What Goes Down Must Come Up

Pelvic organ prolapse and associated pelvic floor disorders used to be associated with the aging woman. Unfortunately, these diagnoses are now becoming more common with young women who exercise regularly. Jogging is a common culprit, creating a repetitive impact on a weakened pelvic floor which contributes to descent of the poorly supported pelvic organs.

So what is an endorphin junkie who can’t quit the “kick’ they get from a good run to do about their heavy, painful sagging insides?

Refuse conventional wisdom. There is a sense of inevitability about pelvic floor issues for many women, a willingness to run their pelvic floor into the ground and just fix it all later with surgery. However, most surgical fixes ultimately require more surgery in approximately 10 years. This is because the pelvic floor never re-learned how to function properly prior to the initial surgery, so it will gradually descend again. In addition, a common side effect of some bladder lift surgeries is incontinence. No thanks.

Prolapse is an injury. If you sprained your ankle, you would hold off on jogging and focus on a walking program until it healed. This mindset of giving an injury a break must be applied to the pelvic floor. Rehabilitation, restoring normal function, of the pelvic floor is critical and possible! Once this is achieved you can gradually rebuild your exercise routine.

Get your butt up. Positions that elevate your bum above your torso will encourage the pelvic floor to return to a higher resting position, and bring relief. For example, prop your bum up on pillows while lying on your back or front; modify All-4‘s (hands and knees) by resting on your forearms and leaving your bum up; or lay over top of small exercise ball while reading or playing with kids. Begin reconnecting with pelvic floor function in this position-feel it descend with inhale, and rise with exhale.

Get your butt out. A tucked under bum position, flattening the low back, is a major culprit in poor pelvic floor function. Gently untucking the bum, to restore a mild low back curve, will maximize the activity of the pelvic floor naturally without having to think about contracting it. Incorporating this position into sitting, standing, walking and exercise form will re-engage the pelvic floor in day-to-day and fitness activities.

Take a break from the pounding! A jogging hiatus will give your pelvic floor a chance to catch up and get strong enough to take the impact you’re dishing out. As a substitute exercise challenge with less impact, try hiking up an incline or a brisk walk on a treadmill on a grade. Both activities force a longer stride to the rear, which naturally gets your butt out (4th Step) and keeps the pelvic floor active.

Prepare the pelvic floor for return to fitness. A classic Kegel does not prepare the pelvic floor for the motion, impact or speed of jogging. The pelvic floor must be trained for power, speed, and shock absorption just like the rest of the leg and upper body muscles. Train the pelvic floor like you would any other muscle for a return to sport-break down the activity. After reconnecting with the pelvic floor (3rd Step) begin exercises in half kneeling (one knee up and one knee down), move to single leg activities, and activities that link the pelvic floor to related muscle groups, then gradually progress to higher impact activities if tolerated.

Take a breath! In addition to jogging, breath holding during resistance exercise can also contribute to prolapse. The pressure created within the abdominal cavity by a breath hold can put significant pressure on the pelvic organs. Performing an exhale before each repetition begins will relieve abdominal pressure and also causes a lift of the pelvic floor. Use the thought “Blow before you go!” as your new exercise mantra.

Issues like pelvic organ prolapse can absolutely be managed conservatively with surgery as a last resort. Addressing the problem in its early stages, rather than ignoring it or assuming there are no alternative solutions, will give women the best possible outcome from conservative measures. Bottom line: Treat it like you would any injury by identifying contributing factors, address those issues, and then gradually build your exercise program as tolerated.

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17 thoughts on “What Goes Down Must Come Up”

  1. Pingback: Body Workout 101
  2. jordan shoes says:

    nice post,bookmark it now,thanks for share!good night!

  3. Thanks for the blog.Thanks Again.

  4. Great article, but are you somebody who suffers themselves? Were you diagnosed early as a child? Just curious as your perspective seems unique.

  5. Clad Genius says:

    I’m impressed!! Really informative blog post here my friend. I just wanted to comment & say keep up the quality work. I’ve bookmarked your blog just now and I’ll be back to read more in the future my friend! Also nice colors on the layout, it’s really easy on the eyes.

  6. Julie Wiebe says:

    Thanks for your question. My own experience recovering from issues following two vaginal deliveries pushed me to understand how pregnancy and delivery impacts a woman’s body. I have combined the knowledge I gained through research, courses, and clinical experience with my background and training in sports medicine. As you noted this has allowed me to create a very unique approach and perspective on rehabilitating women and returning them to fitness. For more info on my background, please see http://interiorfitness.com/about/bio/

    Hope that helps, let me know if you have any other questions. All the best. Julie

  7. Incostress says:

    Very nice article Julie. Would like to retweet this but can’t find the tweet to post the article.
    Love the work you do and dedication to all those with pelvic floor issues. Thank you.

    1. Julie Wiebe says:

      Thanks G! I don’t have the cool tweet buttons on my posts….sorry! It is on the list for my website upgrades. You just have to do it the old fashioned way! Thanks for passing it along.


  8. susan pollack says:

    ok here’s my question that I have been thinking about for a while. Is the goal to make the prolapse go away, is that possible or are we aiming to have no symptoms. Without a doubt these principles have alleviated symptoms ( many years past delivery) but I still have a stage 2 prolapse. Whats my goal if I’m not having symptoms? Thanks!

    1. Julie Wiebe says:

      Hi Susan,

      With your permission, I posted my reply as a new blog post. You can see it here: http://www.juliewiebept.com/individual/pelvic-organ-prolapse-rehabilitation-return-to-fitness/ .Thanks for the great question. Julie

  9. Annette says:

    Great post! So many young women (and men) who jog/run and don’t realize what they’re doing to their future body. Thanks for the tips! Off to lay with my legs up and read a book! 🙂

    1. Julie Wiebe says:

      Thanks Annette for commenting and using your time wisely while reading! Julie

  10. Denise says:

    Wow! Julie, you are throwing done some great posts! I’ve really enjoyed reading your last few topics! I agree with your statement about the PF never relearning how to properly function prior to surgery and that being a problem. So many women in that boat! Thanks for your awesome effort!

    1. Julie Wiebe says:

      Hi Denise! Thanks for the encouraging feedback. This is actually a re-post from 2010 that I thought was worth a revisit! Been preaching this message for a long time, holy cow! I hope we continue to see improvements in care for women with prolapse, and get to them before they need surgery!

      Hope all is well! Julie

  11. Denise says:

    Lol, still timely! I do think the message is getting out there.

    1. Julie Wiebe says:

      Yes! Slowly but surely! Julie

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