One of my favorite parts of my job is hearing from YOU. Recently, I received the following question from a FemFusion friend:

“Hi Brianne! In the last month or so I seem to be developing some pelvic floor issues. I did have a traumatic delivery with my first son that resulted in a grade three tear, but never had any problems with incontinence or prolapse following that experience. In the last month I have felt an increased pressure on my bowel that is worse when I am lifting my kids or going for long walks… Still no incontinence… But I’m a little worried about this change in my pelvic area. What do you think? Do I have prolapse? I am having it evaluated by my GYN, however I was wondering if you have any tips in the meantime… I am trying to do kegels but read that they are more effective with biofeedback? I am trying to decide if I should request a consult with a women’s health physical therapist. Thanks for your input.” -Lara

Below is my response to Lara’s question, “do I have prolapse?” along with some tips and tools to help her cope.

“Do I have prolapse?” is actually a fairly common concern among women, so first and foremost, know that you’re not alone! Although it’s not something that’s commonly discussed, pelvic organ prolapse is a condition that many women develop and it can feel REALLY WEIRD. Ranging from a feeling of heaviness or pressure, to feeling like there’s a golfball in your vagina, to strange sensations during sex, to pain… It’s definitely noticeable and can cause quite a bit of distress when it’s discovered.

From your description, it sounds like you might have developed some amount of pelvic organ prolapse. It will be interesting to see what your GYN has to say, and I’m glad you’re seeing someone for an evaluation. In the meantime, I have some tips that will help prevent progression of prolapse if you have it. Even if you DON’T have prolapse, they are great tools for pelvic health for any woman.

Thumbs up for the Squatty Potty!1. Make sure you’re staying regular and that you’re not having to strain to have a bowel movement.

Keep your stools soft and easy to pass by eating a diet that’s rich in liquids from water and soups, and high in fiber, preferably from fruits and veggies and items such as chia and flaxseeds, since whole grains can be inflammatory for many individuals. Some people also benefit from a daily dose of magnesium, a mineral that many are deficient in and that can help calm your mind and keep you regular. Natural Calm by Natural Vitality is a supplement that I personally use and love. You also might want to try putting your feet up on a stepstool when going #2 (sorry to be graphic, but heck, this is real life right?!!!). You can read my review of the Squatty Potty right here. Straining to have a BM puts a LOT of pressure on an already stressed (via prolapse) pelvic floor.

2. Lift correctly.

When lifting your kiddos, prepare for the lift by “sealing off” your pelvic floor muscles (i.e. do a gentle kegel) and then engaging the rest of your core. This is the concept of “zipping up.” Zip up your core — from your pelvic floor on up thru your abs — every time you lift ANYTHING. It’s also helpful to exhale as you lift.

3. Don’t forget about posture!

To prevent progression of prolapse you have to be sure that your posture and alignment are spot-on. Align your head over your shoulders over your hips over your heels. You can read more about posture and pelvic health right here.


4. Consider your kegels…

Kegels (pelvic floor isolation exercises) are usually safe as long as you’re able to fully relax/release between contractions. However, if you’re unable to feel the contraction and/or the release, I definitely encourage you to STOP DOING THEM and seek the advice of a women’s health physical therapist. She will be able to evaluate you to make sure you’re doing your kegels correctly and also to determine if they are appropriate and helpful for you.

For some women with prolapse, the problem is actually short, tight, overly active pelvic floor muscles rather than weak pelvic floor muscles. For these women, kegels are ineffective and potentially harmful! If kegels are appropriate for you and you decide to incorporate them into your fitness routine, remember that when strengthening your pelvic floor muscles, you must ALSO focus on strengthening the rest of your core and MOVING MORE in general. Walk. Do other low-impact exercises such as swimming or rowing or dancing. Try bathroom fitness! Strengthen your abs, back, hips, and glutes with any of my “Midweek Moves” or my core fitness videos on YouTube. Here’s a great back-of-the-body exercise that’s a nice counter-balance for kegels:


5) Take a load off.

If you feel pressure/strain in the pelvic area at any time during the day, take a few minutes to lay down and rest. I suggest doing so with your knees bent and your bottom propped up on a pillow (i.e. a supported “bridge” position… See picture below). This position moves the pelvic organs back into place and takes the pressure off the pelvic floor. Sweet relief! While you’re there, try this 12 minute guided meditation for pelvic pain from Your Pace Yoga. It’s a lovely way to relax and release tension in the pelvis that can build up, especially in women with prolapse.
bridge 2

A great resting position. Check out those two zebra-striped pillows that are supporting my bottom!

As for specific moves to avoid, just  be sure to properly “zip up” during crunches, planks, squats and balance challenges, and be sure to also relax and LET GO of your pelvic floor muscles when cued (and also after you’re done exercising). The goal is to create strong, supple, and responsive pelvic floor muscles… Not to clench them all day long!

You’ve got this, girl!

*NOTE: This website in general, and this article specifically, is for general information and educational purposes only. It is not intended to diagnose or treat any medical condition, but rather to understand what options are available. Please seek the advice of a physician to properly diagnose your symptoms.