June is POP awareness month. Have you heard about POP (Pelvic Organ Prolapse)? POP occurs when the muscles, fascia and ligaments holding your pelvic organs (bladder, uterus, and bowel) are weakened and stretched, which allows the pelvic organs to drop. You can have bladder, bowel or uterus prolapse or a mix of them.

50% percent of women who have had children are likely to have some kind of prolapse at some point in their lives. Many women have it but don’t even realise it. If something doesn’t feel right “down there,” go see a women’s health physiotherapist. As prolapse is due to weak pelvic tissues and PF muscles, to prevent it, all women should keep their pelvic floor muscles strong no matter their age.

Can you exercise? Yes, you can. Many info online will tell you to avoid any crunches, planks, sit-ups, and high-impact plyometric exercises (running, jumping, burpees, etc.) and be careful with weighted exercises, which can put pressure on the PF (don’t lift too heavy!). Is this correct though? And the answer is: it depends. If you suspect or have just found out that you have a prolapse, then yes I would say that the above does apply to you. But that doesn’t mean that it will apply to you for the rest of your life. Firstly see a women’s health physiotherapist so they can assess you and help you with your recovery. What exercises you should or shouldn’t do will depend on many factors e.g. stage of your prolapse and how far post-birth you are etc.

I have a prolapse myself and I can squat and deadlift more then my body weight, I run and jump and even train Muay Thai (and I know other women who run and exercise with prolapse). This didn’t happen overnight though. I was consistent with the exercises given to me by my women’s health physio. I worked on my posture and breathing. And that’s the thing, when it comes to recovery form POP (or even from diastasis or incontinence) it’s not just about the core & pelvic floor exercises. How you breath and your posture are also very important and how you move in your day to day life. If your body is out of alignment it can put your PF in a very vulnerable position and it can prevent your diastasis from healing.

Remember prolapse doesn’t only happen to old people!

What can cause prolapse? Pregnancy and childbirth are the main causes of prolapse. Your PF is under pressure and stretching from the weight and position of the baby during pregnancy. Then, vaginal delivery takes that pressure to another level. Your chance of prolapse also increases with assisted delivery (i.e. use of forceps and vacuum). However chronic coughing, heavy lifting, constipation and being overweight can contribute as well and you don’t actually have to be pregnant or give birth to have a prolapse and PF issues!

How do you know if you have a prolapse? Signs of prolapse include:

  • Incontinence (leaking is never normal and shouldn’t be ignored)
  • A heavy sensation or pressure in your PF
  • A lump coming out of the vagina (which you can feel whilst having a shower)
  • Sexual problems, pain or less sensation (don’t ignore these signs)
  • Reoccurring urinary tract infections
  • Difficulty with bowel movements

I can’t stress enough how important it is to see a physiotherapist specialising in women’s health after childbirth, so you know what’s going on with your pelvic floor and abdominals. I think all new mums should do it just to check that everything is okay, as a six-week check-up with your GP is not enough.

Finding the right women’s health physio is really important as well. Good physio will help you return to do all the stuff you love (or at least some of them). Yes, you might have to adjust the way you train to start with and you might have to avoid certain exercises. But if someone tells you to avoid stuff you do everyday like squats or lunges I would suggest getting a second opinion. Recovery is very individual but in many cases you should be able to live an active life. Saying that you have to be patient as it won’t happen overnight.

Prolapse is not just a body issue, it’s really hard on women mentally! Many mums feel like their body let them down after finding out that they have prolapse. They feel alone, lost, and depressed! They are angry and scared, feel resentment, and hate their body. And on top of that they feel like a shit mother for being unable to enjoy their baby. In addition, if you Google sadly, there aren’t many positive stories. Women don’t like to share about this experience, and I get it. It wasn’t easy at first to share my story publicly either, but I knew that it could give hope and encouragement to others (and I know many other positive stories). Everybody is different, and your recovery might be longer. But remember, you don’t have to fully “fix” your prolapse to have a functional pelvic floor and live a happy, healthy, and active life. But you have to work with a trusted professional (women’s health physio) and be consistent with your exercises. Your pelvic floor won’t get strong by itself.

Luckily most of the time I’m free from symptoms. But there are days when my symptoms increase and on these days sometimes I freak out. I can’t stop thinking about prolapse and thinking if I did something wrong and made it worse. And for some women that’s everyday. Prolapse takes over their lives! I get messages from women all around the world and some of them just break my heart. Some blame themselves for it; they shouldn’t have worked out the way they did whilst pregnant or after giving birth. I blame lack of education! No one told me about prolapse whilst I was pregnant or in the hospital (after I had an assisted birth which can increase the chance of a prolapse) and not even during the short pre & postnatal courses I completed online. And prolapse is very common. That’s why I share my story. If you have a prolapse remember you are not alone. And if you didn’t even know that something like this existed until you read my blog, remember leaking is never normal and if you suffer from incontinence or any other symptoms mentioned above visit a women’s health physio! Don’t take your pelvic floor for granted!

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