The Role of Strength Training in Overcoming Pelvic Organ Prolapse
By Dr. Norah Whitten, PT
“You are not fragile, but you’re also not invincible.”
That quote by Brianna Battles hits the nail on the head when it comes to pelvic organ prolapse (POP)—especially for active women trying to figure out whether lifting weights is off-limits or exactly what they need.
Let’s set the record straight: pelvic organ prolapse is common. Really common. Studies show that up to 50% of women will experience some form of prolapse in their lifetime, with symptoms ranging from mild pressure to more significant pelvic heaviness. It’s especially prevalent postpartum—but it’s not exclusive to mothers, nor is it limited to women. And despite the stigma and scary-sounding name, prolapse doesn’t have to mean giving up your fitness goals.
In fact, when approached with care and strategy, strength training can be one of the most effective tools to support pelvic organ health, build resilience, and reclaim your confidence. This is especially true here in the triangle, where we’re lucky to have access to fitness forward pelvic floor physical therapy practices, scenic trails like Eno River State Park, and a vibrant fitness culture that supports people at every stage of their wellness journey.
So let’s dig in: what is pelvic organ prolapse, and how can strength training help?
Pelvic organ prolapse can feel overwhelming. But it doesn’t have to define you—or stop you from lifting, running, playing, parenting, or living life fully.
What Is Pelvic Organ Prolapse (POP), Really?
Pelvic organ prolapse occurs when one or more pelvic organs—like the bladder, uterus, or rectum—descend into the vaginal canal due to a loss of support from the pelvic floor muscles and surrounding connective tissue. Think of it like a hammock that’s been overstretched: the structure is still there, but it’s not holding things up the way it should.
And no, it’s not just a “postpartum issue.” Men can experience prolapse too, and many women who haven’t had children still deal with it. But regardless of how it starts, the most important thing to understand is: prolapse doesn’t mean you’re broken.
The Strength Training Myth That Needs to Die
Here’s the big, limiting belief that shows up over and over again:
“If I have prolapse, lifting weights will make it worse.”
And while yes—lifting super heavy without a solid foundation can increase intra-abdominal pressure and worsen symptoms—the problem isn’t the lifting itself. It’s the how.
One of our clients here at Functional Phyzio, an avid runner and mom of two, came to us afraid to lift more than her toddler. Through a progressive, personalized strength program, we rebuilt her core, glutes, and confidence. Today, she’s back on the Tobacco Trail, running strong and lifting smart—with zero prolapse symptoms.
Why Strength Training Helps (When Done Right)
Let’s break it down: your pelvic floor doesn’t function in isolation. It works in concert with your core, glutes, diaphragm, and deep stabilizers to support your pelvis during movement. If any of those areas are weak or under-trained, your pelvic floor is left to pick up the slack.
Here’s what a smart strength program for someone with POP should include:
- Movement Foundation – Learning how to breathe, brace, and engage your lower core.
- Functional Patterns – Training squats, hinges, lunges, carries, and pressing movements that mirror everyday life.
- Progressive Loading – Gradually increasing weight, reps, or complexity to challenge the system safely.
- Symptom Awareness – Using pelvic pressure or heaviness as feedback, not failure.
Think about it: if you’re a mom wrangling two kids at Durham Central Park, lifting strollers into your trunk at Southpoint Mall, or hiking in Umstead, you’re already strength training in real life. Structured training just makes you stronger and safer doing those things.
What Most People—and Providers—Get Wrong
Unfortunately, a lot of well-meaning advice around prolapse is either too cautious or too aggressive.
Here are common mistakes we see:
- “Just avoid lifting.” Blanket restrictions like this rob people of confidence and function.
- Staying stuck on the floor. Yes, there’s value in deep core activation and basic movement retraining. But you don’t live your life lying on your back doing kegels.
- No progression. Without increasing intensity or complexity over time, your body won’t adapt. You’ll plateau—and stay scared of movement.
We see this play out in local gyms and even some physical therapy clinics in the Triangle. Women are told to “take it easy” forever instead of being empowered to rebuild their strength
Managing Intra-Abdominal Pressure Without Fear
Let’s talk about intra-abdominal pressure (IAP)—one of the most misunderstood concepts in the prolapse world.
Yes, bearing down chronically (like during constipation or uncontrolled straining) can worsen prolapse. But not all IAP is bad. In fact, your body uses it to stabilize your spine and pelvis during lifting.
The goal isn’t to eliminate IAP—it’s to manage it well.
That includes:
- Exhaling on exertion (like during the hard part of a lift)
- Learning the Valsalva maneuver safely with guidance (especially for heavy lifts)
- Avoiding breath holding for too long
- Monitoring symptoms before, during, and after exercise
With the right coaching, you can learn to use IAP to your advantage without overwhelming your pelvic floor.
How to Start Strength Training with POP
Whether you’re newly diagnosed or years into managing prolapse, you can benefit from strength training. But it needs to be done intelligently.
Here are three steps to get started:
- Find a pelvic floor PT or coach who understands strength training. Not all providers do. Look for someone who will meet you where you’re at—but also push you to progress.
- Adopt the “I’m resilient” mindset. Fear is normal, especially if you’ve had scary symptoms. But your body isn’t fragile. It just needs smart support and consistent training.
- Start with foundation, then build. Focus on breathing, coordination, and movement patterns. Then load those patterns with bodyweight, resistance bands, kettlebells, dumbbells—whatever feels accessible.
A good program will look different for everyone. A postpartum runner will have different needs than a post-menopausal 55-year-old. But in both cases, the goal is the same: build strength, confidence, and function.
What If Symptoms Flare Up?
It happens. You might feel a little more pressure or heaviness after a challenging workout. That doesn’t mean you’ve “damaged” something or made your prolapse worse.
Instead, treat symptoms like feedback:
- What movements did you do?
- How intense was the session?
- Did you breathe well and warm up properly?
- How long did symptoms last?
Use that information to adjust. Maybe it means dialing back the intensity for a session or two—or it could mean focusing more on recovery strategies like deep breathing or core resets.
Final Thoughts: You Are Not Broken
Pelvic organ prolapse can feel overwhelming. But it doesn’t have to define you—or stop you from lifting, running, playing, parenting, or living life fully.
If you’re in Durham or anywhere in the Triangle, know that you have access to skilled, forward-thinking pelvic health providers who won’t tell you to stop moving. In fact, they’ll help you move better.
Strength training isn’t the enemy. When it’s rooted in good mechanics, breath, and progressive overload, it’s one of the best tools we have to restore function and resilience.
About the author. Dr. Norah is not only a physical therapist and owner of Functional Phyzio in Durham, NC, but also an athlete, coach and mom. Norah grew up a competitive athlete, specifically as a high level gymnast and diver. After sports Norah knew she needed a way to fulfill her competitive outlet and found CrossFit while in PT school. From day one she was hooked. Since starting CrossFit she has developed a passion for functional movement & strength training. This not only influenced her personal life, but her professional role as a movement specialist as well. Norah utilizes the movement patterns and philosophies of functional fitness to get her patients the outcomes they deserve and help them become stronger than they ever thought possible.
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