Lifting with P.O.P.

Thanks Mark for the Starting Strength program! It is exactly what I was looking for and need. To get to the point, I have a significant pelvic organ prolapse which developed from the birth of my last child over 2 years ago. My pelvic floor is shot! It is more of a quality of life issue than a significant health issue. Heavy lifting with this condition is contraindicated. I disparately what to lift heavy again after over a decade of neglecting my strength. I have searched the internet over trying to find other female lifters with this condition and find nothing. There are plenty of elite female lifters that have had kids and heavy lifting alone can cause this condition in a female. Do you have any experience with female lifters that have developed pelvic organ prolapse and were able to continue to lift heavy? Thanks for any insight!

I feel quite certain that female lifters never develop POP. But the actual question is whether or not you can lift with it now. Unless there is an overt hernia or a fistula of some sort, I see no reason why the program would not help with this situation. We'll ask.

Thanks for the prompt response! Thank goodness I do not have a fistula. I also do not suffer from any incontinence. The hernia is substantial but I am determined to work through it. I am looking into a pessary for added support while lifting. I do not want to proceed with surgery at this time as lifting heavy can certainly jeopardize it. I agree with you that strengthening my core will help to a degree, but unfortunately over stretched ligaments and damaged facia will not recover. I guess my biggest concern is that inevitably the stronger I get and the heavier I lift the Valsalva maneuver could possibly make things worse as far as the prolapse. I'll continue to train and as I progress I will report back.

As far as female lifters never developing POP, I find that hard to believe. Maybe they are too embarrassed to talk about it. This female lifter seems to suffer from some type of pelvic floor disfunction http://www.youtube.com/watch?v=_TVwRTtBVS8
Thanks!

You will not work through a hernia. They do not heal when substantial, if at all, like the over-stretched ligaments and damaged fascia. You can't lift heavy without the valsalva, so it makes no logical sense to say "I do not want to proceed with surgery at this time as lifting heavy can certainly jeopardize it." I'd get the surgery done so you can get on with your training, or just learn to live with the condition.

And you are mistaken if you think a pelvic floor defect is required for a female to be incontinent under a 102kg over-limit front squat. Things get heavy and women are just not as good at bladder control as men are. I would normally have deleted this video, if nothing else for the fools posting in the comments, but I think it's important that you understand that such things occasionally happen in world-class women's competition, both powerlifting and Olympic lifting. Those of us actually involved in the sport tastefully ignore it.

When I was doing some research for a friend of mine who’d had a hard forceps delivery, I came across this:

http://mamasweat.blogspot.com/2010/0...s-are-not.html

I realize she’s talking about PFD and not POP, but pelvic floor integrity is key to both, so I think you might find it of interest. Bowman has some important things to point out about the anatomy of the pelvic floor and the importance of glute strength.

She kind of goes off the rails of logic, in my opinion, when she starts talking about strong muscles being too tight and therefore weak (?) and uses that weird conclusion to recommend only stretching and bodyweight squats. I also think she oddly singles out the glutes and shorts the rest of the posterior chain’s importance to maintaining proper alignment of the pelvis and lower spine.

But the point is, if you take a proper look at the anatomy of the PF, the kind of balanced strength one would build from barbell lifting, especially the squat, is highly likely to be protective of the PF much more than it is dangerous to it. So I believe Rip when he says female weightlifters probably don’t get POP--or at least, not nearly as often as women who do not lift. And I imagine lifting would have great rehabilitative potential as well, although probably not without risks. Squats, as most of us have learned, correct a lot of postural problems and imbalances. I don’t see why it would be otherwise with the pelvis and sacrum/coccyx.

Of course, your situation involves an already compromised PF. Doctors who know a lot about the PF aren’t likely to know anything about barbell lifts and what they do for the body. And experts on the barbell lifts aren’t likely to know much about the PF. But I would guess that the connection between PF trouble and heavy lifting occurs mostly in weak individuals who suddenly have to lift very heavy loads and not very often at all in lifters who already have a strong foundation and lift heavy.

You’re kind of a pioneer, since most women would never consider doing the barbell lifts if their doctors told them to avoid it. But it’s probably good to keep in mind that the vast majority of doctors can only see the risks of barbell lifting because they don’t understand the benefits.

In your place, I’d get surgery, then start lifting. I’d probably ramp up the intensity much more slowly than what is recommended in SS, but I would still set a goal of lifting heavy eventually. It sounds like a bad idea to start lifting without correcting the hernia.

Mark, thank you for letting me post the video. I also found the comments VERY distasteful, but I felt like the footage was relevant to our conversation. My comment about heavy lifting jeopardizing the surgery comes from the surgeon. The repair involves reapproximating and suspending already compromised tissues. In turn making the prolapse likely to occur again under strain. He is a world renowned surgeon in this field and the surgery is costly. My reasoning for starting training now is if I make things worse, well, I already need surgery. If the prolapse reoccurs after the surgery I am out some money and have to have it redone. My hope is that a well fitted pessary and also something called a V2 supporter (it's actually for varicosities during pregnancy) will offer me enough support to eventually lift heavy again.

I certainly didn't think at the age of 32 I would be dealing with this crap. It makes me feel older thank my years. Thank you for allowing me to open a discussion on this topic. Pretty much everything else on the internet states P.O.P. (especially after surgery) equals never lifting over 10-20lbs for life. As a former Olympic Lifter in my youth I don't want to accept this. In fact it has motivated me more than ever to begin lifting again.

Spar, thanks for your input! I had already come across another one of Katy Bowman's articles about squats and PF and liked that she gave me an added reason to do them. I also hate kegels, so it is a win win.