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If you’ve given birth, whether vaginally or via C-section, you owe it to your current and future health to have a good understanding about prolapse.

What is pelvic organ prolapse?

In Pelvic Organ Prolapse, or POP, one or more pelvic organs have begun to lose their position in the pelvis and descend or “slump” downwards. This can happen when there is weakness or damage to the normal support of the pelvic floor. POP can be a result of pregnancy and childbirth. Other risk factors for POP include: prolonged labor, instrumental delivery of baby, episiotomy, chronic constipation, hysterectomy, and advancing age.

It is best to catch this slumping as early as possible in order to treat it well with physiotherapy and specific exercises, and restore it as closely as possible back to its original position.

The pelvic organs that you’ll most commonly hear about in postpartum prolapse cases are:

• Bladder, called cystocele
• Rectum, called rectocele
• Uterus, called uterine prolapse

Prolapsed bladder, called cystocele | Image: www.healthwise.org

Prolapsed rectum, called rectocele | Image: www.healthwise.org

Uterus, called uterine prolapse | Image: www.healthwise.org

These are all referred to “vaginal” prolapse because they descend into the vagina or vaginal walls.

Not all POP is created equal

There are different “grades” of prolapse, ranging from minor to severe:

• Grade 0 (no prolapse)
• Grade 1
• Grade 2
• Grade 3
• Grade 4 (organ in question is bulging out of the vagina)

You can read more specific information on the grades of prolapse in this article from American Family Physician.

How do I know if I have it?

The best way to determine if you have POP is to have an internal assessment performed by a skilled pelvic floor/health physical therapist.

POP can be tricky. Many women who have some degree of prolapse are unaware of it. This could be because they’ve never had a thorough internal examination of the pelvis, they have no symptoms, or they’ve just simply never heard of it before and assume any symptoms they’re having are “normal.”

It’s also possible that other health care providers who perform an internal exam miss the prolapse. Thus, it goes undetected and undiagnosed.

For example, if your OB performs an internal exam post-pregnancy but only does so when you’re lying down on your back, it’s hard to know how the pelvic organs are responding under pressure from gravity when you’re standing up, not to mention when you’re loading your body with stress of exercise postpartum.

Signs and Symptoms of POP

Many women with prolapse have no symptoms at all! However, you may be experiencing:

• Urinary incontinence
• Difficulty with bowel movements
• A feeling of heaviness or pressure in your pelvic floor
• You can feel your pelvic organs bulging out of the vagina (e.g. you can push them back in with your fingers)

Can I exercise?

Yes, you absolutely can exercise safely with prolapse, or prevent it while your body is healing postpartum.

There are some things you need to keep in mind with your exercise programming, though. You need to exercise in a way that strengthens your body and supports your core and pelvis, but doesn’t create an environment where the pelvic organs are excessively stressed or have added pressure placed upon them.

Things to keep in mind:

• Limit the amount of time spent on your feet during an exercise session. Vary the body position: standing, seated, side lying, supine, incline, etc.
• Use caution with regard to the intensity of the load (weight) in certain exercises, especially lower body exercises such as squats, or overhead exercises such as overhead presses
  

  You can lift weights. You can do weighted squats, lunges, etc if your prolapse is well managed, your physio gives you the all-clear, and you know what sensations to be aware of.

• Limit the amount of impact to the body during exercise. Running and jumping are not likely to be recommended.
• Pay close attention to the sensations in your pelvis. During and after exercise is there any heaviness or pressure in the pelvis/pelvic floor?
  

  You really need to hone into these sensations. Are you working out at the end of the day and feel more heaviness? If yes, adjust the workout (for example: move to more seated, side lying, supine positions instead of standing). No ego here, please!

Prolapse Friendly Strength Training Workout

1 — Superset: Perform 3 – 5 sets

1A. Hip Thrusts with Bands

 

• Your upper and lower body move in unison as you lower and raise.
• Squeeze your glutes to lift your body, but only until it’s in a straight line at the top, no higher.
• Exhale as you lift, inhale as you lower.
• Perform 15-25 reps

1B. 1-Arm Incline DB Chest Press

 

• Roll from your side into the starting position on your back.
• Push the weight up, pull the weight down.
• Exhale as your lift the weight, inhale as you lower the weight
• Perform 8-12 reps per side.

