“Can I ride my Peloton or attend my favorite cycling class since I have pelvic organ prolapse?”
I hear this question often, especially since at-home cycling has increased in popularity since the beginning of the pandemic.
The short answer to this is, “probably”!
I know that doesn’t sound super promising, so let’s dive into considerations to take to make cycling feel good for you.
First, so many women are often given a black and white list of exercises to avoid when diagnosed with a POP, BUT in my opinion, that’s not good enough. There are so many factors we can consider and the main one is that every person’s experience with POP and their tendencies are different.
So what feels good for one person, may not for the next.
Or maybe they can do it, but HOW one person performs the movement or task may look and feel different than the next person.
So, we need to consider each person’s individual needs and goals and find a plan for them to help them get back to, or continue doing, what they love!
As a quick note, if you experience any of the following symptoms, it may be a sign to make an adjustment to how you are performing the exercise and consult with your pelvic floor physical therapist, physician, and/or coach:
An increase in, or new, prolapse symptoms
Any amount of unintentional leaking (urine or feces)
Pelvic pain or pressure
Pain during or after exercise (back, hips, pelvic area, etc)
Whether you are new to riding on a bike (stationary or not) or an avid cycler or cycling class-attendee prior to your POP diagnosis, let’s go over some tips on how you can make cycling work for you and the stage you are at right now.
When you are first getting started, I suggest riding alone (i.e. not jumping straight into a class or intense ride) so you can bring some awareness to how things are feeling and strategies you are using.
To better understand how it feels for you, start slow. Stay in the saddle and keep the resistance lower (just at first!). This will allow you to better control your movement and management of any typical POP symptoms you may experience.
As you get a better handle on riding, play with different variables like hill climbs, resistance, standing, speed, duration/distance, etc. It will likely be most helpful to try one at a time to ensure it is feeling good and you are handling it well.
When (or if) you add standing in, it may be helpful to increase the resistance a bit to reduce the amount of bouncing your body is doing. It can allow you to be a bit more controlled and smooth as you climb.
Other things to be mindful of:
Are you holding tension as you ride? If you are squeezing everything in the whole ride, try to adjust the intensity or position you are in to allow yourself to relax when you don’t necessarily need that tension-you probably DON’T need tension during a whole ride, or even the majority of it, especially if you are just getting started. There’s a time and a place where a bit of tension may be helpful, but it’s important to get a good grasp on your tendencies first. And, holding in a lot of tension can actually contribute to symptoms, so learning how to manage how much you need is important.
Do you notice you are holding your breath in certain positions or at certain resistances or speeds? If so, try to adjust that by breathing through those variables to see how that feels on your pelvic floor. Breath holding *may* increase pressure on your pelvic floor (if not distributed well throughout the core) and contribute to symptoms like heaviness or bulging, pressure, peeing, or pain.
Adjust the height of the seat to allow you to get a full pedal stroke without feeling symptomatic. And this may be in a different position than it previously was if you used to ride prior to POP as you may find that adjusting the height can make a difference in how you manage pressure on your pelvic floor.
Adjust how you sit on the seat if you feel heaviness or bulgy-try sitting more forward, or back further, or shifting your pelvis a bit to find a more comfortable position.
For example, if you have a rectocele, maybe it would feel better (at least initially) to rock your pelvis backward slightly to take some pressure off of that posterior wall. Shift around to see what feels good for you! (And it may change throughout the ride too and that’s okay!)
Consider getting a different or more cushioned seat if you are finding the one you have to be very uncomfortable or painful.
If you “overdo” it and start experiencing symptoms, dial it back to an intensity and positions that feel better and progress