Wed 29, May 2019

Shira Leading Class

Katherine Modoo, a continence nurse advisor at the Sunraysia Community Health Service near the South Australian/Victorian border, told of how she was left speechless after two patients came to her during the same week with disturbingly similar problems.

One of the women was in her 40s and the other was in her 60s, and both had re-prolapsed after embarking on a vigorous fitness and exercise program.

“The woman in her 40s was quite devastated; she’d had a vaginal repair after childbirth, and had decided to start exercising to lose a bit of weight,” Katherine said.

The older woman had had a surgical sling repair done on her vaginal prolapse several years earlier, but had put so much strain on the repair it was no longer able to contain her prolapse, Katherine said.

The women, who were unknown to each other, told Katherine their personal trainer had incorporated weight-bearing exercises and lunges into their fitness program. More disturbingly, the trainer made no mention of their pelvic floor, or the need to protect it, during the classes.

“It’s a bit of a worry that there are personal trainers out there who aren’t aware of the risk to the pelvic floor with certain exercises,” Katherine said.

“Professional personal trainers should ask the questions (about the pelvic floor).  I know the Continence Foundation of Australia has worked really hard to have a continence component incorporated into personal training courses,” she said.

Katherine said there were many ways to improve fitness and lose weight without risking damage to the pelvic floor.

“When the younger woman told me she wanted to lose weight, I thought, ‘oh no, why didn’t you go walking or cycling or swimming?’ There are so many other ways to exercise that are friendly to the pelvic floor.”

She recommended women and fitness professionals visit the Pelvic Floor First website (, which has information on safe exercises, and detailed information on pelvic floor muscle exercises and the causes and symptoms of incontinence.

The free Pelvic Floor Safe Exercise app, which has customised workouts for people of all fitness levels and pelvic floor strength, can also be downloaded from the website. 

“It’s a fantastic website with fact sheets and lots of other resources for personal trainers and anyone who wants to exercise without injuring their pelvic floor,” Katherine said.

Pregnancy and childbirth put women at a greater risk of incontinence and prolapse, and the Continence Foundation of Australia, in conjunction with The Pregnancy Centre, has also developed a free Pregnancy Pelvic Floor Plan app, which guides women through safe exercising and the maintenance of bladder and bowel health during pregnancy.

Katherine said women, particularly those with a history of pelvic floor problems, should consult their health professional before embarking on an exercise program.

“It’s great to want to exercise and be healthy, but if there are any exercises that risk damaging the pelvic floor, women need medical advice from the doctor or the surgeon who did the work so there’s no risk of injury or a repeat of the prolapse.”

Health and fitness professionals and anyone experiencing continence or prolapse issues can phone the National Continence Helpline (1800 33 00 66), where the continence nurse advisors can provide confidential advice, referrals, information and resources.  

State-based health promotion officers are also available for information sessions for groups of health and fitness professionals. For more information phone 03 9347 2522.