Pelvic organ prolapse cannot be completely cured by exercise alone once it reaches stage 2-4, but proper pelvic floor training and lifestyle changes can dramatically improve symptoms, halt progression, and often avoid or delay surgery.
Today, I want to talk about how to strengthen pelvic floor prolapse and give you some workout videos that you can do at home.
First, pelvic organ prolapse (POP) is common in women during pregnancy. What I want you to know is that it won’t get better on its own, so you will need to seek help.
Your pelvic organs include your bladder, uterus and bowel. They are held in place by tissues called “fascia” and “ligaments”. These supporting tissues help attach your pelvic organs to the bony side walls of your pelvis and hold them inside your pelvis.
In this comprehensive guide, we explore the ins and outs of pelvic organ prolapse, a condition that affects millions of women around the world.
From causes and symptoms to treatment options and prevention strategies, we cover everything you need to know to take control of your pelvic health.
Step 1 – Get the correct diagnosis first
See a pelvic floor physical therapist (PT) or urogynecologist for an internal exam (vaginal and rectal if needed).
They will tell you:
1. Which organs are affected (cystocele, rectocele, uterus, etc.)
2. Stage (1-4)
3. Either your muscles are weak AND tight, or just weak
4. If you have problems with dilatation or scarring (common after a C-section)
DON’T just do generic Kegels – up to 40% of women do them incorrectly and worsen prolapse.
Step 2 – The 3-Part Strategy That Works
What to do
1. Proper pelvic floor training
a. First learn to completely relax the pelvic floor (most women with prolapse maintain chronic tension)
si. Then do proper lifts (not push-ups)
do. Quick movements and long holds (5–10 seconds)
hey 8-12 slow reps and 20-30 fast reps, 3-5 times/day
Why it matters: It gets stronger without falling
2. Core and pressure management
a. Activate the deep core (transversus abdominis) before and during every lift, cough, sneeze
si. Exhale with effort (blow before you go)
do. Avoid constipation and chronic cough
Why it matters: Reduces downward pressure on weakened tissues
3. Changes in lifestyle and location
a. Avoid lifting heavy weights (>10-15 lbs / 5-7 kg) or proper squatting
si. Lose weight if BMI >30 (every 5kg reduces symptoms)
do. Treat constipation (soft stools daily)
hey Use Correct Toilet Posture (Squatty Potty, Lean Forward, Support)
Why it matters: It removes the daily stress that keeps prolapse symptomatic
Best evidence-based exercises for prolapse
Exercise 1. Diaphragmatic Breathing
Lie on your side or semi-recumbent. Inhale the abdomen rises, the pelvic floor gently falls. Exhale pelvic floor lifts naturally.
Sets / reps: 2-3 minutes, 3 times?/day
Exercise 2. Lengthening and Elevating the Pelvic Floor
On exhalation, imagine “picking a blueberry with your vagina” and then let go completely. No influence.
Sets / Reps: 10 slow and 20 fast, 3 times?/day
Exercise 3: Heel slides with TA brace
Lie on your back (or side if lying down makes the bulge worse), exhale and pull your belly button in, slide one heel out and back.
Sets / reps: 10-15 each leg
Exercise 4: Seated or side-lying march
Exhale and hold TA, lift one knee a few inches (as if walking).
Sets / Reps: 10-20 moves
Exercise 5: Kneeling Hip Thrust / Glute Bridge (only if NO increase in swelling sensation)
Kneel on all fours or lie on your back with your knees bent. Exhale, gently lift the hips while engaging the pelvic floor.
Sets / reps: 10-15 reps
Exercise 6: Side Clams / Hip Abduction
Strengthens the gluteus medius for better pelvic stability.
Sets / Reps: 15-20 each side
Avoid or modify these (they usually make prolapse symptoms worse):
1. Cramps during pregnancy, sit-ups, biceps dips
2. Full planks when pregnant, push-ups from the toes
3. Jumping, running, heavy weights
4. Wide deep squats without support
5. Holding your breath while lifting anything
Don’t let pelvic organ prolapse hold you back any longer.
Train yourself and strengthen your body today!
I will discuss pelvic organ prolapse during pregnancy, a common but often overlooked issue that many women face during this special time.
I will explore the causes, symptoms and treatment options for pelvic organ prolapse, as well as provide helpful tips and advice for pregnant women dealing with this condition.
Whether you are currently pregnant or she is planning to have a baby Going forward, this guide will provide valuable information to help you navigate pelvic organ prolapse with confidence.
What are my pelvic floor muscles doing?
