How to Strengthen Pelvic Floor Prolapse

Pelvic organ prolapse cannot be fully cured by exercise alone once it reaches stage 2-4, but correct pelvic-floor training and lifestyle changes can dramatically improve symptoms, stop progression, and often avoid or delay surgery.

Today, i want to chat about how to strengthen pelvic floor prolapse and give you some workout videos 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 the bladder, uterus and bowel. They are held in place by tissues called ‘fascia’ and ‘ligaments’. These supporting tissues help to join your pelvic organs to the bony side walls of the 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 worldwide.

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 Right Diagnosis First

See a pelvic-floor physiotherapist (PT) or urogynecologist for an internal exam (vaginal and rectal if needed).

They will tell you:

1. Which organ(s) are prolapsing (cystocele, rectocele, uterine, etc.)

2. Stage (1-4)

3. Whether your muscles are weak AND tight, or just weak

4. If you have diastasis recti or scar issues (common after C-section)

Do NOT just do generic Kegels – up to 40% of women do them incorrectly and make prolapse worse.

Step 2 – The 3-Part Strategy That Works

What to Do

1. Correct Pelvic-Floor Training

a. Learn to fully relax the pelvic floor first (most women with prolapse hold chronic tension)

b. Then do proper lifts (not hard squeezes)

c. Quick flicks and long holds (5–10 sec)

d. 8-12 slow reps and 20-30 fast reps, 3-5 times;/day

Why It Matters: Strengthens without bearing down

2. Core and Pressure Management

a. Activate deep core (transversus abdominis) before and during any lift, cough, sneeze

b. Exhale on effort (blow before you go)

c. Avoid constipation and chronic coughing

Why It Matters: Reduces downward pressure on weakened tissues

3. Lifestyle and Positional Changes

a. Avoid heavy lifting (>10-15 lb / 5-7 kg) or squat-lift correctly

b. Lose weight if BMI >30 (every 5 kg reduces symptoms)

c. Treat constipation (soft stool daily)

d. Use correct toilet posture (Squatty Potty, lean forward, brace)

Why It Matters: Removes the daily strain that keeps prolapse symptomatic

Best Evidence-Based Exercises for Prolapse

Exercise 1. Diaphragmatic Breathing

Lie on side or semi-reclined. Inhale belly rises, pelvic floor gently drops. Exhale pelvic floor lifts naturally.

Sets / Reps: 2-3 min, 3 times;/day

Exercise 2. Pelvic Floor Lengthening and Lift

On exhale, imagine ‘picking up a blueberry with vagina’ then fully let go on inhale. No bearing down.

Sets / Reps: 10 slow and 20 fast, 3 times;/day

Exercise 3: Heel Slides with TA Brace

Lying on back (or side if supine worsens bulge), exhale and draw belly button in, slide one heel out and back.

Sets / Reps: 10-15 each leg

Exercise 4: Seated or Side-Lying Marches

Exhale and TA brace, lift one knee a few inches (like marching).

Sets / Reps: 10-20 marches

Exercise 5: Kneeling Hip Thrust / Glute Bridge (only if NO increase in bulge feeling)

Kneel on all fours or lie on back with knees bent. Exhale, gently lift hips while engaging pelvic floor.

Sets / Reps: 10-15 reps

Exercise 6: Side-Lying Clams / Hip Abduction

Strengthens glute medius to better pelvic stability.

Sets / Reps: 15-20 each side

Avoid or modify these (they usually worsen prolapse symptoms):

1. Crunches during pregnancy, sit-ups, double-leg lowers

2. Full planks when pregnant, push-ups from toes

3. Jumping, running, heavy weights

4. Wide deep squats without support

5. Holding breath while lifting anything

Don’t let Pelvic Organ Prolapse hold you back any longer.

Educate yourself and empower your body today!

I will be discussing 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 planning to have a baby in the future, this guide will provide valuable information to help you navigate through pelvic organ prolapse with confidence.

What Do My Pelvic Floor Muscles Do?

Your pelvic floor muscles hold up your pelvic organs from below. If your pelvic floor muscles are weak, then your pelvic organs might not be held in their right place.

As a result, they may bulge or sag down into the vagina.

