Hi Doctors!
I am a 32 year old female who is currently on the SSLP (on my 8th week). This week I noticed feeling a bit “different” down there. Note that after having kids, Ive never really looked down there. So, before jumping in the shower, I had a look and noticed something protruding out. I thought, “oh God, its a vaginal prolapse”. A bit upset and thought if I should keep working out, I thought of what my husband would do. So I said, yup, gonna keep hitting those PR’s tonight. And since I’m due for a pap smear, Ill get myself checked out tomorrow.
So here’s a bit of a back story:
A bit of gynae history:
I had my first son on September 2015 (2.5 years old) and had our second son May 2017 (10 months old).
First Pregnancy was uncomplicated except for the fact that I had ongoing spotting from 20 weeks onwards (all investigations were inconclusive). He was born at 39+2 weeks, 4.12kg, 38 hour labor, NVD with forceps and a third degree tear (required stitches). Apgar of baby was 3,5,7 but recovered well and didn’t need NICU. I saw a rectal surgeon for follow up due to the tearing but was cleared and needed no other intervention but advised to focus on pelvic floor exercises.
Second Pregnancy was uneventful. Born at 39+6 weeks, 3.95kg, 7 hour labour, NVD with no intervention, second degree tear with no stitches required. Baby’s apgar was 9. Before being discharged from hospital, the nurse said my abdominal separation was 1-2 cms. Post-natally, I had some retained POC which was treated conservatively with antibiotics. No D&C was required.
SSLP:
I’m 58kg
Squatting 50kgx3 sets of 5
Benching 31kgx3 sets of 5
Pressing 20.5kgx3 sets of 5
Deadlift 71kgx1 set of 5 every session (no cleans)
Other personal history:
No surgical medical history
recurring back pain due to babies and from work (nursing)
No incontinence
Usually fit and well
Never been overweight
Always grew up doing some sort of sport but not good enough to make it to the team 
So back to the doctor/OBGYN:
My doctor did the pap smear and assessed the situation. She confirmed that I had a small vaginal prolapse (descended about 1-2 cms). However given that I do not have any “red flags” of incontinence or recurrent UTIs, treatment remains to be conservative. Given we are still planning to have children in the future, surgery is not an option till we finish with that business. She also assessed my abdominal separation which measured at 3-4cms.
Recommendations from Dr:
- Need to focus on addressing the abdominal separation before proceeding with any heavy lifting. She has given me some simple abdominal exercises, 4 times a day (seated knee lifts, engaging my core, four point kneeling, individual arm lifts, lying down leg slide). She advised me to return in 2 weeks with the hope of the separation reducing to 1-2 cms.
- After 2 weeks if the separation has decreased, she will recommend doing stage 3 of the exercises (pilates based core muscle strengthening program) until the separation is non existent.
- She does not recommend any barbell training until the abdominal separation is addressed (note: she was shocked to hear how much I was deadlifting). On the handout she gave me, she gave me some examples of exercises to avoid: abdominal curls, oblique curls, pilates 100s, double leg lifts, medicine ball rotations, planks and pushups. “Avoid exercises that cause twisting stress across the midline of your abdomen as this can impeded your healing”
- And of course she recommended pelvic floor exercises (10 times a day) to help the situation down there. Given your knowledge with Barbell medicine, would you recommend I follow the above and omit barbell training until the separation is addressed (approx 4-6 weeks)?