I just returned from a continuing education course in which the primary message delivered was that the human body is driven by activity.  It is our activity level throughout our day that dictates the health of our bones, our muscles, our nerves, our brain, and more.  Without activity, our bodies begin to degrade.  That’s right, degrade!

Research has shown that our bones begin to break down if they aren’t stressed and we also begin to lose muscle tissue quite rapidly with lack of use.  Even more intense, recent studies have shown that this phenomenon of healthy tissue breakdown doesn’t just occur in individuals over the age of 50 or 60, but affects everyone, including young people in their 20’s and 30’s, and it even affects our children.   What the research is showing is that no matter what your age, your cells are susceptible to breakdown if they are not being used or stressed.  As our healthy bone cells and muscle cells break down, they are often converted into fat cells.  So not only do we lose healthy bone and muscle tissue if we don’t exercise, but that healthy tissue is replaced with fat that takes up residence within our bones and our muscles.  This increase in overall body fat is directly linked to an increase in chronic disease, including an increase in incidence of diabetes, MS, Parkinsons, cancer, Alzheimers, stroke and more.  This inactivity and increased amount of body fat is also linked to an increase in symptoms such as poor balance, incontinence, prolapse, decreased lung volume, arthritis and more.  Quite simply, all of these symptoms are directly linked to the amount of time spent sitting throughout your day. 

Don’t be intimidated by the word exercise.  Simply being active and staying off the couch will stress your bones and muscles and prevent healthy tissue breakdown.  Researchers stress that we don’t have to go for a 30 minute run every day to have a positive impact on our health.  Simply 10 minutes of brisk walking in the morning, afternoon, and evening is a great goal.   This can include:  climbing stairs instead of taking the escalator, working in some lunges when you push the vacuum, having a couple of favorite exercises you like to do in the shower, performing 8 squats every time you stand up from your desk.  All of these activities contribute to a more active lifestyle that can have significant effects on your health.

Keep in mind that you are the best example for your children that sit along with you watching TV, working on the computer, etc.  When they get home from school, do you get outside in the yard, walk the dog, ride your bike, or rake the leaves?  Our children are affected just like us and the more they sit, the more their muscle and bone tissue is replaced by fat at a young age.  This is why the epidemic of childhood obesity is so high as there is less time for gym activities during their school week and they come home to TV and video games.  You can teach your children at a young age the importance of activity.  You are the example, so work to set a good one!

Certainly, as we age, it is the norm to become even more sedentary than we were in our younger years.  We adapt to postures that are comfortable and require less muscle activation and energy to hold.  Most of the activities that we perform throughout our day work the muscles on the front side of our bodies since most of what we do draws our bodies forward and very little we do requires us to extend back behind our bodies.  This means that the muscles that are used the least are those extensors including the glutes, lats, lower traps, and external rotators that work to hold us all upright.  Also, we allow our bodies to slink forward into a lazy posture that has us relying on the tension of our ligaments and tendons instead of our muscles to hold us upright (i.e. locking our knees back, thrusting our hips forward, rounding our shoulders forward).  All of these postural habits, or tendencies, lead to disuse of important muscles such as the transversus abdominus, multfidi, and our pelvic floor which are important for controlling continence and back pain.  We also have decreased muscle activation in our legs, leading to muscle breakdown and an increase in adipose or fat tissue that is linked to increased arthritis symptoms.  The final postural mistake that we all make is to round our shoulders forward, stretching out the weakened muscles of our mid and upper back.  This leads to changes within our spine, giving our upper back a hump, limiting the amount of air we can take into our lungs, and pulling our head forward, stressing our neck.  

We can take all the pills we want to control many of these symptoms, but the honest answer is that increasing our activity level is the best medicine for our bodies.  Be conscious of the amount of time you spend sitting and begin to perform strengthening exercises for those muscles that aren’t used as much throughout our daily activities.  Also be aware of the posture you hold and work to recruit those muscles that hold us in a healthy neutral spine posture (see Give Your Tail Bone a Lift).   All of these efforts will help to prevent muscle breakdown and the subsequent symptoms that come along with decreased muscle activation. 

Below, I have included some simple exercises to work the back sides of our bodies.  They are a great starting point for all of us! 

2-Step Kegel Sequence (8 repetitions):  To perform a 2-step Kegel sequence, begin on your back with your knees bent.  In this position, first perform a Kegel contraction by tightening your pelvic floor as if to stop the flow of urine or the passing of gas.  Hold this Kegel contraction as you begin to elevate your pelvic floor up into your pelvic outlet.  Imagine there is a string attached from your belly button down to your pelvic floor and you are attempting to pull it up.  Keep pulling that “string” up for a full 8-count.  (You will feel your belly button draw in as you work to pull your pelvic floor higher and that is okay.  This is your transversus abdominus coordinating with your pelvic floor)

At the count of 8, release your hold, relaxing your pelvic floor down, allowing yourself to take in a deep breath and release, relieving all muscle tension.  Now, follow with 4 quick flicks or quick Kegel contractions.  With this action, you are only tightening the muscles around the openings of your pelvic floor as if you don’t want to pass any urine or gas.  These are quick contractions with a quick release to a rhythm of “tighten, relax, tighten, relax” and so on for four quick flicks.  These quick flicks isolate the sphincter muscles of your pelvic floor so your back shouldn’t move and your legs should remain in the same position (bent at 90 degrees) as when you started the exercise.  At the end of your 4 quick flicks, reset, and perform a 8 second pelvic floor elevation once again.  Repeat this entire sequence 8 times.

