Weight Training and Prolapse-is it OK?

Weight training and prolapse-is it OK? Asking for a friend. Short Answer: Yes. Long answer: keep reading.

A No-No?

Heavy weight training activities like CrossFit© are often No-No’s in the conversation around pelvic organ prolapse (POP). Many women are advised to avoid these strenuous loads during pregnancy and beyond due to a potential for POP. However, similar to most pelvic health issues, the development of POP is multifactorial. Recent studies have provided us with a broader look at the relationship between weight training and prolapse. To shed new light, investigators have compared the rate of POP in athletes that lift heavy weights with those that are inactive or lift light loads. 

What Does the Research Say?

Almeida et al., (2016) contrasted amateur athletes that weight trained with non-athletes and found that only 2.3 % of the athletes reported POP symptoms. While High et al., (2020) noted POP symptoms in only 3.2% of 314 female CrossFitters.

In addition, a large survey study by Forner et al., (2020) compared inactive females with those that lifted light (<15 Kg), moderate (16-50 Kg) or heavy weights (>50 Kg). The authors found that only 14.4% of the 3794 participants reported symptoms of a vaginal bulge sensation. Furthermore, POP symptoms occurred more frequently in women that were either inactive or lifted light. Also, the study results indicated that vaginal deliveries and inactivity were most associated with prolapse symptoms. 

Time to Re-evaluate Weight Training and Prolapse

We cannot draw cause-effect conclusions from these study findings, however, they do support re-evaluation of the blanket premise that weight training leads to POP. Instead, the results beg the question – How do we alter our messaging to reach or prevent inactivity? Have we unintentionally moved them toward inactivity or under-load them with prolapse ‘safe’ exercises in an effort to “protect” them from POP? Thus, we have not created opportunities to build adaptions through resistance training. Not only could this potentially reduce symptoms, but it would also boost their resilience to meet the challenges in their day. Important questions to ponder.

Adaptive weight training strategies have their place to help build resilience as a way forward (find ideas here and here

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Almeida MBA, Barra AA, Saltiel F, Silva-Filho AL, Fonseca AMRM, Figueiredo EM. Urinary incontinence and other pelvic floor dysfunctions in female athletes in Brazil: A cross-sectional study. Scandinavian journal of medicine & science in sports. 2016;26(9):1109-1116. doi:10.1111/sms.12546

Forner LB, Beckman EM, Smith MD. Symptoms of pelvic organ prolapse in women who lift heavy weights for exercise: a cross-sectional survey. International Urogynecology Journal. 2019;31(8):1551-1558. doi:10.1007/s00192-019-04163-w

High R, Thai K, Virani H, Kuehl T, Danford J. Prevalence of Pelvic Floor Disorders in Female CrossFit Athletes. Female Pelvic Medicine & Reconstructive Surgery. 2020; 26 (8): 498-502. doi: 10.1097/SPV.0000000000000776

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