Does Swimming with Prolapse Get the Green Light?

 I get asked repeatedly in my physiotherapy clinic and my Pelvic Power Movement Community whether ladies who experience prolapse can and should be exercising. For many, a prolapse diagnosis hits them hard, and the huge fear is that it is a life sentence that will stop them from ever doing the things they enjoy again. And for most, this is not true.

Knowing the right balance between keeping active and not pushing yourself is hard, and unfortunately, there is no one size fits all answer to achieving the right balance. Every single one of us is different – different bodies, different minds, different strengths, and different pelvic floors. You can scroll through Google and find a million and one things to avoid when you are suffering from pelvic floor concerns of any kind, but then you are also bombarded with other things you should be doing – it’s a minefield.

So let's keep it super simple. 

For majority of people, having a prolapse is not a ticket to be sitting around and not exercising. It is not a time to forget exercise and leave it to ‘those that can, because everyone can. It might just involve a bit of adapting. If you have experienced pelvic health concerns, it is time to focus on getting back on track.

What’s ok and what’s not?

In a nutshell, pelvic organ prolapse happens because the pelvic floor muscles can no longer support their organs, or the organs have been forced into the vaginal canal by increased intra-abdominal pressure. This causes them to drop or bulge. It can be caused by high-impact exercises, childbirth, heavy lifting, scaring, constipation, holding your breath, bracing, coughing, menopause…basically anything that either puts additional pressure on the pelvic floor muscles and tissues, or causes the pelvic floor to weaken or tighten – for most people the cause of their prolapse is combination of many factors. I would argue that in the most part, it’s not the activity that causes the prolapse, but more the way it is done. For example, poor posture, poor form, incorrect breath work, all combine to make a recipe for pelvic floor disaster. 

But lets keep it as simple as we can. If you are suffering from prolapse and you aren't seeing a physio, which I would highly recommend by the way.

The general rule if you are wanting to exercise but play it safe. Is start by sticking with low impact prolapse-friendly exercises, which generally means that the action should involve moving with at least one foot in contact with the ground at any one time, i.e., walking, cycling, swimming, etc. Low-impact exercises will minimize this stress on your pelvic floor. Reducing strain on muscles already weak or stretched but help you start to exercising them again. 

Swimming (along with other water-based exercises) is low impact and therefore considered one of the ‘safer’ exercises for those experiencing prolapse symptoms. It is excellent for raising the heart rate, burning calories, and toning. Swimming is a great all-round exercise. However, even swimming can be detrimental to your pelvic floor if not done in a prolapse-safe way. Holding your breath while exerting yourself, can cause pressure on the pelvic floor, making prolapse symptoms worse. Always remember to exhale on exertion. 

You can control your breathing more easily and lift your pelvic floor by using a snorkel and/or blowing bubbles in the water. This technique is essentially a long exhale that engages the core and pelvic floor system and blows off pressure while you are swimming. Alternatively, stick to strokes like breast or backstrokes where you don’t have to hold your breath for too long.

There are other ways to prevent abdominal bracing and high pressure while swimming, including good form, and  kicking with long legs from the hips and not from the knees.  It is all about being mindful of how you are moving your body.  Although swimming has an excellent reputation as being a fantastic low-impact exercise (which it is), it can also be a symptom producer for some, just like any other activity. You can still bear down or grip your abs while swimming in a way that applies pressure against yourprolapse and recreates symptoms, hence the reason it is so important to focus on getting the technique correct.

Most women with pelvic floor symptoms and even those who have undergone pelvic floor surgery can return to some form of exercise to maintain their mental and physical fitness and general well-being. However, it is important to stress that you should always check with your doctor before commencing any new exercise program, particularly if you are unfit, overweight or have never exercised. Exercise is fantastic in many ways, as it helps to promote heart health, increases lung capacity, lowers cholesterol and burns calories - a winning combination.

Is high-impact ‘anything’ a big no-no?

 I often say that it isn’t always the type of exercise that is either ‘safe or dangerous’ for prolapse but how it is done. However, unless we fully understand our bodies, feel confident in how our bodies will respond to particular activities and have built up strength and functionality with our bodies (for the purpose of this blog – our pelvic floor), then yes, it is much ‘safer’ to stick with low-impact exercises like swimming. Many women can, and do return to higher impact activities such as running and heavy weight-lifting, and I wouldn’t for one minute say they shouldn’t, but (and this is a big but), my experience has taught me that it often boils down to the ‘how' of the activity as opposed to the ‘what’. Swimming is low-impact; focusing on deep breathing, reaching and turning, and kicking with the glutes can feel great for those with prolapse.  In contrast, others feel confident returning to running after learning to understand their bodies – their breathing, posture, and a holistic approach to recovery. This is my work and life mantra.

So, why do I love swimming as a ‘prolapse-friendly’ exercise? For me, it’s about the sense of freedom and weightlessness, you don't need any gadgets, just you and the deep blue sea. Plus; it's all inclusive, it can be enjoyed alone or with friends of family, anyone of any size and ability can do it.  But would I rule out other exercises? Absolutely not! There are so many fun and enjoyable activities out there. It's is important that you find the exercise that is right for you. Take the time to learn about pressure management, building strength and body awareness, who knows what you could be enjoying with time. The world is your oyster.