The one thing you should NEVER do if you have pelvic organ prolapse!
Sit-ups? No, that's not it! Baby wearing? Heavy deadlifts? Guess again. Running? Nope, not even close.
We're all familiar with the lists of "safe" and "unsafe" exercises with POP.
Every day, we see women in the clinic and the gym wanting "the list". You know the one: a neat and tidy "do" and "don't" list that dictates what will and won't cause problems for someone with POP. While that list might seemingly make our jobs easier, we refuse to give it out. And if you've been relying on generalized a list like this? We're going to invite you to do something that might seem totally wild: tear it up. Let's replace it with critical thinking, personalized recommendations, strategies, resources, and tools. Authors of "The List" mean well, but a binary grouping of exercise meant to be applicable to a diverse population will come up short every time. We all manage movement differently. Each of us is unique in every factor that could influence whether a movement is the best choice for us right now: pelvic floor strength and function, fitness level, fitness interests, how we execute the movement, presentation of symptoms, POP type & grade, access to resources, hormonal factors, what we like to do, how much we slept last night, whether we're breastfeeding/pregnant/menopausal, beliefs about exercise, etc. etc. etc. What is appropriate for someone could be detrimental for another. And a list that aims to keep someone safe, could have physical and mental health ramifications for someone else.
If we want to be safe movers with POP, we have to get rid of the idea that a singular "safe" list is appropriate for everyone with POP.
So Often, We Become Our Diagnosis
We become our prolapse, our pelvic floor strength, our symptoms, our loss of function. We introduce ourselves as Cystocele, Grade 2. We lose sight of what we like to do. We abandon the idea that we are even allowed to have interests, now that we are "prolapse".
We tend to forget that the pelvic floor and the vagina are parts of a larger system. We are quick to celebrate the incredible ability of the body (and the brain!) to adapt -- unless there's a vagina involved! But the body and the brain are still incredibly adaptable - even, yes, with POP. We can improve our pelvic floor strength, timing, and coordination. We can manipulate how we move, and how we approach movement. We can train to have pressure serve its purpose, instead of having it present a problem. We can move and think and function differently - these truths are still present even as our organs shift. But, instead, we've been reduced to categories that name our limitations without even knowing of what we're capable. With nothing but good intentions, many practitioners and providers have reduced their clients and patients to merely their pelvic floors. Is it really any wonder that so many of us with POP have started to believe that's all we are, too?
The One Thing You Should Never Do With POP
We're not talking about crunches and double-unders and muscle-ups. We're not talking about baby wearing, or standing in a posterior pelvic tilt, or even bearing down on your pelvic floor, for that matter. What's the single thing we never want you to do, if you have pelvic organ prolapse? Believe that you are solely defined by your pelvic floor. You are not your pelvic floor. You are not your prolapse. You are not your diagnosis, your grade, your symptoms. You are so much more than your pelvic floor.
And because you are more than your pelvic floor, you deserve for all of the parts of you to be considered when you seek guidance on movement, exercise, and management with POP.
Making Decisions About Movement and Activity With POP Requires YOUR Input
We know how overwhelming it can feel to receive a diagnosis of POP and then be bombarded with considerations you never thought you'd need to know. We know that going on a website and seeing a list of things you "can" and "can't do" might seem like a welcome respite from all the thinking and decision-making you likely feel you're already doing so much of. A "safe" list of exercises feels safe in other ways, too; it's easier and comforting to rely on the suggestions of someone else, if you're feeling like you're ill-equipped, or have lost trust in your body and its ability.
But what if you were able to regain confidence and trust in yourself again? What if you acquired the skill and the knowledge to be able to assess for yourself, if a movement was beyond your functional capacity? What if you could learn how to break down movement, any movement, to make it more accessible to you? What if you were actually able to someday make things on the "don't" list become appropriate for you? What if you were able to learn about your body, your prolapse, and movement and have that knowledge carry you through this chapter, and every chapter to follow? What if you were able to make choices that honored your body, your interests, your needs? What if you celebrated yourself as the beautifully complex individual you are, who is so much more than a pelvic floor? We believe you can. And we also believe we can help! What can initially feel like an investment will serve you the rest of your life. Once you know how and what and why (to manipulate), you regain autonomy, trust, and ability. Lists of "safe" and "unsafe" things weren't written for you. A list can never empower you as fully as you can empower yourself. The decisions you make will take into consideration new information as it arises. Your decisions will shift and evolve...with you.
We will support you in your fitness endeavors, your desires for a more functional and fulfilling life. We will cheer you on as you create better strategies, gain awareness, move in meaningful ways, and gain confidence. We will support you as you grieve, as you process your anger, as you learn to trust yourself, as you laugh until you cry and cry until you laugh. We will remind you that you are not alone - we are not alone. We will help you learn to consider the factors that might influence your symptoms, or your success, in executing a specific movement. We will always offer you the driver's seat. We will always remind you that there is so much more to you than your prolapse.
Members of POP UP are lifting, running, cycling, doing yoga, CrossFit, pole dancing, carrying their toddlers, and so much more. They are making decisions for themselves with professional in-person and online guidance and support. They are taking control of the elements they can control in their journey with POP. They are thinking critically, moving meaningfully, and honoring their whole selves. If you're looking for a comprehensive program on managing pelvic organ prolapse that can help you regain trust, build confidence, and strength in all the ways, we hope you'll join us.