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Episode #49: Barbell Training, Powerlifting & Prolapse: Does it just affect women? Can you train? Do you need surgery?
Pelvic organ prolapse is a dysfunction of the human body that is experienced by men and women. Yes, you read that right, men too. So it’s important to understand the symptoms, causes, and treatment options so you’re not left wondering: “Can I powerlift with a prolapse?” or “Do I need surgery if I have a prolapse?”
Vaginal and rectal prolapse are sensitive topics for most people. In fact, this often leads people to suffer in silence, lose enjoyment for life, and even stop barbell training or competing in powerlifting. However, there are ways to non-surgically address prolapse and continue to barbell train.
When belts are worn correctly, the Valsalva Maneuver is executed appropriately, and training volume, intensity, and technique are monitored and adjusted systematically, you can train without experiencing or worsening prolapse.
In this episode of the PRS Podcast Dr. Breanne Maruca, PT, PRSCC, CLT, WCS and Dr. Rori Alter, PT, PRSCC, SSC bring awareness to pelvic organ prolapse by discussing:
Types of prolapse that men and women experience
Symptoms of vaginal and rectal prolapse
Their personal experiences with both
A docked boat analogy for the pelvic floor muscles, organs, and ligaments
Various treatment options for pelvic organ prolapse
Pessary
Surgery
Medication
Resources Mentioned in this Episode:
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Dr. Rori Alter, PT, PRSCC, SSC: [00:00:25] Dr. Rori Alter Head clinical coach here at Progressive Rehab & Strength with my lovely co-host for this month, Dr. Breanne Maruca. She's our pelvic health specialist here at PS. She's a clinical coach, she's a CrossFit coach, a strength training and barbell training coach. So she's all good things that integrate strength training and your pelvic health and all those good things. So what we're doing in this episode is we're talking about prolapse, pelvic organ prolapse, which is very common, but not normal. You should not be experiencing this. And if you are experiencing prolapse, there are tons of things that you can do to address it non-surgically, non-pharmacologically, if that's the right word, and continue to train. So Bre, before we even explain what prolapse is, because I'm sure people who have prolapse are like, I'm going to listen to this episode, but I'm sure there's people who don't have prolapse and might not even know what it is that are listening to this episode because they just want to learn from our podcast. So firstly, everybody who knows what prolapse is knows that women get prolapse. However, can men get prolapse?
Dr. Breanne Maruca, PT, PRSCC, CLT, WCS: [00:02:07] Yes. Yes, men can get prolapse. Now let's actually back up even a little bit more to like a little quick anatomy lesson of just Pelvic Organs 101, because it's really important to know these because the names of prolapse and what's involved in prolapse is directly related to what organs are involved. So if we know what organs are involved…
Dr. Rori Alter, PT, PRSCC, SSC: [00:02:29] I think that's really important to note because not all prolapse is the same.
Dr. Breanne Maruca, PT, PRSCC, CLT, WCS: [00:02:32] Yes, there are multiple types of prolapse that you can experience and that dictates maybe some of your symptoms. But truthfully, in most in a general sense, it's not really changing the treatment as kind of but not really in a general sense. So it all depends, right?
Dr. Rori Alter, PT, PRSCC, SSC: [00:02:51] It's kind of like when we look at back pain and we say, okay, this person has back pain, but we don't need to know if it's a bulging disc or a compressed nerve or stenosis, facet joint, we don't need to know because we're going to treat the symptoms and the root cause like the thing that's leading to whatever's compressing on the nerve. We're going to address that, not the nerve being compressed, if that makes sense.
Dr. Breanne Maruca, PT, PRSCC, CLT, WCS: [00:03:17] Yes, exactly. So going to this pelvic anatomy first, if we look at a pelvis in our pelvic, again, a pelvis is like a bowl without a bottom. And that bottom of the pelvis is covered by a sling of muscles called our pelvic floor muscles. And you can go back to our functional anatomy podcast episode talking all about those muscles. But specifically when we look then at what's inside the bowl, the pelvic bowl, let's start from the front. So we have our pubic bone in the front and you can feel that on yourself. You can press with your fingers, feel that bone in the front. Directly behind that pubic bone is your bladder. And that's in men and women. Your urinary bladder is right behind sitting nicely behind that pubic bone. But so we have the pubic bone, the bladder next in line, we have the vagina or the vaginal canal. And on top of that vaginal canal are connected at that superior end of it, we have the uterus. So it's basically the uterus connecting then from basically the door between the uterus and the vagina is the cervix. So when we hear about like cervical dilation and labor delivery, things like that, that is that door opening. And then we have the vaginal canal, which is where prolapse this is like where all the naming and everything comes into play. Then we have directly behind that the rectum or the large, the large intestine and the rectum. So just with that general anatomy, obviously men, they do not have a uterus and vagina, but that bladder and that rectum are and then they have the prostate. But generally those instead of the vagina and the uterus, men have that prostate in between. So in general, again, when we so so now that you have a good little one on one pelvic anatomy, pelvic organ anatomy lesson, let's get into naming these types of prolapse. So every type of prolapse except rectal prolapse specifically is named based on what organ is pressing into the vaginal canal. So cystocele, that is the bladder pressing into the vaginal canal. Now, even let me back up a quick second here. Nothing other than if we have uterine prolapse and very, very, very severe uterine prolapse, do we?