Pelvic Organ Prolapse and Lifting Weights: Why the 10-Pound Rule May Be Holding You Back
You were told you have a pelvic organ prolapse. Now what?
If you were given nothing but restrictions: such as “don’t lift anything over 10 pounds”, “modify your exercises”, or “don’t strain”. You probably left that visit wondering: what CAN I do? Or is this a death sentence for the rest of my life?
And you may find yourself thinking things like:
Can I lift my grandbaby when I babysit?
Can I carry groceries or will that make it worse?
What if I move houses? Will I be able to carry items or furniture?
Can I workout at the gym anymore?
I love running, is there a way to do that safely?
Does this mean I can’t do squats?
I need to lift weights for my bone health, but a 10 pound limit isn’t going to cut it.
For many women diagnosed with either bladder prolapse, uterine prolapse, rectocele, or another type of pelvic organ prolapse, the diagnosis itself isn't always the most frightening part.
It's the idea that living their normal life is only going to make the prolapse worse.
At Refine Physical Therapy, we want to challenge that idea!
Because while there may be times when temporarily modifying an activity or reducing load is appropriate, we do not believe an arbitrary lifting restriction should become your long-term strategy for managing prolapse.
Your body needs something much more useful than fear. It needs capacity. And a plan to get you there.
What Is Pelvic Organ Prolapse?
Pelvic organ prolapse occurs when one or more pelvic organs, such as the bladder, uterus, or rectum, descend toward the vaginal canal because the tissues supporting them are not managing pressure and load as effectively as they once did.
Women often describe pelvic organ prolapse symptoms as:
Vaginal heaviness or pressure
A bulging sensation in the vagina
Feeling like something is “falling out”
Pelvic pressure that gets worse after standing, lifting, or exercising
Difficulty emptying the bladder or bowels
A feeling of fullness around the vagina or rectum
If you've recently received this diagnosis, you've probably also Googled some version of:
Can pelvic organ prolapse get worse?
Can you exercise with prolapse?
Can I lift weights with pelvic organ prolapse?
Can pelvic organ prolapse heal?
Can pelvic floor physical therapy help prolapse?
What exercises should I avoid with prolapse?
Can I run with prolapse?
How do I stop prolapse from getting worse?
All of those questions stem from the same thought: What am I allowed to do?
However, at Refine Physical Therapy, we help you reframe the fear and instead we ask: What does my body need to become strong enough to do what I want to do?
The Problem With the “Don't Lift More Than 10 Pounds” Rule
Ten pounds is not a magical threshold where your pelvic floor suddenly stops working. The restriction simply stems from the idea that in order to heal, you need to take a step back first. The real problem isn’t the lifting restriction, the real problem is believing the lifting restriction is permanent and something to adhere to for life.
Not to mention, putting a restriction at 10 pounds really isn’t functional for life. For example:
The average toddler weighs 20 pounds or more
A luggage bag can easily weight over 40 pounds
A full bag of groceries can weigh 10 pounds
Telling an otherwise active woman that she simply shouldn't lift heavy things anymore doesn't necessarily prepare her body for the reality waiting outside the clinic.
And avoiding items that are heavy for an indefinite amount of time has another problem:
You never give your body an opportunity to become better and stronger at managing load.
That doesn't mean we hand someone with significant prolapse symptoms a heavy barbell on day one and tell her to push through. Absolutely not! That really would be a good way to make symptoms worse.
However, if we figure out why your current strength and body mechanic system is struggling with pressure and load, address those pieces, and progressively build your capacity. THEN we can start pushing you toward being able to tolerate higher and higher loads without symptoms.
The goal here isn’t to lift weights just to lift weights, it’s to undergo the process necessary to go from unable to capable.
It’s not only about your pelvic floor strength.
Your pelvic floor isn't working by itself to hold your organs up.
In fact, it is part of a much larger pressure-management and movement system involving your diaphragm, abdominal wall, hips, rib cage, glutes, connective tissue, breathing mechanics, and the way you coordinate all of those pieces when you move.
When you squat down to pick up your child, your body has to manage pressure.
When you lift a dumbbell, your body has to manage pressure.
When you cough, jump, run, carry groceries, push a stroller uphill, or move a piece of furniture, your body has to manage pressure.
We cannot eliminate pressure from life.
So why would our ultimate goal be to teach your body to avoid it?
We want to teach your body how to handle it.
