I have a new client who has prolapse in the beginning stages. Her doctor recommended doing her kegels. I have tried to help her to learn how to identify her kegels as well as how to "draw up like an elevator" vs. pulling the belly button to the spine and squeezing her tush.
I was told by another instructor that women with prolapse should not not do any pilates exercises that take their back behind her hips when they are seated.
Can anyone give me a list of "no no" mat moves for prolapse and "yes" exercises for prolapse.
Thank you.

The issue isn't so much what exercises she is doing as it is how she does them. It is crucial that she engages her pelvic floor, breathes, and does not tighten and bear down into her abdomen and pelvis. She must constantly pull in and up and NOT bear down, as the bearing down will worsen the prolapse. While Pilates mat exercises would be good, but working on the equipment would be better.

Hi there. I have been working with a client for the past 8 months who is prolapsed. She came to our studio with no prior pilates experience hoping to avoid having surgery.

Once someone is prolapsed their pelvic floor has basically failed. Kegels are a great recomendation, but if they knew how to find those muscles they probably wouldn't have prolapsed in the first place. Focus on building awareness.

As for specific exercises, I approached my client like a prenatal client but in reverse. We started where I would with someone in their 3rd trimester - lots of transversus and pelvic floor focus and kneeling/standing work so she could start to feel her abs in functional positions, and have gradually started incorporating more exercises recommended for 2nd and 1st trimester (it took a long time for her to support both legs in tabletop but she can do it now!) I love using props between the knees because engaging the adductors will inherently help engage the pelvic floor. Grounding is really great, or leg pull front preps once the client is ready. Try some kneeling work on the BOSU. If you have access to a chair, footwork on the chair is also great.

Good luck!

To ensure your client does not push down instead of connecting to the pelvic floor - work at low load, rather than try to get her to understand how to contract and engage her postural muscles by adding on something - drawing in, bracing or hollowing, take away all the things that will not allow her to work safely - eg to much load ( both legs lifted in the 100). By allowing her to start standing on a narrow base (feet together) then staying tall to lift one leg, her core muscles will automatically engage. Even this basic movement she may find difficult, if when she lifts the leg she loses height you will know her core is not activated. Once she understands the "feel" of the core activation you can move on to more complex moves which will involve more superficial muscles and work for strength as well as stability. I have found with some clients who lack body awareness, the simple "stand tall" cue helps them sooner that instructing them to "engage or lightly contract" their deep abdominal muscles. I agree with Lynda its not the exercise but the performance of it - your clients needs to understand stability before attempting to strengthen her abdominal muscles.

Great information. Make sure that anything you do is done with caution and awareness.

What exercises can I do on the Pilates Premier machine that will help prolapse?