Vaginal prolapse in squat and deadlift

I had a client who we did not have squat because squatting causes her vagina to prolapse. She was able to deadlift, but at heavier weights (100x3) she feels it prolapse after relaxing immediately after unloading. It is not a comfortable occurrence, nor is it healthy with repeated occurrence from what she has told me.

She came in for a consult today to talk about this.
I have been trying to figure out what advice to give, and what I've come up with so far is "deadlift as heavy as it will allow, and if you're able to get into a commercial gym with a leg press, use a leg press." I said this, because the problem for her is generally gravity, so if she's inverted at a 45 degree angle, my thinking is that it won't be an issue. And at the end of the day, if she can leg press with a squat-stance, hit depth, and she's getting stronger, her life is improving.

Do you have any experience with this?

What would you recommend?

I would recommend getting her out of my office and into a gyn consult. This needs to be repaired.

It's already had a repair which failed, and they (gynecologist and patient) decided not to pursue further intervention.

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Originally Posted by AndrewLewis

I have been trying to figure out what advice to give, and what I've come up with so far is "deadlift as heavy as it will allow, and if you're able to get into a commercial gym with a leg press, use a leg press." I said this, because the problem for her is generally gravity, so if she's inverted at a 45 degree angle, my thinking is that it won't be an issue. And at the end of the day, if she can leg press with a squat-stance, hit depth, and she's getting stronger, her life is improving.

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Gravity is already operating on the prolapse anyway, and the pressure against the pelvic floor certainly varies with the load, not the back angle. If it were my client, I'd get rid of her until it was repaired. Imagine the spectacle of an extruded vaginal prolapse in your gym, and imagine whose fault it will be.

Quite the image. She's not currently training with me, but I see your point. Thank you for the help.

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Originally Posted by AndrewLewis

It's already had a repair which failed, and they (gynecologist and patient) decided not to pursue further intervention.

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Just my take: Your patient needs either a second opinion possibly by a urologist who's very experienced in female incontinence surgeries. There's a lot of overlap between vaginal prolapse and such operations.

If she's weightlifting hard and wants to get stronger, she's salvageable and needs this operated on by someone 1) who'll work with her lifestyle and 2) knows what they're doing regarding this particular problem.

It's possible that the patient "agreed" just because that's the recommendation she received from the person she agreed with. If she can't be bothered then I agree with Mark.

Thank you for your input. I get the impression that she has resigned herself to her current situation, but I will keep this in mind for future clients or if the time comes that she wants to talk about it again.

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Originally Posted by AndrewLewis

It's already had a repair which failed, and they (gynecologist and patient) decided not to pursue further intervention.

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Unfortunately surgical repairs for prolapse are often unsuccessful. This is a difficult case and there are various variables to dealing with it and training.
I am a SSC, 6 months postpartum and currently training while recovering from a prolapsed bladder. There are some ways to 'try' to manage it while training in some capacity. If she would like to talk with someone who is familiar with this, feel free to have her contact me SHancock@startingstrengthgyms.com

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Originally Posted by Shelley Hancock

Unfortunately surgical repairs for prolapse are often unsuccessful. This is a difficult case and there are various variables to dealing with it and training.
I am a SSC, 6 months postpartum and currently training while recovering from a prolapsed bladder. There are some ways to 'try' to manage it while training in some capacity. If she would like to talk with someone who is familiar with this, feel free to have her contact me SHancock@startingstrengthgyms.com

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Thank you for the offer Shelley. I will pass your email onto her, and I hope she contacts you.

Shelley is right, and the person in question should definitely take her up on her generous offer, but for a variety of reasons I would still recommend at least considering a surgical repair.