Living with a prolapsed uterus can be frustrating. Any gym workout, yoga pose or Pilates routine that puts downward pressure on your pelvic floor is suddenly off-limits. But exercise itself isn't taboo. By replacing harsh core exercises with gentler, more supported ones, you can remain just as active as you were before your prolapse or surgery. Always discuss any intended workout with your doctor before trying it out.
Uterine prolapse occurs when the pelvic floor weakens and can no longer support the uterus in its proper position. Instead, the uterus slips downward into the vaginal canal. In milder cases, the cervix descends into the lower third of the vagina. In the most serious cases, the uterus itself may be visible outside the vaginal opening.
If you have experienced uterine prolapse, even in its mildest form, it's best to avoid intra-abdominal pressure. Any activity that puts downward pressure on your pelvic floor is apt to further weaken those lower abdominal muscles and ligaments. This can exacerbate your prolapse.
Exercises to Avoid
Refrain from any exercise in which you harden, contract or push down with your abdominal muscles. This includes situps, curls, abdominal crunches and most leg-lifts. Even some Pilates exercises and yoga poses can have a detrimental effect. Michelle Kenway and Dr. Judith Goh, authors of the women's pelvic support guide "Inside Out," say that if the exercise involves raising both your legs off the ground at once, or if it involves raising your head and shoulders off the ground while you're lying down on your back, it's an exercise you should avoid.
Other Contraindicated Activities
Avoid heavy lifting and straining, as these put unwanted pressure on the weakened pelvic floor and can cause symptoms to worsen. Coughing is also potentially problematic. If you suffer from a chronic cough, seek treatment. If you cough because you smoke, pursue cessation strategies. Additionally, seek treatment for severe or long-term constipation, since that can increase abdominal pressure and exacerbate your condition.
Kenway recommends replacing situps and abdominal crunches with gentler core exercises performed while sitting on a yoga ball. The seated posture provides needed support for the pelvic floor. An example situp replacement is to slowly raise and lower your arms from the shoulders while gently drawing in your abdominal muscles. This will help develop strength and control in your core.
If you used to perform yoga before your prolapse and would like to continue, Jaki Nett of Yoga Journal recommends shifting your focus to inversions, or upside-down poses. Be aware of the nature of any intra-abdominal pressure your poses cause. If your abdominals "bellow out and become hard," he says, or if your lower back arches up, these are warning signs. Instead, allow the abdominal area to soften. Pull its contents backwards toward the spine. Make your waistline narrow, lift your chest and spread your diaphragm.
- NYU Langone Medical Center; Uterine Prolapse; Michelle Badash, MS; September 2010
- University of Maryland Medical Center: Uterine Prolapse -- Treatment
- "Yoga Journal"; Reversing a Prolapsed Uterus; Jaki Nett
- Pelvic Exercises; 12 abdominal exercises to avoid with prolapse or after prolapse surgery; Michelle Kenway and Dr. Judith Goh; May 2010
- Pelvic Exercises; Core Exercises for Prolapse and After Previous Prolapse Surgery; Michelle Kenway; March 2011