That is a very different approach to pelvic organ prolapse treatment than the typical recommendation of avoid anything over 10 pounds and remember to do your kegels.
Yes, Strength Training Can Be Part of Prolapse Rehabilitation
One of the biggest misconceptions about exercise with pelvic organ prolapse is that strength training automatically makes prolapse worse.
The reality is more nuanced.
At Refine Physical Therapy we ask questions like:
How much load can you currently tolerate?
How well does your pelvic floor lengthen and contract?
Can you coordinate your pelvic floor with your breath?
What happens to your organs when abdominal pressure increases?
Are the muscles surrounding your hips, low back, and abdomen contributing appropriately?
Do your symptoms appear during the activity, immediately afterward, or several hours later?
And perhaps most importantly:
What do you actually need your body to be capable of doing?
Those answers matter much more to us than an arbitrary number on a dumbbell.
For the right person, appropriately progressed resistance training can become part of building the muscular strength, coordination, pressure management, and physical capacity needed to support an active life with prolapse.
We don't just want you strong enough to perform pelvic floor exercises on a treatment table. We want your pelvic floor to participate when the rest of your body has something difficult to do.
This Is Why We Don't Just Tell Women to “Do Kegels”
Pelvic floor strengthening for prolapse is not simply doing more Kegels.
In fact, some women with prolapse actually have pelvic floor muscles that are already gripping or overworking, and therefore, aren't coordinating well enough to manage pressure.
At Refine Physical Therapy, we first want to understand your system.
Can the pelvic floor relax?
Can it contract?
Can it move through its full range?
Can it coordinate with the diaphragm?
Can your abdominal wall contribute?
What are your hips doing?
What happens when we add load?
We work on the foundation first. Then we build strength. Not just in the pelvic floor but in how it work with the whole body to move and function.
Because eventually, we want those muscles to respond automatically when life demands something from them. You shouldn't have to spend the rest of your life thinking about your prolapse every time you pick something up. And we believe it’s possible to resolve this.
Our Goal Is Not to Give You a Longer List of Things You Can't Do
This is where our approach at Refine is different.
We aren't interested in handing women random restrictions without understanding why they're necessary or what the plan is for moving beyond them.
If we do give out a modification, it will have a reason AND a plan to move forward so that in the future we won’t need the modification anymore.
For example, if lifting 30 pounds causes vaginal pressure today, our question isn't:
“How do we make sure she never lifts 30 pounds again?”
Our question becomes:
“What does her body need so that someday 30 pounds doesn't feel like such a big deal?”
Because Your Goals Matter
A 68-year-old woman who wants to comfortably garden, travel, hike, and lift her grandchildren may need a different rehabilitation plan than a 35-year-old mother who wants to return to CrossFit.
A mother who needs to repeatedly lift a 35-pound child has different demands than someone whose favorite activity is walking.
There isn't one universal “safe weight” because there isn't one universal life. That’s why working with a pelvic health professional is so critical to making progress.
Can Pelvic Organ Prolapse Get Better?
Short answer: YES!!! With professional guidance, your symptoms and function can improve significantly. At Refine, we have helped 100’s of other women go from not being able to stand up without feeling their prolapse to being able to lift weights at the gym, heaviness-free.
It all depends on your commitment to getting better, consistency at making the necessary changes, and the belief that there is hope for you!
At Refine Physical Therapy, we specialize in helping women understand what is actually happening inside their bodies and creating a progressive plan to move from symptoms and uncertainty toward strength, resilience, and confidence.
No random restrictions.
No generic list of exercises.
No telling you that your only option is to stop doing the things you love.
We figure out where your foundation needs support, strengthen the muscles surrounding your pelvis, and progressively increase the demands placed on your body until those strength gains actually mean something in your real life.
Because we don't just want you to feel strong in the clinic.
We want you to feel your body supporting you when your life gets heavy.
Ready to Understand What Your Prolapse Actually Means for You?
If you've been diagnosed with bladder prolapse, uterine prolapse, rectocele, or pelvic organ prolapse and you're worried about exercise, lifting weights, running, or what this diagnosis means for your future, give Refine Physical Therapy a call.
Talk with one of our pelvic floor physical therapists about what you're experiencing, what you've been told, and, most importantly, what you want to be able to do again.
Your diagnosis tells us where we're starting. It doesn't get to decide where you finish.