2 — Circuit: Perform 3 – 5 sets

2A. Bodyweight Squat to Low Box

 

• Squat down and sit to a bench or box/step, going as low as you can while keeping good alignment through your lower back and pelvis.
• Squeeze your legs (quads and glutes) strong to stand up straight.
• Inhale to sit down, exhale to stand up.
• Perform 10-20 reps.

2B. Seated Cable Row

 

• Sit in good alignment on the sitz bones.
• Squeeze the back muscles and feel the shoulder blade travel backward, drawing the elbows to the sides of the ribcage.
• Exhale to pull, inhale to reach back in.
• Perform 8-12 reps per side.

 

 

2C. Half-Kneeling Pallof Press

 

• Kneel down on the knee closest to the cable or band attachment.
• Squeeze the glutes on the back leg and slightly lean your body forward while keeping your chest lifted and your torso tall.
• Press your arms straight out in front of you until they are fully straight, without letting your body turn inwards or outwards.
• Feel tension in your abdominals and hips to keep your body still.
• Exhale to press out, inhale to return back in.
• Perform 8-12 reps per side.

 

 

3 — Optional

 

Treadmill incline walking intervals

 

• Increase the incline for 30-60 seconds on the treadmill and walk at a moderate pace.
• Step off to the sides of the treadmill to rest, or lower the incline and walk slowly to recover for 30-90 seconds.
• Perform 5-10 sets total.

 

 

As you can see, you definitely can exercise with prolapse. Consult with your doctor before following any the guidelines in this article. So long as your POP is well-managed by you and your medical provider you should be able to exercise safely.

 

Resources and more information:

American Family Physician — Pelvic Organ Prolapse

Continence Foundation of Australia — Fact Sheet: What is a prolapse?

Continence Foundation of Australia — Don’t ignore the signs of prolapse. Seek help.

Contemporary OB/GYN — Forceps delivery, perineal lacerations raise risk of pelvic floor disorders

 

 

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Originally posted at: http://www.nerdfitness.com/

Although it’s “just a desk job,” working in an office can wreak absolute havoc on our bodies.

If you’re somebody who spends all day at a desk and computer (which I’m guessing applies to a majority of the Nerd Fitness Rebellion), you know exactly what I’m talking about.

Whether it’s lower back pain, wrist pain, a really tight neck, or a lack of mobility, when we spend all day at a desk to pay the bills, our bodies often get stuck picking up the tab.

What can we do to counteract this office life we have to live?

Although I’ve done some crazy things like exercise around the world, most of my time is spent sitting at a desk for 10+ hours a day, connecting with readers, writing articles, and watching stupid cat videos on YouTube.

I feel like I’ve cracked the code for staying limber despite sitting all day, and I want to share it with my fellow desk-dwellers!

Set your workspace up to succeed

If you work a desk job, you probably spend more time at your desk than you do at anything else in your life.

And yet, that time is often spent sitting in a chair that’s too low, with a desk that’s too high, and our necks bent down looking at a screen at an angle that makes us feel like Quasimodo.

That can result in all sorts of nasty stuff, like eyestrain, shoulder pain, back pain, arm pain, wrist pain, and neck pain.

Desk jobs might not seem physically taxing, but they can certainly cause us some physical problems. If you’re going to level up your office life, it’s time to do a desk audit.

So let’s start with setting your desk chair at the proper height so you can type without scrunching your shoulders up. I swear, 90% of desk/chair combos, in offices or in coffee shops have this ratio wrong.

You want to sit in a chair at a height where you can sit with your shoulders relaxed and pulled back, you’re sitting up tall, and your forearms are parallel to the ground or or lower, meaning you don’t need to reach up to your keyboard, nor shrug your shoulders.

I can tell when I work at a desk that’s the wrong height, and you probably can too: my shoulders shrug up, I get tense, and my neck bothers me for the next few days.

So, set your desk at the right height for you!

1. PICK A GREAT CHAIR:

You probably spend more than a third of your existence at a desk chair, so do what you can to make sure you’re setting in a chair that is not destroying your spine!

Last year, in an effort to fix my back issues, I bought a great desk chair (the Herman Miller chair). Honestly, it’s been fantastic, and my back feels great sitting in it for extended periods of time. But, I know it’s incredibly pricey.

