Strength Training, Prolapse, and Managing Symptoms: A Comprehensive Guide

Strength training is a well-established practice with numerous health benefits, including reducing the risk of cardiovascular disease, cancer, and diabetes. However, for women dealing with pelvic floor issues such as prolapse, understanding the relationship between strength training and symptom management is crucial. Let's delve into what we know about strength training, prolapse, and how to effectively manage symptoms.

Improving Symptoms with Combined Training

Studies have shown that combining strength training with pelvic floor muscle training can lead to significant improvements in symptoms such as urinary incontinence (Virtuoso et al., 2019). In a twelve-week study, researchers found that participants who engaged in weight training experienced a higher reduction in incontinence symptoms compared to those who only performed pelvic floor muscle exercises. The key is to understand how to safeguard and utilize our pelvic floor during weight training. Many individuals (including fitness professionals) lack the understanding that our pelvic floor is actually an essential component of our core.

 The Principles of Exercise Training and Pelvic Floor Function

Understanding the principles of exercise training—overload, specificity, and reversibility—is essential when addressing pelvic floor function (Marques et al., 2010). Overload, which involves increasing the workload on muscles to enhance strength and endurance, is particularly relevant for individuals with prolapse. Daily activities like squatting, lifting, and bending create demands on the pelvic floor muscles, highlighting the importance of targeted exercises. Unfortunately, studies indicate that pelvic floor symptoms stop women from engaging in exercise (Dakic et al., 2021).

 Specificity in Training

The principle of specificity emphasizes training muscles in a manner consistent with their functional use and intensity. For instance, engaging in exercises that mimic daily activities, such as carrying a child on one hip, can effectively target the pelvic floor muscles. This functional approach ensures that muscles are trained to meet real-world demands, leading to improved strength and support.

Maintaining Progress

Reversibility underscores the need for consistent exercise to maintain the benefits gained from training. Regularly working the pelvic floor muscles is essential for sustaining strength and endurance improvements. By incorporating targeted exercises into a routine, individuals can effectively manage symptoms and promote long-term pelvic floor health.

Addressing Psychological Distress

It's essential to recognize the psychological aspect of experiencing prolapse symptoms. Research suggests that symptoms may not correlate with the severity of prolapse but rather with the psychological distress associated with the diagnosis (Drage et al., 2022). Catastrophic thinking can exacerbate symptoms by increasing awareness of the pelvic floor and heightening sensations.

Safe and Effective Exercise Practices

Contrary to common fears, lifting heavy weights does not increase the prevalence of prolapse symptoms when performed correctly (Forner et al., 2020). Studies have shown that women who regularly engage in weightlifting, including heavy lifting, do not experience a higher prevalence of symptoms compared to those lifting moderate weights. This reassurance underscores the safety and effectiveness of strength training for managing prolapse symptoms.

In conclusion, understanding the relationship between strength training, prolapse, and symptom management is crucial for women seeking to improve pelvic floor health. By incorporating targeted exercises, addressing psychological distress, and adopting safe exercise practices, individuals can effectively manage symptoms and enhance overall well-being. Empower yourself with knowledge and proactive steps to support pelvic floor health and live life to the fullest.

References:

Dakic, J. G., Cook, J., Hay-Smith, J., Lin, K. Y., & Frawley, H. (2021). Pelvic floor disorders stop women exercising: A survey of 4556 symptomatic women. Journal of science and medicine in sport, 24(12), 1211–1217. https://doi.org/10.1016/j.jsams.2021.06.003

Drage, K. J., Aghera, M., MacKellar, P., Twentyman, R., Jacques, A., Chalmers, K. J., Neumann, P., Nurkic, I., & Thompson, J. (2022). The relationship between symptom severity, bother and psychological factors in women with pelvic organ prolapse: A cross-sectional observational study. Neurourology and urodynamics, 41(1), 423–431. https://doi.org/10.1002/nau.24842

Forner, L. B., Beckman, E. M., & Smith, M. D. (2020). Symptoms of pelvic organ prolapse in women who lift heavy weights for exercise: a cross-sectional survey. International urogynecology journal, 31(8), 1551–1558. https://doi.org/10.1007/s00192-019-04163-w

Marques A, Stothers L, Macnab A. The status of pelvic floor muscle training for women. Can Urol Assoc J. 2010 Dec;4(6):419-24. doi: 10.5489/cuaj.10026. PMID: 21191506; PMCID: PMC2997838.

Virtuoso, J. F., Menezes, E. C., & Mazo, G. Z. (2019). Effect of Weight Training with Pelvic Floor Muscle Training in Elderly Women with Urinary Incontinence. Research quarterly for exercise and sport, 90(2), 141–150. https://doi.org/10.1080/02701367.2019.1571674

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