab-it.com/?page_id=120

[melbourne groover]

I highly recommend High Vibes(Vibration training place on Melbourne Grove) effective but can be really low impact if that's what is required.

[Gooders79]

You need to be careful with most forms of exercise, muscles fatigue and you can use the wrong ones in the wrong way very easily. Some muscles are power muscles,others are stability muscles, you could achieve the plank using power muscles and it would do nothing to improve your core stability or recruit transversus and may potentially do you some harm... The difficulty with core stability exercise overall is to do it properly you often need it be well supervised to ensure you are carrying out correctly and also to progress at an appropriate rate, which will be entirely individual.

In this context I think you need to consider a slow build up, not only looking at how your body responds at the time of exercise but in the day that follows. Walking may be fine for some people, brisk walking may be too much of a challenge, especially if pram pushing at the same time....

Not sure this is helping but it's m complicated than it might look at first glance...

[Audrey]

So as to make the info I got publicly available:

Mild prolapse- swimming, walking and post natal yoga fine, potentially able to take up running in 3 months after a check up. In the meantime LOTS of PFE, also, do them standing so you are working against gravity. It strengthens the pelvic floor more than doing the exercises lying down.

[womanofdulwich]

I think cycling would be ok- and rowing! the cross trainer in the gym too. These are all for burning calories though- not for toning your inside up.

[supergolden88]

cycling I have been told is ok - though I must say doing spinning at home on your own is not the same (and right now no time or funds to go to gym). Rowing not sure.

confusingly some Pilates exercises are very good for PF but some are not allowed. Any pilates instructors out there willing to pitch in?

[fapl]

From the book "inside Out" by Michelle Kenway on spin classes:

Avoid using heavy resistance through your legs.

Stay seated if the class includes out-of-the-seat/saddle-climbing tracks.

Activate your deep abdominal muscles gently, not forcefully, when leaning forward and riding your bike.

The sub title to the book says "A complete guide to pelvic floor safe exercises for women". It is not a cheap book to buy in the UK because it is not really for sale here in the UK, but you can buy it on ebay. Supergolden if you want to borrow it from me get on touch (sorry can't be lending it out to everybody :)) Cheaper than buying tena pads for decades though.

[Salvia]

I got my prolapse after 4 spinning classes over Christmas and yes we did do a lot of 'bunny hops' up and down! Was fine in all classes until then. Never tried spinning before, mostly do Body conditioning, lots of Step, Body Pump and power stretch with no after effects!

There is SO much conflicting advice though. No one treatment and no one approach . It's really depressing not knowing who to believe ! Even surgery seems to have dire results.

Do any of the toners etc work?

[Monkey]

And mine is coming back after just a few sessions on the cross trainer! Going back to physio next week. :-(

[Salvia]

oh dear sorry to hear that Monkey.

Only had mine or about 3 weeks but the 'uncomfortable' feeling and a future with incontinence and goodness knows what developing makes me want to scream already:)

They do say being overweight can make it worse and losing weight helps, but I was put on a low tablet for blood pressure (Amlodepine) last year and have steadily put on 10 pounds since then, which can't help!

After reading all the above I spent last night going through all the websites I could find which recommend and crticise every approach in equal numbers! I walk 10 -12 miles on a Saturday or Sunday, will I have to stop?

[canela]

i was told if you want to do some cardio/ fat-busting then fast swimming is the safest option. and to be really vigilant with doing the old pelvic floor exercises.

[supergolden88]

i have pfilates (minus the ball) for sale if anyone is interested ?10. Could not get the hang of it but it is meant to be very good. They actually created the exercises by testing PF response

http://www.amazon.co.uk/Pilates-Ball-and-DVD/dp/B003U3UYNW/ref=sr_1_1?ie=UTF8&qid=1359206009&sr=8-1

my prolapse is much worse because i have not been keeping on top of the PF exercises. Only myself to blame really

[Salvia]

Good grief, i don't think i could swim fast enough to make it a cardio blast! I do quite heavy gardening for people plus my classes at the gym plus walk my friends two labradors since mine died, but also finding walking on pavements easier than on uneven ground, must be the balancing which I know I have never been good at.

Will have to give up the 10 miles I usually do on a Saturday but according to my doctor I should be pleased as the condtion isn't life threatening :)

What books do people recommend?

[Monkey]

Having a good physio really helps. Not just for the kegel exercises but also for advice re: what to do or not. going back next week to see what I am doing that's so wrong on the cross trainer for example. To me, body pump sounds like the worst thing you can do with a prolapse. I am convinced it's bad any way. We were never designed to do so many squats with large weights on our shoulders, a few maybe but not endless repetitions.

The toners do work but you should really have a proper examination before starting.

Comments from GP that it is quite Common and not life threatening are really annoying!

Happy to share physio's contact details.

