Heavy Lifting After a Pelvic Organ Prolapse

In my free Facebook group, Restore Your Core Community, I am often asked by women who lift if getting back into heavy lifting is possible. The short answer is yes, many, many women can go back to lifting after a pelvic organ prolapse. The extended version of that answer is that those who can and those who do so without risk are the ones who train progressively over time and with load progression.


What is a Pelvic Organ Prolapse?

Pelvic organ prolapse (POP) is a condition in which one or more pelvic organs (bladder, rectum, small bowel, uterus, etc.) move toward or into the vaginal canal. This happens due to imbalance of the muscles and ligaments supporting the pelvic floor. Folks who have experienced pelvic organ prolapse often describe symptoms as feeling a “stuck tampon” sensation, bubbles in the urethra, and heaviness in the pelvic floor. Other symptoms may include constipation, pelvic pain during intercourse, and incontinence (fecal and/or urinary).

Recently, I began to work with a new client who has been doing CrossFit for quite some time but assured me up and down that she does not bear down, push out, etc. in response to weight/load. However, she was very confused as to why her pelvic organ prolapse was getting worse when her loading and core strategy was “perfect.” So, I tested her.

I asked her to hold two 4 lbs weights in one hand and to hold her hand at a 45 degree angle to her body (think holding a serving plate to your side). I asked her to relax her belly and side bend while leaving her other hand on her belly. I told her to tell me what her core did, how it reacted. And sure enough, it bulged into her hand. Only 8 lbs and there was a bulge in the belly. Meaning downward and outward pressure on her core. Not an ideal strategy for pelvic organ prolapse or any core issue.

She was shocked that her body’s natural/reflexive strategy in response to weight/load is to bear down. From this one test I was pretty sure that this same exact reaction must be happening with a kettlebell, a squat, a barbell, etc. We tested that too and sure enough there was a compensation.


How Long After a Pelvic Organ Relapse Before Heavy Lifting Again?

We cannot and should not lift, swing, load heavy until our core is reflexive and responsive to weight. First we must train the core to automate, then add load slowly over the course of 6-8 months, increase endurance, tolerance and time. Those are all important factors to strengthening the core the correct way and many of do not train that way. They go right back to heavy loads on a core / pelvic floor that is still loading. My 13-week step by step program Restore Your Core is a great place to start training your core before getting back to heavy lifting. I have seen many clients return to lifting with pelvic organ prolapse. It is all in how you train your core. Education is empowerment. Do your research. Learn the strategies and progress slowly over time. You’ve got this!

For additional support and resources, check out the following:

A basic summary and FAQ about POP is available from the US government’s Office on Women’s Health

APOPS website: The Association for Pelvic Organ Prolapse Support has extensive information related to many of the common medical approaches to healing POP, including surgery and physical therapy.

If you’re interested in looking at prolapse from a PT’s perspective, Julie Wiebe’s blog has a wealth of information.

If you work as a movement teacher or trainer, this article does a nice job of outlining how to work with your clients with POP. And if you’d like to learn how I work with my POP clients, check out the RYC™ Teacher Training program.

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