Getting Back to Exercise After Summer: What If You Have Pelvic Floor Symptoms?

Ali Cansell

1 hour ago

5 min read

September often feels like a natural point to reset. New routines, back to the gym, more regular walks, perhaps finally returning to the exercise you enjoyed before summer got in the way.

But if you experience bladder leakage, pelvic heaviness, pelvic pain or symptoms of prolapse, getting back into exercise can feel far from straightforward.

Pelvic floor symptoms don't automatically mean you need to stop moving, and I want to explain why, and how to approach getting active again with a bit more confidence and a bit less fear.

Woman in white workout clothes does a leg raise on a Pilates reformer, pulling a black strap in a warm beige studio.

Exercise and your pelvic floor symptoms

One of the most common misconceptions I come across in clinic is that pelvic floor symptoms mean exercise is off the table.

It's an understandable conclusion to reach. If you've leaked while running, felt heaviness after a workout, or noticed symptoms of prolapse after lifting weights, your instinct might be to stop doing whatever seemed to trigger it.

But avoiding movement altogether isn't necessarily the answer. Pelvic floor dysfunction presents differently from woman to woman, which is exactly why there isn't one universal list of exercises everyone should or shouldn't do. NICE's guideline on pelvic floor dysfunction is clear that management should be tailored to a woman's symptoms, circumstances and goals, rather than following a blanket rule.[1]

So instead of "what should I avoid?", the more useful question is:

What's actually happening for you, and what do you want to be able to do?

If you've had a summer of doing less

Maybe you've been walking rather than running, or you stepped back from Pilates because you were worried about your symptoms. Perhaps you've been putting off the gym because you weren't sure what was safe.

You don't need to go from nothing straight back to your previous routine. It's usually more useful to rebuild gradually and pay attention to how your symptoms respond as you do.[3]

Your starting point might be a walk, a gentle strength session, or returning to an activity you already know your body tolerates well. And if something doesn't feel right along the way, that's useful information to work with, not a sign you've failed.

What about pelvic floor exercises?

You may well have been told, "just do your pelvic floor exercises." But pelvic floor muscles aren't only about strength. They also need to relax, lengthen and coordinate with the rest of your body, including your breathing and your core.

NICE recommends that pelvic floor muscle training is supervised by a physiotherapist or other healthcare professional with the right expertise, and that the programme is tailored to your ability to contract and relax the muscles, any discomfort you feel, and your individual goals.[1]

So if you've been doing hundreds of squeezes a day and nothing seems to be shifting, it's worth having your pelvic floor properly assessed rather than continuing to guess.

What if you have a prolapse?

A prolapse diagnosis can understandably make exercise feel frightening. You might have been told to avoid lifting, running or anything strenuous, or found yourself quietly stepping away from the activities you love in case you make things worse.

A prolapse doesn't have to mean your life gets smaller. There are several management options, and the right one depends on your symptoms, the type of prolapse, your lifestyle and what matters most to you. For some women, NICE recommends a course of supervised pelvic floor muscle training as a first step, while a pessary is another non-surgical option worth considering. Where surgery is on the table, NICE is clear that this should be discussed alongside the non-surgical options and weighed against your own preferences, not presented as the default.[2]

The aim isn't to give you a list of what you can't do. It's to work out how to help you do more of what you actually want to do.

This is very much the direction pelvic health and sports medicine is moving in. Physiotherapist Gráinne Donnelly, whose work I follow closely, has written extensively on bringing pelvic floor care properly into the sports medicine conversation rather than treating it as separate from it. Other clinicians in this space, such as Christina Prevett, make the point that how your symptoms actually feel day to day matters more than a diagnosis or grade alone when it comes to deciding what's right for you.

When should you get some help?

I'd encourage you to seek support if you're experiencing any of the following:

Bladder or bowel leakage
A feeling of heaviness, pressure or bulging in the vagina
Pelvic pain
Pain during sex
Symptoms that are stopping you exercising the way you'd like to
Worry about returning to running, weights or other activities
A prolapse diagnosis you don't feel confident managing

These symptoms are common, but that doesn't mean they're simply something to put up with. NICE highlights the importance of women having clear information about pelvic floor dysfunction, its symptoms, and when and where to seek help,[1] and that's very much the spirit behind this post.

(A note on the words above: heaviness, pressure and bulging aren't just informal descriptions, they're the recognised clinical terms used to describe prolapse symptoms.[4])

Your September reset doesn't have to mean starting from scratch

This September doesn't have to be about pushing harder. It could just as easily be about understanding your body a little better.

If pelvic floor symptoms have made you nervous about exercise, there's usually a middle ground between stopping altogether and pushing through regardless. A pelvic health assessment can help you understand what's going on, identify what might be contributing to your symptoms, and build a plan around your body, your goals and the activities you want back in your life.

Whether that's returning to running, lifting your grandchildren, getting back to Pilates, or simply exercising without constantly thinking about your bladder, that's what I'm here to help with.

Your pelvic floor shouldn't be what decides what you can and can't do.

Ready to feel more confident about exercise?

If pelvic floor symptoms are holding you back, I can help you understand what's happening and work out a way forward together.

Book a Pelvic Health Initial Assessment, or get in touch to talk through whether pelvic health physiotherapy could help you.

Book an Appointment

References

National Institute for Health and Care Excellence (NICE). Pelvic floor dysfunction: prevention and non-surgical management (NG210), 2021.
National Institute for Health and Care Excellence (NICE). Urinary incontinence and pelvic organ prolapse in women: management (NG123), 2019.
Goom T, Donnelly G, Brockwell E. Returning to running postnatal – guideline for medical, health and fitness professionals managing this population, 2019.
Haylen BT, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP), 2016.