How To Exercise With A Weak Pelvic Floor

If you suffer from a pelvic floor disorder you may have been advised to reduce the amount of time you spend exercising, or even to avoid exercising entirely. But staying active is hugely important for everyone, and should remain part of your healthy lifestyle. Here we have compiled advice on which exercises you can continue to enjoy - which have a low risk of causing a pelvic floor disorder to occur or an existing disorder to progress.

Choose Low Impact Exercises

Traditional exercises do not strengthen your pelvic floor, however there are a number of exercises that have a low risk of causing damage, and some exercises which can be amended to even enhance your pelvic floor muscles. It’s entirely possible to get an effective workout that has all the benefits of higher impact sports without the risk to your pelvic floor. These exercises are also ideal after surgery or childbirth.

Take a look at the list below for some ideas of low impact activities you can have a go at:

Pilates - Modern Pilates incorporates deep breathing and pelvic floor contractions. Even though the movements are not designed to specifically strengthen your pelvic floor, you may notice an improvement. Ensure you avoid core-straining moves.
Yoga - As with Pilates, ensure you avoid core-straining moves. Yoga also includes deep breathing routines, with along with the mental and spiritual benefits, you may see greater control of your pelvic floor.
Swimming and water aerobics - The water will act to reduce the pressure on your pelvic floor.
Road cycling - The seat reduces pressure put on your pelvic floor. We have specified road cycling as rough surfaces will likely bump you around on the seat.
Gym equipment - Such as the elliptical and stationary bike, which do not require you to jump and do not strain your core.
Core-stability training - Stretching and strengthening exercises to improve the strength of your pelvic floor muscles and control of your pelvic organs, without straining your core.
Hiking and walking
Golf
Rowing
Tai Chi
Low impact aerobics

Avoid High Impact Exercises

The main type of exercise you should avoid, to stop a pelvic floor disorder from occurring or worsening, is high impact exercise. This means any type of exercise that involves jumping with both feet off the ground simultaneously. When you land, the pelvic floor experiences downward pressure. When repeated as part of an exercise routine, your pelvic floor can fatigue and experience damage that lasts.

Studies suggest that as a result of undertaking high impact exercises frequently, more than half of elite female athletes experience urinary incontinence, even when they are not exercising. With gymnasts being the most vulnerable, increasingly so if they are also mothers.

If you are suffering from a pelvic floor disorder or have previously undergone pelvic surgery to rectify a pelvic floor disorder, we recommend avoiding high impact exercises. Including:

Gymnastics
Running
Weightlifting
Triathlons
Intense core exercises - Like crunches and squats.

Protect Yourself Whilst You Exercise

We understand that if there’s a sport you really love it’s very difficult to come to terms with the idea that you may have to give it up. Whilst you complete any exercise there are a number of things you can do to reduce your risk of your pelvic floor disorder worsening:

Wear a pessary - A pessary can be used to support a pelvic organ prolapse whilst you exercise, to reduce urine loss and the prolapse from worsening.
Breath deeply - It's important to control your breathing as you exercise, to change the pressure within your pelvis and improve the quality of your exercises in general.
Wear specialist support underwear / shorts - These provide support for your pelvic floor, reducing the stress put on your muscles as you exercise. The compression uplift supports the pelvic floor and any prolapse you are suffering with, supporting the lower back and reducing muscle vibration.
Maintain good posture - When you have poor posture, your body is unbalanced. As a result you will be putting uneven pressure on your pelvic floor as you exercise.
Know your limit - Here are some warning signs you can look out for that suggest your pelvic floor is being overloaded; lower back pain (your prolapse may be at risk), pelvic pressure, bladder problems, bowel problems, bleeding (exercise can irritate severe prolapses as they rub on skin and clothing) and a vaginal bulge (any exercise that causes your prolapse to feel like it’s protruding more than usual is a very bad idea).

Sources

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Carvalhais, A. Natal Jorge, R. Bø, K. (2017). British Journal of Sports Medicine.Performing high-level sport is strongly associated with urinary incontinence in elite athletes: a comparative study of 372 elite female athletes and 372 controls. [online] doi:10.1136/bjsports-2017-097587 [viewed 17/04/18]. Available from: http://bjsm.bmj.com/content/early/2017/07/24/bjsports-2017-097587.long

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