POP is an acronym for Pelvic Organ Prolapse. Doesn't that almost sound cute?? POP occurs when the support structure within the vagina (represented by the hammock in this image) is compromised and one or more of the organs that should be supported by the pelvic floor (bladder, uterus or rectum) descend into the vaginal wall and cause it to droop. For some people, POP can invoke symptoms of heaviness, bulging or pressure in the vagina or perineum, incontinence, a feeling like something is falling out of the vagina, sexual dysfunction or queefing. But 𝙢𝙤𝙨𝙩 people only experience a few of these symptoms. Some people experience no symptoms at all! The degree of descent is known as the “grade” of descent and it’s so important (and beneficial) to note that the severity of symptoms does not correlate to the grade or to the worsening of the grade. Symptoms do however correlate to things like stress, sleep, time of day, time of the month and management (or not) of intra-abdominal pressure.
Estimates of the prevalence of POP vary widely- so anywhere between 50% to nearly 100% of people who have given birth will experience some degree of POP (not a terribly useful set of statistics). It’s very common. We just don’t talk about it. No sugar coating this, it’s not like, something you’d choose. But at the same time, a POP diagnosis does NOT necessarily mean that you have to give up the sports or activities that you love. POP isn’t “curable” but in many (most?) cases the symptoms are manageable and in some cases the grade can even be corrected a little bit. It just takes a bit of effort to find the appropriate help, experiment with strategies and learn what works best for you.
Here are seven suggestions that may help you manage POP and its symptoms:
1. Schedule an appointment with a pelvic floor PT so you can get a personalized assessment and rehab plan. Visit my Resources page to find links to national and international directories of pelvic floor physical therapists. For recommendations specific to Seattle's Eastside neighborhood, visit this blog post: Core and Pelvic Health Resources for Seattle's Eastside Communities.
2. Listen to your body. Specifically, pay attention to sensations of pain or pressure in your vagina or pelvic floor or leaking of urine (or anything else, really…). If you experience these symptoms, check your breathing/alignment/movement strategies yourself or with the help of a pelvic floor PT or qualified fitness pro.
Need more information on what it means to listen to your body? Check out this recent blog post: What it Actually Means to "Listen to Your Body" When You're Pregnant or Postpartum
Need help troubleshooting your breathing, alignment or movement strategies? Check out my (free) comprehensive resource, The No B.S. Guide to Breathing.
3. Incorporate a lot of movement variability into your workout- in particular, include seated, supine (lying on your back) and feet-elevated exercises to give your pelvic floor a rest. Example exercises include seated overhead presses, seated rows, glute bridge variations (including feet-elevated glute bridges) or clamshell variations.
4. Slow your breathing down and make sure you relax your abdominal wall and pelvic floor between reps and sets.
5. Take as much rest as you need. Rest between reps, between sets, between workouts. Be honest with yourself.
6. Experiment with the time of day when you exercise. Prolapse symptoms can vary over the course of the day. For example, some people might feel better earlier in the day before the pelvic floor has had to work hard to support your body all day!
7. Pay attention to your clothing choices and try to avoid restrictive items like pants with tight waistbands or extremely compressive sports bras. Your abdominal wall and rib cage need space to expand in order to best distribute intra-abdominal pressure offload your pelvic floor.
If you experience POP or work with people that do- have you found other strategies that are helpful? I’d love to add to the list. Please get in touch!
Take a deep dive into HOW to dial in your breathing strategy to manage your pelvic health and feel stronger in your workouts. Download a copy of The No B.S. Guide to Breathing for a STRONG Pregnancy and Postpartum.
My mission is to make sure that having a baby is not a reason why you can’t do all the things.
Contact me if you have questions about exercise or pelvic health pertaining to pregnancy or postpartum. I work with people locally (Seattle's Eastside: Redmond, Bellevue, Kirkland and surrounding areas) and online to develop personalized pregnancy and postpartum personal training plans.