I was teaching pre and postnatal Pilates for 3 years before I got pregnant and my biggest fear around birth / the postnatal period was getting a prolapse. I saw first hand the stress it can create and that it isn’t an easy recovery process. It can feel like it’s getting better and then suddenly at certain times of the month it feels worse again. It can feel totally overwhelming. And if the issue isn’t resolved within the first year, it can feel like you are stuck with it forever.
Rest assured, that you can do something about prolapse. So how does Pilates aid prolapse recovery? Pilates helps to improve your breath work, core function and posture, all of which can be instrumental in recovery from / living with prolapse. If you have a prolapse, it is important to work alongside a Pelvic Health Physio with any exercise programme.
In this blog post, I’ll be sharing my story about prolapse and the Pilates exercises I did to help me with the recovery process. I also teach these exercises in my Your Core Matters programme, available online.
So of course I was diagnosed with a prolapse about 6 months after my first baby was born. I knew I was susceptible as I am hypermobile. I had an 8lb 9oz baby and a long pushing stage. I also got up and about within days of the birth, wearing a badge of honour that I was recovering so well (SO cross with myself for that one!). And I didn’t give myself adequate recovery time.
Luckily with all the Pilates I did and the knowledge I had, I was symptom free. But then I had another whopper at 9lb 2oz and another long guided pushing stage (the midwives got nervous because it didn’t seem to be happening on its own). After baby number two the symptoms were more noticeable.
It was never terrible but I could get caught off guard and find myself leaking if I sneezed out of the blue. Running or high impact exercise didn’t feel like an option for a while. However, over time I have managed to get symptom free again and here are some of my favourite exercises that I believe have helped me on this journey.
Please see a Women’s Health Physio and get signed off by a health professional before doing any exercise, especially if you have been diagnosed with a prolapse. There is so much you can do to support it better but exercising in a way that doesn’t suit you can make things worse. It is therefore advisable to get as much support and guidance from an expert as possible.
Lying on your back with your knees bent up and your feet in parallel. Place your over ball (or a cushion) in between the tops of your legs, up towards your pubic bone. Inhale to relax. As you exhale, gently squeeze into the ball and feel your pelvic floor and abdominals connect. Inhale to consciously release. Repeat about 10 times.
Lying in neutral spine with your knees bent up and your feet in parallel. Inhale to release the pelvic floor, exhale, relax first and then connect to the pelvic floor muscles and tuck your pelvis under feeling your sit bones draw together. When you have found the tucked pelvis press into your feet to lift your pelvis off of the floor and think of peeling your spine up one vertebrae at a time. Make sure that you don’t lift your ribcage at the top. Inhale at the top then exhale to soften your ribcage and slowly peel the spine back down making sure your pelvis stays tucked until you release back into neutral. Repeat about 8 times.
Lying in neutral with your feet together. Inhale to open both knees out to the side, about half way down to the floor. Try to consciously relax the pelvic floor as you do this movement and try to keep the pelvis still. Exhale to relax and allow your abdominals to drop then gently connect to the pelvic floor muscles and lower abdominals and pull the legs back together again. Think of the legs being a weight for you to pull back to the centre. 10 reps.
Lying on your side with your knees bent up and your feet roughly in line with your sit bones. Try and think of your pelvis being level so you are reaching your top hip away from you and getting a sense of lift in your underneath wait. Inhale to spiral your top leg outwards to open the knee, allowing the pelvic floor to release. Exhale to close the leg and gently connect to the pelvic floor. Think of the action coming from your hip joint so you are focusing on mobilising while keeping your pelvis stable. Repeat about 10 times on each side.
Stand with your feet a little wider than hip width and work to bring the outside edges of the feet into parallel. Inhale to squat down, keeping the knees over the ankles and sending your bottom backwards like you are trying to sit into a chair. Exhale to push back up to standing, bringing your pelvis stacked over your ankles and your ribcage stacked over your pelvis.
When you breathe in this way with movement, it allows your pelvic floor to function in rhythm with your breath. This means you are teaching the pelvic floor to release as well as contract and learn to work with your movement patterns to function well on it’s own and support you.
Listening to your body is important. If any of these exercises don’t feel right then stop!
When we breathe we create intra-abdominal pressure and it is important to make sure that this is as balanced as possible through the torso. Make sure you are able to breathe into the whole ribcage and that you aren’t using a ‘belly breath’ which increases the pressure going into your pelvic floor.
When your bones are well aligned it makes it easier for the muscles and fascia to function well. For example excessive rounding of the upper back has been shown to correlate with pelvic organ prolapse – this makes sense because it is likely to cause the person to bear down and put extra pressure into the pelvis. Ensuring that there is balance throughout the body, the legs are aligned within the hips and there is a sense of lift throughout the torso rather than bearing down can all help.
Constipation and bearing down to go to the toilet can contribute to pelvic floor dysfunction. Make sure you drink lots of water, increase the fibre in your diet and look at the angle at which you sit on the toilet. Ideally your knees would be higher than your hips so you are almost in a mini squat position. You can use a squatty potty or toddler step to help with this.
If you feel like you would like some more help and guidance around this do feel free to get in touch. You may be interested in our Your Core Matters online Pilates classes or a regular Pilates class to help support your pelvic floor.