Help me come up with a back-to-gym plan; pelvic floor issues

[LambChopsMcGee]

Hiya,
I've posted a few times I think about issues with (mild) prolapse and my desire to get back to exercise. DD is 2 now and I am really noticing that my fitness has gone down and my weight has gone up, and my anxiety and depression are creeping back in.

I used to go quite hard out at the gym (for me). My routine was rowing machine to warm up, run 5km on the treadmill, then maybe 20 min cross trainer before weights (either machines or free dumbells) and sit ups (I would do something like 100 of various sorts).

After giving birth I had a mild prolapse and while I know serious runners manage to keep going, I am basically too nervous. If I do too much walking even I notice the return of heaviness.

I have some of the tight shorts that are supposed to support pelvic floor in exercise, so I wear them at the gym, but I am basically looking for help in devising a regime for prolapse safe exercise. I have looked at the PTs at my gym but none mention post-baby as an area of knowledge, so I wanted to ask here first.

I was thinking I could still row, or is that a no-no? And then could use the exercise bike instead of running -- advice on that appreciated (if I used to run 5km, what would be a good distance to work toward?). Should I use the normal bikes or the ones with the chair-like seat maybe?

I have read that people with pelvic floor issues should avoid lifting weights. Does that just mean heavy bar bells or should I be wary lifting my little 5kg dumb bells as well? What about weights machines?

And in terms of sit ups, floor exercise and planking, what should I avoid?

I also wanted to return to bikram yoga in the winter, but I wonder if that is unwise. I tried regular yoga not long after birth (less than a year anyway) and tmi but it was very queefy!

Any advice at all appreciated. I really need to get back into a regular routine and I think it's going to have to be before work each day so I need to feel confident and motivated!

Sorry for the long post.

Hopeful Sunday evening bump..

Take yourself off to a decent physio with a fitness interest. You need specialist help to start off with, you don't want to make things worse.

Bumpity bump for you.

Is there any way you can see a women’s health physio? Not sure if they’re ever available privately. I am seeing one tomorrow (slightly different problem; on NHS). I could ask them a very specific and short question for you but it really sounds like you need someone to work on a gym program with you.

Avoid weights machines, planking and sit ups, they all put a lot of stress on the pelvic floor. For weights, go lower weights and more reps, avoid heavy weights like the plague! It’s really hard to get good pelvic floor exercise advise but my physio said if you must run, then no more than 5k every other day. I think cycling and cross trainer are ok.
I would also go for Pilates over yoga but make sure you get a good instructor who is aware of which exercises you will need to avoid eg planks, the 100, anything involving double leg lifts.

It’s not easy, I’m in the same situation and also can’t cycle or swim for other health reasons Feel like a lardy lump.

I wasn't fobbing you off, PTs are limited to the healthy general population, unless they have specialist qualifications. My physio also runs a gym and there's quite a few that do, it's increasingly common.

Even a session or two, to work out a plan for exercise will keep you safer even if you go on your own thereafter.

Hey, fellow baggy-fannied anxiety/depression-prone runner here

I’ve got a grade 2 cystocele and a slight uterine prolapse, as well as nerve damage and very stretched pelvic floor muscles post birth a year ago. I’m on week 6 of couch to 5k (fucking depressing given that I used to run half marathons over mountains for fun, but still a huge step forward from where I was a year ago!) and so far so good symptom wise. However, have had a year of rehab to get to this point - definitely good to see a pelvic floor physio or specialist nurse (the one I see via NHS referral is brilliant).

8 weeks post partum I started post-natal Pilates. Class is run by a qualified physio who knows about my prolapse and helps modify exercises where needed.

I downloaded the NHS Squeezy app and do 4 sets of 10 long and 10 short pelvic floor contractions a day.

I did the free ‘lift’ programme on Femfusion Fitness’ YouTube channel.

The nurse lent me an electrical stimulation unit for my pelvic floor muscles (like a kegel8 machine) as the nerve damage meant I couldn’t recruit all the muscles. I think I did 8 weeks of 20 minutes daily and have now bought my own which I use maybe every other day.

I did spin classes (but stay sat down!) and used a turbo trainer for cardio before I tried running.

The gynae prescribed topical oestrogen to use vaginally to plump/tighten up tissue as I’m still breastfeeding, so dry and saggy (nice! Sorry. ), and fitted me with a ring pessary which I just use (along with those support shorts) when I run.

Do avoid crunches, planks, pull-ups, heavy lifting etc (anything that increases intra-abdominal pressure) until you’re sure your pelvic floor muscles are as good as you can get them, introduce gradually and stop as soon as you feel symptoms.

Haley Shevener is inspiring (there’s a Lori Forner pelvic health podcast with her on, talking about doing kettlebells with prolapse).

And come and chat to us over here if you like - lots of people in a similar boat www.mumsnet.com/Talk/am_i_being_unreasonable/3332405-To-ask-for-your-Pelvic-Organ-Prolapse-Surgery-success-stories

(Sorry for the essay, just remember how utterly shit I’ve felt and how great it feels to finally get a bit better, so wanted to pass it on!)

Amazing! Thank you all for the advice. And the essay is appreciated Verbena, I'm struggling to understand the whole situation and what is safe so more detail is always good!

I have seen a physio, ages ago, but I was more focussing on actually managing the prolapse and doing my PF exercises, so I might see about getting a specific gym session. I wonder if there are any personal trainers who could show me around the actual gym floor with this in mind.

I have been swimming and I love that, but I miss exhausting cardio. It really helps my mental health more then other exercise.

I'll look into Pilates then. I've never done it. I used to love Bikram...if I go back I'll speak to them first and maybe just enjoy the warm room...

Thanks again. Any more experiences and ideas welcome.

Cardio is magic for a wobbly brain! I’d try a spin class if you’re after a prolapse-safe burn. It’s properly knee-wobblingly knackering and sweaty, and is meant to be safe. Some advice says not to stand in the pedals at all but actually I found after a few classes it didn’t make things worse.

The annoying thing about ‘prolapse safe’ exercise is that it’s different for everyone as different bodies handle intra-abdominal pressure differently, so you need to also just pay attention to any feelings of heaviness/dragging/pressure while you exercise and stop doing what causes it.