Top 3 Exercises for Pelvic Organ Prolapse: Managing Pressure for Effective Strengthening

By: Erica Tran, PT, DPT, OCS and Chelsey Vasquez, PT, DPT, PRPC

Pelvic organ prolapse (POP) occurs when the pelvic organs descend due to weakness in the pelvic floor muscles and connective tissues. Proper coordination of breath with movement is essential for optimal pelvic health function and managing intra-abdominal pressure effectively. Inhalation allows the pelvic floor to relax, while exhalation engages and contracts the pelvic floor muscles. For each exercise, you will exhale during the most challenging part to enhance stability and support. This condition can cause discomfort, pressure, and functional limitations. A key component of managing prolapse symptoms is strengthening the core and pelvic floor while maintaining proper pressure management.

Here are three effective exercises designed in gravity-eliminated positions to reduce intra-abdominal pressure and enhance pelvic floor engagement:

1. Bridges

Why it works: Bridges strengthen the glutes and core while promoting pelvic floor activation in a supine position, minimizing downward pressure on the pelvic organs. To increase difficulty, place a yoga block between your knees and gently squeeze to activate the adductors and enhance pelvic floor contraction.

How to do it:

• Lie on your back with your knees bent and feet hip-width apart.
• Inhale to prepare, allowing the pelvic floor to relax.
• As you exhale, engage your core and pelvic floor, lifting your hips off the floor.
• Engage your core and pelvic floor muscles.
• Lift your hips off the floor while maintaining a neutral spine.
• Lower back down with control.
• Perform 10-15 reps for 2-3 sets.

2. Elevated Feet Pelvic Tilt

Why it works: Elevating the feet reduces the gravitational pull on the pelvic organs, allowing for better pressure management and core activation. To make this exercise more challenging, place a yoga block between your knees and apply a gentle squeeze to further engage the pelvic floor.

How to do it:

• Lie on your back with your feet resting on an elevated surface (e.g., a bench or yoga block).
• Inhale to relax the pelvic floor.
• As you exhale, gently tuck your pelvis to flatten your lower back against the surface.
• Gently tuck your pelvis to flatten your lower back against the surface.
• Hold for a few seconds, focusing on deep diaphragmatic breathing.
• Release and repeat for 10-12 reps.

3. Quadruped Knee Hovers

Why it works: This exercise engages the deep core muscles while keeping intra-abdominal pressure controlled in an all-fours position. For those with sensitive knees or wrists, a modification can be made by propping the elbows on a box or chair to reduce pressure on these joints. To add difficulty, place a yoga block between your knees and squeeze gently while hovering to enhance pelvic floor activation. For those with sensitive knees or wrists, a modification can be made by propping the elbows on a box or chair to reduce pressure on these joints.

How to do it:

• Get into an all-fours position with your hands under your shoulders and knees under your hips.
• Inhale to prepare, keeping the pelvic floor relaxed.
• As you exhale, engage your core and lift your knees 1-2 inches off the ground. (Modification: If you have sensitive knees or wrists, place your elbows on a box or chair to support your upper body.)
• Engage your core and lift your knees 1-2 inches off the ground.
• Hold for 5-10 seconds, then lower with control.
• Repeat for 8-12 reps

The Science Behind These Exercises

According to research published in the Journal of Women’s Health Physical Therapy, exercises performed in gravity-eliminated positions can help reduce excessive intra-abdominal pressure and improve pelvic floor activation, making them ideal for individuals with POP (Hagen et al., 2014). Strengthening the glutes, core, and deep stabilizers plays a crucial role in managing symptoms and enhancing functional movement.

Final Thoughts

Incorporating these exercises into a pelvic health routine can improve strength, stability, and symptom management for those with pelvic organ prolapse. With the right exercises and training, you can improve the efficiency of your pelvic floor, improve your exercise performance, and enjoy the things you love. Reach out to one of our pelvic health physical therapists to get started on your personalized plan! Schedule  here in either our Boulder or Lafayette locations today!

Reference:
Hagen, S., Stark, D., Glazener, C., et al. (2014). Pelvic floor muscle training for pelvic organ prolapse: a randomized controlled trial. Journal of Women’s Health Physical Therapy, 38(1), 5-12.