Bridge with adductor squeeze (3 sets of 8 repetitions):  To begin, position yourself on your back with your knees bent, squeeze your buns tight, press through your heels, lifting your buns up off the floor (to the point that your thighs and hips make a straight line) for a 3-count before slowly lowering.  Continue to a rhythm of “bridge up  2, 3, and down, bridge it up 2, 3, and down…and so on for 8 repetitions.

Standing multifidi extension  (3 sets of 10 repetitions):  Standing so that you have a side view of your body in a mirror will give you the best visual feedback for this exercise.  Place your hands on your hips, so that you can feel the subtle movement of this exercise.  As you activate your multifidi muscles of your low back, you will tilt your tail bone “up.”  The view that you would see in the mirror would be the motion of being in neutral spine, moving to more of a gymnast posture when you activate your multifidi muscles.  Make sure the movement is at the level of your pelvis only and there is no movement of your legs, upper back or shoulders.  Repeat this multifidi extension for 10 repetitions.  Remember that your pelvic floor muscles attach to your tail bone, so with each extension you are increasing the tension in your pelvic floor muscles and then relaxing them repetitively throughout the reps.

Prone W’s – (3 sets of 10 repetitions):  Lie on your stomach, with your palms flat on the floor, making a  “W” position with your arms (i.e., elbows bent, palms down, with your finger tips aligning approximately with the top of your head).  Lift both arms slightly off the ground, squeezing your shoulder blades down and in. Remember to pull your elbows down so you feel it between your shoulder blades and not in your neck.

Published by Tasha


  1. Thank you so much for the detailed description of these exercises. I really needed this. Now I just need to figure out how to implement a routine.

    There is a thread going on motheringdotcommune.com about prolapses, and I am posting a link to this page there. The thread can be found at http://www.mothering.com/discussions/showthread.php?t=713732
    It would be great to get your input here.

  2. Thanks for the link. I will follow up on that site. As for finding your routine, this is the challenge for all of us and we all have our own schedules to manage. Just when you find the time slot that works best, your little one will change their nap schedule and you need find a different time. Just keep it as a priority and you will continue to adapt! Good luck to you.


  3. Tasha, I very confused seeing seemingly contradictory advice. I had a hysterectomy 18 years ago due to prolapsed, tilted uterus and have had no problems until recently. Two weeks ago, while showering I felt something bulging from my vagina and called the doctor. I was diagnosed with a rectocele, given Premarin cream and told to do Kegels. I have no pain, nor elimination issues, just this uncomfortable bulge when on my feet too long. I began studying and found WholeWoman.com which indicates there isn’t much hope for those who’ve had hysterectomies. Is your advice similar, or is it your feeling that even those with prior hysterectomies can help improve their prolapse situations? I’ve studied info on your site as well as WW and prolapsehealth.com. Right now, I think I’m feeling overwhelmed, as well as confused.

  4. I feel strongly that all of our bodies are different. Some have been injured through childbirth or pelvic surgery, some have developed significant weakness following hormone changes, and so on. We are all different, but there is no doubt that we all can establish improved pelvic support through a combination of the correct exercises, neutral spine posture, and dietary intake.

    Don’t be discouraged by reading the wrong messages. Remain positive in the changes you are making and you will see your body respond. I believe the ladies on prolapsehealth.com offer many different approaches to recovery and it is your job to see how your body responds to these different approaches. Always remember how amazing our bodies are. They respond when we give them the right tools. Unless you have had significant nerve injury or complete muscle tear, there is no reason why you can’t estabilish better control of your entire pelvic basket.

    Stay focused on your goal and keep us updated on your progress!


  5. Hi Tasha. I had a baby 4 mos ago and just came to terms with my prolapse which I think is stage 2. I was super active while pregnant and still try to exercise 4x a week. I have become more aware of the prolapse recently so I feel it might be getting worse? I bought your DVD last week and just started doing the exercises over the weekend. I feel hopeful and am so thankful for your DVD. I was wondering what you feel is the best cardio to do while I am trying to rehab myself. Is walking on the treadmill best right now? Spin classes? Elliptical? Any information would be great!
    Also, what are your thoughts on how nursing affects prolapse? I have heard it can hinder the healing process.

    Thank you!


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