Early Signs of Prolapse during Pregnancy

1. Feeling of heaviness or dragging in the pelvis (worse later in day)

2. Visible bulge at vaginal opening (especially when standing)

3. Urinary issues: incontinence, difficulty emptying bladder

4. Bowel issues: constipation, incomplete emptying

5. Pain during intercourse (if sexually active)

6. Lower back or pelvic pain

Types of Prolapse

1. Pelvic organs may bulge into the front wall of the vagina (cystocele).

2. Through the back vaginal wall (rectocele or enterocele).

3. The uterus may drop down into the vagina (uterine prolapse).

5 types of Pelvic Organ Prolapse

1. Cystyocele (bladder drops and bulges into the vaginal canal).

2. Rectocele (large bowel or rectum bulges into the vaginal wall).

3. Enterocele (intestines).

4. Vaginal vault (vagina caves in on itself, possibly after uterus is removed-hysterectomy).

5. Uterine (uterus).

Signs of Prolapse

1. Urinary tract infections

2. Difficulty emptying your bowel.

3. Heavy sensation or dragging in the vagina.

4. A lump bulging out of your vagina.

5. Your bladder not emptying as it should.

6. Weak urine stream.

7. Sexual problems (pain or less sensation).

Causes of Prolapse

Often it is childbirth that is the main cause of a prolapse. On the way through the vagina, the baby can stretch and tear the supporting tissues and pelvic floor muscles.

The more vaginal births you have, the more likely you are to have a 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 ligaments supporting pelvic organs

2. Growing uterus – Adds mechanical pressure on pelvic floor

3. Previous vaginal births – Stretches/damages pelvic floor muscles

4. Chronic constipation – Straining weakens support –

5. Obesity or high BMI – Excess weight stresses pelvic floor

Management of Prolapse during Pregnancy

Australian guidelines (RANZCOG, Continence Foundation of Australia) recommend non-surgical management unless severe.

1. Pelvic floor muscle training (PFMT)

Supervised by a women’s health physiotherapist (e.g., via Pelvic Floor First app or local clinic). Start early, continue postpartum.

2. Pessary

Silicone ring inserted vaginally to support organs. Safe in pregnancy if fitted by a specialist (urogynaecologist). Requires regular cleaning/checks.

3. Lifestyle

– Avoid heavy lifting
– Treat constipation (Movicol, high-fiber diet)
– Maintain healthy weight gain

4. Support garments – SRC pregnancy shorts/leggings (Australian brand) can reduce symptoms.

Avoid surgery during pregnancy unless life-threatening (e.g., uterine incarceration).

Prevent Pelvic Organ Prolapse

What you can do is to strengthen your pelvic floor muscles.

Your pelvic floor muscles can be made stronger with the right exercises.

And I will show you these exercises!

Pelvic Organ Prolapse Exercises Video 1

Pelvic Organ Prolapse Exercises Video 2

In this short 7-minute Gentle postpartum exercise routine focused on assisting recovery from a POP particularly after birth.

Pelvic Organ Prolapse Exercises Video 3

Building on from Pelvic Organ Prolapse Exercise Video 2; this workout is longer at 9-minutes including all four kneeling exercises to help progress your recovery.

Pelvic Organ Prolapse Exercise Video 4

Building on from Pelvic Organ Prolapse Circuit 3 this circuit is longer at 11-minutes including supine exercises on your back without the assistance of a pelvic lift with a cushion.

My Online Program

In my program we delve into the struggles faced by pregnant moms dealing with the shocking reality of pelvic organ prolapse.

Discover how this condition can impact both the mother and the baby, as we explore the symptoms, causes, and possible treatment options.

PregActive Community

Join us as we share heartfelt stories, expert insights, and coping strategies to raise awareness about this often-overlooked issue in pregnancy.

If you or someone you know is facing similar challenges, this video aims 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 correct training and lifestyle changes.

Stage 3 and 4

Exercises and pessary or surgery usually needed for full resolution, but training still reduces symptoms and helps post-surgery recovery.

Start today with the breathing and proper pelvic-floor lifts and book a pelvic-floor physiotherapist within the next 2-4 weeks.