[Salvia]

Thnaks Monkey for the advice. I only rarely do Body Pump now when there's no other classes, I found it made my joints ache as I am a part time gardener. However I love Step (4 days a week) and it hasn't made anything worse since the proplapse happened! I've also downloaded all the advice from Michelle Kenway's great website and will give to my instructors.

I have had a proper examination and I am being referred to a physio - whenever that will be!

Squats even without weights I find uncomfortablel now, walking on flat surfaces fine, walking on uneven ground especially in this snow really uncomfortable, I am guess it's the core working to keep balance?

Someone did suggest support underwear, not sure about that.

This forum is very reassuring, not full of the scary stories in other places. It's the 'uncomfortable' feeling which is driving me nuts :)

[supergolden88]

I would say that even physios dont really know what to advise sometimes. You have to find what makes you feel good and what to avoid. I would say lifting heavy weights is definitely bad - in the gym or real life. Lifting light weights however is fine I think. Crunches that push down on the pelvic floor are bad but core exercises are beneficial. Pilates are good but need to modify certain exercises. The Hab-it DVD is really the best out there.

I was advised to stop running, which I initially did, but it made me very unhappy. I tried power walking but found it very frustrating. I then started power walking with ankle weights on and eventually shuffle running with weights on. Eventually I started running again - not as fast as before or as often but it makes me feel better and keeps me fit(ter) so I am not prepared to give it up. The physio at kings have given me this silicone cube to 'wear' which pushes everything up and keeps it where is should be. It is a bit of a pain to insert and take out but it does make you forget the prolapse. It is not for constant wear - unlike some rings which are designed to be worn internally all the time. The physio said women who were sexually active (ha! chance would be a fine thing) did not like these so much. But there are other pessaries and rings out there which may help some people depending on level of prolapse. Take a look here (some devices come free on the NHS. Read about them and speak to the physio if you think you want to try them.

[Monkey]

Salvia, I know exactly what you mean by the uncomfortable feeling. Kegels and toner really helped with it within 3-4weeks I would say so do not despair. It's all about getting acquainted with your body as it is now and learn how to live with it and protect our pelvic floor. Slowly reintroducing exercise like supergolden and seeing what works. One thing to bear is mind is to engage your pelvic floor when exercising. This should help a lot.

[Salvia]

Thanks supergolden, and supergolden. Your common sense and empathy has really cheered me up. I am surprised they don't have more Pelvic floor classes :) I have ordered the dvd recommended (hab-it) and also went and ordered Michelle kenways book though i also found it free on the net after i had ordered it :)

Things don't look quite so balck now though I am going to have to face up to gardening and not humping weights around.

[supergolden88]

sorry meant to post this source

http://www.stressnomore.co.uk/pelvic-floor/pelvic-floor-exercisers.html

I have bought the kegel 8 and did use it for a little while. Not sure it made any difference to be honest and the physio likened it to a slendertone belt - it exercises your muscles but you don't put any effort it and it is a superficial tightening. When you do the kegels you make a real effort and learn how your body works. If the physio thinks it would help then they would prescribe you one for free - it works for those whose pelvic floor is too weak and they need help doing the kegels

[canela]

i went to the physio, and they said if you can lift the weight comfortably with one arm then it is fine. otherwise, a no-no. that includes shopping, children and all the things of life as well as exercising....

[Salvia]

oh that's a relief though i will double check when I get to see a physio. I can easily lift 4-6 kg with one arm, (done so in classes for about 4 years) but I presume only one arm at one time or you are lifting in the middle as well?

I had visons of having to stop all my gmy classes (which keep me sane since my husband died) and all my gardening which allows me to stay in our house!!

This forum had been amazingly helpful It ought to be made into a self help book/blog :)

[ZE Pilates]

There has been some useful advice in this thread. Thank goodness this generation can discuss prolapse - it is more common postnatally than you might think, and our mothers and grandmothers suffered in silence! However, as a Pilates teacher, I would say that the type and amount of exercise that you should do following a prolapse depends on a number of factors, including: the severity of the prolapse; how much time has elapsed since giving birth; whether or not you are still breastfeeding; and the degree of elasticity in your connective tissue pre-pregnancy. Pelvic floor exercises do work, and are well worth doing, but the time it takes to feel any effect will depend on the same factors. For example, for some people, pelvic floor exercises will need to be done lying down initially (there is no way they could even contemplate going for a run)! Ab curls should also be avoided at the outset (and not just because of pelvic floor issues). If your prolapse is quite severe, it is worth seeking a referral to a specialist women's health physio (e.g. at King's College Hospital). In any event, it can be very helpful to check that you are doing the right exercises for you, and doing them correctly, by seeing a suitably qualified teacher who can also help strengthen your whole body safely (not just the pelvic floor). The Guild of Postnatal Exercise Instructors (http://postnatalexercise.co.uk/) lists teachers in your area, and also gives some exercise advice. Pelvic floor dysfunction is not exclusive to the postnatal period - it can occur/recur after the menopause too, so it is well worth sorting out sooner rather than later. . .

www.zepilates.com