Q: Do you have any suggestions for swimming with a pelvic organ prolapse. 

A:  I really love swimming for my female athletes as they work to recover from prolapse and return to some movement and fitness and get their heart rate up. Generally, the lack of impact makes it a great place for ladies who have prolapse to get their sweat on. But a bad strategy (how they do it) can make it a symptom producer for some (just like any other activity). In other words, you can still bear down or grip your abs while swimming in a way that applies pressure against your prolapse and recreates symptoms. So here are some suggestions to counter that:

1. A simple trick is to blow bubbles while you are swimming. This is essentially a long exhale that engages the system and blows off pressure while you are stroking. You can also use a snorkel. Both will help you avoid a breath hold which creates higher pressure from above on your prolapse. The exhale also triggers a response and lift from the pelvic floor to support the organs and retrain the system. 

2. Breathe on an odd stroke (freestyle).  This means you will end up alternating which side you are breathing on, “forcing” you to use the muscles and pressures on both sides of your body in a balanced way. The breath is a rotational opportunity. Rotation is a great way to break-up abdominal bracing that might be adding constant pressure. Inhale is an opportunity to allow give and excursion in the central postural system. This is another way to prevent abdominal clenching and high pressure.

3. Using strokes like Breast or Back will reduce the probability of breath holding. Though it may happen there too, so be mindful of how you are seeking stability.  

4. Keep your eyes on the black line on the bottom of the pool vs the end of the pool to keep you from  pulling your ribcage up (I call this bell rung up). This improves the way you use your diaphragm to access the system of support and promotes better rotation through the whole torso (vs just the upper chest and shoulders). Again, rotation is a huge plus to prevent a uniform tummy hold.

5. Be sure you are kicking with hips up, and long legs, not from the knees. This will keep your bum untucked and engage your glutes. Glutes and the pelvicfloor are BFFs!

6. Flip turns are often where folks breath hold, and have the added exertion of the push-off. Keep this in mind and become aware of your pattern. This is another chance to blow bubbles to avoid a breath hold. 

These tips are helpful for any pelvic or postpartum issue where pressure is an issue, i.e. incontinence and diastasis too! The goal is not just to prevent irritating the prolapse, but to actually apply these strategies to help alleviate the symptoms through swimming! Enjoy!! 

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