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Having a prolapsed uterus is a burden in itself but when you start hearing gossip about exercise limitations and your new sedentary life, it is no wonder that patients are hysterical when they come to the clinics. Are these restrictions really needed?

Uterine prolapse is an unfortunate part of life for women as they age. In general epidemiological studies, more than 25 percent of women are suffering from symptoms associated with a severely prolapsed uterus in the United States as you read this article [1]. Women that have more severe forms of this prolapse tend to experience changes in their urinary, bowel and sexual function [2]. Patients with this condition have feelings of bloating, incontinence and an overall reduced quality of life. The consensus in society when living with a prolapsed uterus is that exercise as an additional strain on your abdomen will surely make the uterine prolapse worse. But is that in fact true? 

How Much Exercise Does it Take to Increase Intra-Abdominal Pressure? 

One logical thought process when it comes to seeking your uterine prolapse treatment is that the harder your exercise, the more likely there will be pressure put on your uterus resulting in a worsening of the uterine prolapse. Researchers designed a novel study to put this logic to the test. Researchers were determined to quantify how much of a strain on the abdomen women experienced during strenuous activities. Women from various age ranges were asked to partake in exercise routines while sensors were placed in their uterine cavity. These exercises were designed to be strenuous in nature, and each subject completed exercises three times a week. At the conclusion of the study, researchers were able to conclude one thing: that there is no consistent link between exercising routines and intra-abdominal pressure. Researchers believe that it is impossible to quantify a particular level in which doctors should recommend patients not to exceed a certain threshold because a woman's uterus responses subjectively based on an individual's anatomy. [3]

A smaller study further attempted to quantify this impact of exercise in another manner. Participants were measured before and afterward of exercise routines and researchers determined that there was a worsening level of uterine prolapse but the symptoms or quality of life of the women was not worsened in any circumstance in any participant. [4]

What Exercises Are Right for Me? 

Traditionally, when it comes to your uterine prolapse treatment, some exercises have always been more favored than others to reduce the likelihood of aggravating your prolapsed uterus. The majority of websites recommend avoiding sit-ups, medicine ball sit-ups, hanging knee raises, bicycle kicks and even leg raises. With such a gauntlet of restrictions, it may just be easier for physicians to say don't exercise your abdomen at all; not good news if you are still in pursuit of that elusive six-pack. Thankfully, as you have seen from the first section, the medical investigations just do not support that these exercises can aggravate your prolapsed uterus even further. Every patient's physiology is different, so it is impossible to give a blanket guideline for patients coming from different physical fitness levels, body weights, and proportions. 

On the contrary, physicians generally encourage patients to exercise not only after elective surgeries, but also before to adequately prepare the body for the physiological stress associated with the surgery [5]. Having regular exercise sessions stimulate blood flow and help reduce post-operative inflammation. Obviously, this is not a blessing to register for the next marathon within 100 miles of your house after a by-pass surgery. Patients need to be realistic about their abilities and avoid over-exertion. These patients will be able to return to a higher quality of life sooner as well as have a reduced period in the hospital [6]. As a patient exercises, it is also logical to assume that they will lose weight which will also indirectly improve their pelvic performance. 

Even if exercises themselves may not be dangerous to violently alter the expected prognosis of a patient with pelvic floor dysfunction, it is still in the best interests of the patient to try to avoid any excessive straining when it comes to post-operative exercise programs. Ways that can significantly reduce the amount of strain placed on the abdomen instructing patients to breathe out when exerting during an exercise to reduce pressure. Patients should also habitually reduce weight and resistance as they age to avoid any inadvertent herniations. Lastly, after surgery patients should limit the amount of exercise they do initially after the procedure and slowly build up. [7

In conjunction with reducing abdominal load during their exercises, women should also be encouraged to target exercises specific for their uterine muscles. Kegel exercises, lower pelvic floor muscle training and the use of vaginal pessaries are just a few of the many available options that women can incorporate into their lifestyle [8]. These exercises are supposed to be done in short increments to avoid vaginal fatigue and surely will go a long way with other exercise routines to improve your uterine contours. 

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