Teaching Pilates Effectively for Prolapse: 4 Steps


The first step in restoring the health & function of your pelvic floor is rebalancing your breathing.

Did you know that more than 50% of women report symptoms of prolapse? I believe that is conservative because many women I work with have no idea what the symptoms are. So, of course, this means that it’s highly likely you are working with women who have prolapse whether they know or you know it.

I have had many experiences since I have been flying the flag and reinventing pelvic floor exercises, where women I’ve taught for a decade or more have said “you know you are talking a lot about prolapse, I have that.”

I am sharing this honestly with you because I know how you feel in the not knowing what we don’t know. It’s real. Nobody ever taught me to screen for any pelvic floor dysfunction let alone prolapse. so I know you haven’t either.

I naively assumed people would tell me all their information when I screened them. Therein lies the problem. Women often don’t know they have symptoms, don’t relate the Pilates we do with them to their pelvic floor dysfunction, don’t think it matters or is important or don’t believe it can be improved. So what I am trying to say is we can give ourselves grace for not asking.

What if you did ask, what would you do with the information? Do you think you could help or would you be filled with fear of making it worse? The latter is the most common response I get from teachers I work with, which is why I teach my mentorship and why I wanted to share some tips with you here. What do you need to know:

What is Prolapse and can Pilates help?

Pelvic Organ prolapse is the displacement of one or more organs into the vagina. Often a women will experience a bulging or dragging sensation into their vagina or the front of the pelvis. It can feel like you are sitting on a small ball or lump of tissue, making it very uncomfortable to be seated for long periods of time. In extreme cases, it can be displaced lower than the vaginal wall and create a rubbing sensation when walking, making walking very uncomfortable and also painful. It does not always come with incontinences, but it can, and it doesn’t always have pain, but it can.

What causes a prolapse?

Pelvic organ prolapse happens because our incredible suspension system has an imbalance in it somewhere. An imbalance is when there is a restriction from tension, tightness, scar tissue or injury that pulls consistently over time, causing the organ to move out of its usual home. It’s not dropped or fallen, though women may describe it that way. The organ has been pulled out of place.

It’s also important to say that organs move all the time and that is normal. Think of your bladder getting full, taking up more space it then pushes on and displaces the neighbouring uterus or bowel, once it empties they will move again. Movement is expected, its when the organ displaces down into the vagina and doesn’t return that it needs targeted Pilates to help.

Based on us being a suspension system, we as Pilates teachers can help women to restore balanced tension. I mean really folks, it’s what we do!

How though? How do you use Pilates to help?

Step One:

First off, we start with our overriding Pilates Principle of breathing. Allow them to let go and breathe into their pelvis!

Step Two:

Teach them movements that will help them to release the tension in their body that is not serving them, whether it is pelvic floor tension, deep hip rotator or even those upper respiratory muscles. Please release it, let it go!

Step Three:

Get them moving through all the ranges in their pelvis. Deep hip flexion, internal and external rotations, tailbone and spine mobility. Get it all moving.

Step Four:

Help them to reawaken their neuromuscular coordination, slowly building up the responsive stamina of their pelvic floor for the activities it supports.

Whatever school you trained with, you are a specialist in Pilates, you are a nurturing lifeline for women who grace your studio. You got this!!

I’d love to hear how you get on with these steps and if you need more support I’d welcome you to join my mentorship for teachers.