You don’t need to spend hundreds of dollars on a great chair (unless you can afford it) – you simply need a chair that has an adjustable height so you can set it so your feet are comfortably on the floor, a solid cushion to sit on, and good lower back support.

If your company supplied you with a crappy office chair, ask for the money to buy a good one (“it’ll improve my productivity!”), and head to an office supply store and try out a bunch of chairs. If they won’t pay for it, consider making the upgrade yourself.

A quick search on Amazon revealed this chair that has the best reviews ever – not bad for $150!

2. SET YOUR MONITOR AND DESKTOP PROPERLY:

If you work with a laptop, you are spending most of your day hunched over a tiny keyboard and trackpad.

Even if you work with a desktop computer, it’s certainly possible the monitor is not high enough for you to be able to not have to tilt your head down to look at it.

You want the height of your monitor to be such that you can look straight ahead and not have to adjust your neck angle to view the screen.

After spending a few years hunched over a laptop, I fixed my posture by adjusting where my eyes have to look by drastically raising the height of my monitors. Just raising my viewing angle was enough to get me to stop slouching, I no longer shrug my shoulders for hours, and my spine/back/shoulders/neck no longer hate me!

You don’t need anything fancy. I even just added some books to get the right height:

• Laptop stand with with a copy of Tim Ferriss’s 4-Hour Chef and 4-Hour Body under it!
• Monitor stand
• Apple Wireless Keyboard
• R.A.T. 7 Gaming Mouse
• 3M Precise Mouse Pad
• Desktop background: Ori and the Blind Forest (Game of the year so far!)

You don’t need to spend a lot of money to change your setup, and I’ve found that the inexpensive solutions above were well worth the money invested. Feel free to prop your monitor up with whatever you have around.

For laptop users, a separate keyboard and mouse can alleviate a lot of the “cramped” feelings and prevent you from ending up hunched over a laptop.

IF YOU WANT TO REALLY NERD OUT: check out this cool site from Ergotron (note: not a member of the Autobots). Simply put in your height and it can help you determine the height of your chair, keyboard, and monitor.

Now, if you have Quad Desk, or a Dwight Schrute exercise ball, you will probably have a different set of problems on your hands.

This should get you started with setting your desk up to win. But what about the rest of the day when you’re not sitting?

Staying limber in the office

Along with having a properly constructed office or cubicle, there are a few other things you can do to combat officitis:

THE MOST IMPORTANT THING – don’t stay in the same position for hours upon hours! Studies suggest the best plan for prolonged spinal health is to consistently alter your work environment – move around, stand when possible, sit…just don’t sit in the same position for 8 straight hours!

Set a timer every twenty minutes, and get up and do something! Take a lap around the office, do some shoulder rolls, neck rolls, or twists. I use a program called “focus booster” that pings me every 20 minutes to get up and do something (take a lap around NF HQ – my apartment – or do a quick stretch).

If you have your own office, or you work in a cubicle and don’t mind getting some funny looks, feel free to try some of the following:

The Couch Stretch: because I’m on my ass all day, my hip flexors tend to get tight. So I make sure to do a two minute-couch stretch every single day to help open up my hips:

The Thoracic Bridge Stretch (Hat tip to my buddy James Clear for finding this):

Consider dropping down into a basic body weight Grok Squat:

Own your office space

To answer your final question: you do not NEED a standing desk, even though the internet has a LOT to say about sitting all day.

I often stand when doing basic tasks like checking email or chatting with Team NF, but I really struggle with writing creatively while standing, so I’m almost ALWAYS seated for article writing.

If you ARE interested in a standing desk, we’ve actually already written a whole article about it on Nerd Fitness a few years back, but most of the ergonomic advice from the regular chair carries over.

We are all products of our environment, and by making small subtle changes to our batcaves we can set ourselves up to win.

I’d love to hear from you –

How have you combatted the evil forces of officitis?

How have you altered your working space to set yourself up to be healthy?

-Steve

 PS: Speaking of mobility, we just announced Nerd Fitness Yoga coming out later this month! Sign up for updates to get some cool bonuses and be the first to learn more about it!

PPS: How I made it this far without an Office Space reference is mind-boggling. even quoted that movie in my graduation speech. So, here you go: down with TPS reports!