Your pelvic floor muscles hold your pelvic organs underneath. If your pelvic floor muscles are weak, then your pelvic organs may not be held in their proper position.
As a result, they may swell or fall down into the vagina.
Early signs of prolapse during pregnancy
1. Pelvic heaviness or drag (worse later in the day)
2. Visible lump in the sinus opening (especially when standing)
3. Urinary problems: incontinence, difficulty emptying the bladder
4. Bowel problems: constipation, incomplete emptying
5. Pain during intercourse (if sexually active)
6. Pain in the lower back or pelvis
Types of prolapse
1. Pelvic organs may bulge into the front wall of the vagina (cystocele).
2. Through the posterior vaginal wall (orthocele or enterocele).
3. The uterus may fall into the vagina (uterine prolapse).
5 types of pelvic organ prolapse
1. Cystic hernia (the cyst falls and swells in the vaginal canal).
2. Orthocele (the colon or rectum bulges into the wall of the vagina).
3. Enterocele (intestines).
4. Vaginal dome (the vagina recedes, possibly after removal of the uterus-hysterectomy).
5. Uterine (matrix).
Signs of prolapse
2. Difficulty emptying your bowels.
3. Sensation of heaviness or crawling in the vagina.
4. A lump protruding from your vagina.
5. Your bladder isn’t emptying like it should.
6. Weak flow of urine.
7. Sexual problems (pain or less sensation).
Causes of prolapse
It often is birth this is the main cause of prolapse. On the way through the vagina, the baby can stretch and tear the supporting tissues and muscles of the pelvic floor.
The more vaginal births you have, the more likely you are to have prolapse.
Why does POP happen in pregnancy?
Pregnancy increases intra-abdominal pressure and hormonal changes that soften connective tissues.
1. Hormonal changes (relaxin, progesterone) – Loosens the ligaments that support the pelvic organs
2. Growing uterus – Adds mechanical pressure to the pelvic floor
3. Previous vaginal births – Stretches/damages the pelvic floor muscles
4. Chronic constipation – Strain weakens support –
5. Obesity or high BMI – Excess weight puts strain on the pelvic floor
Treatment of prolapse during pregnancy
Australian guidelines (RANDSKOGContinence Foundation of Australia) recommend non-surgical management unless severe.
1. Pelvic floor muscle training (PFMT)
Supervised by a women’s health physiotherapist (eg through the Pelvic Floor First app or local clinic). Start early, continue postpartum.
2. Pessary
Silicone ring inserted vaginally for organ support. Safe in pregnancy if approved by a specialist (urogynaecologist). Requires regular cleaning/checking.
3. Way of life
– Avoid lifting heavy weights
– Treat constipation (Movicol, high fiber diet)
– Maintaining healthy weight gain
4. Supportive clothing – SRC (Australian brand) maternity shorts/leggings can reduce symptoms.
Avoid surgery during pregnancy unless it is life-threatening (eg, incarceration of the uterus).
Prevention of pelvic organ prolapse
What you can do is get stronger pelvic floor muscles.
Your pelvic floor muscles can be made stronger with the right exercises.
And I will show you these exercises!
Pelvic Prolapse Exercises Video 1
Pelvic Prolapse Exercises Video 2
This short 7 minute gentle postpartum exercise routine focused on aiding POP recovery especially after birth.
Pelvic Prolapse Exercises Video 3
Based on video 2 of the pelvic organ prolapse exercise. This workout is longer at 9 minutes, including all four kneeling exercises to help progress your recovery.
Pelvic organ prolapse exercise video 4
Based on Pelvic Organ Prolapse Circuit 3, this circuit is longer at 11 minutes, including exercises lying on your back without the aid of a pelvic lift with a pillow.
My online program
On my show we delve into the struggles pregnant moms face as they face the shocking reality pelvic organ prolapse.
Find out how this condition can affect both mother and baby as we explore the symptoms, causes and possible treatment options.
PregActive Community
Join us as we share heartfelt stories, expert knowledge and coping strategies to raise awareness of this often overlooked issue in pregnancy.
If you or someone you know is facing similar challenges, this video is meant to provide support and information.
Realistic Expectations
Stage 1 and mild stage 2
70-90% of women become symptom free with 3-6 months of proper training and lifestyle changes.
Stage 3 and 4
Exercises and pessary or surgery are usually required for complete resolution, but exercise still reduces symptoms and helps recovery after surgery.
Get started today with breathing and proper pelvic floor lifts and book a pelvic floor physical therapist within the next 2-4 weeks.
