Why Certain Breathing Positions Can Make a Bladder Prolapse Feel Worse
Many women living with a bladder prolapse tell me the same story: “Some days I feel light and lifted, other days I feel like everything is dragging.” What’s interesting is that certain positions or exercises that should help can actually make things feel worse, especially when props or breathing techniques are added in.
One example is lying on your side with a soft ball under the ribs or pelvis, practising a long 3-6-9 breath and apnoea (the Hypopressive breath hold). While this combination can be powerful for fascial release and rib cage expansion, some women notice their prolapse symptoms flare.
Why? Let’s look at the anatomy and the nervous system behind it.
Pressure Pathways and the Pelvic Floor
When we breathe in, the diaphragm descends, pressure in the abdomen rises, and ideally the rib cage expands out to the sides and back. In Hypopressives, the apnoea creates a suction effect: the diaphragm lifts and, reflexively, the pelvic floor should also lift.
But if rib cage expansion is blocked (for example by lying on a ball in side-lying), the pressure has to go somewhere. Instead of spreading wide through the ribs, it may vent forwards and downwards, pressing more into the bladder wall (the front vaginal wall). That pressure shift alone can make a prolapse feel heavier.
Fascia, Bracing, and Support
Adding the ball is meant to unstick tension in the fascia of the ribs, obliques, or pelvic side wall. This can be fantastic for mobility, but here’s the catch: sometimes the body’s “bracing” has been quietly giving the bladder extra support.
What is bracing?
Bracing is when we unconsciously tighten or “hold” areas of the body, such as clenching the abdominal wall, gripping the pelvic floor, or stiffening the ribs, in an attempt to create stability. It is the body’s way of protecting itself, especially when it feels vulnerable.
Why bracing isn’t optimal
While bracing can feel like it gives us strength, it actually creates rigidity rather than resilience. Fascia, the connective tissue web that surrounds and links every muscle, organ, and nerve, is designed to glide and transmit force. When we brace, the fascia is compressed and held tight, which can reduce its hydration and mobility. Over time, this can leave it feeling “dry”, sticky, and less able to respond to movement.
What fascia really is
Fascia is made of collagen (for tensile strength), elastin (for flexibility), and extracellular matrix (ECM), a fluid-rich environment that keeps everything slippery and responsive. When fascia is hydrated and healthy, it feels juicy, springy, and adaptable. It supports efficient movement, helps distribute load, and even plays a role in how our nerves glide.
The positives of bracing
Bracing does serve a short-term protective role. If you have just had surgery, injury, or you feel instability, the body will use bracing to “splint” the area. This can give temporary support, which is why, when bracing is released, a prolapse can sometimes feel more exposed at first.
Why mobilisation matters
The goal isn’t to eliminate support, but to replace rigid bracing with dynamic resilience. Mobilisation work, such as using a ball, practising Hypopressives, or gentle fascia release, restores the sliding, hydrated quality of fascia. This allows the pelvic floor and bladder to be supported by a living, responsive system rather than a rigid, tiring grip. Over time, mobilising fascia helps reduce symptoms, create more lift, and improve overall pelvic health.
So, while releasing fascia may make symptoms feel more noticeable at first, in the long run it creates a healthier, more functional support system.
The Nerve Pathways at Play
Your bladder and pelvic floor are not just passive tissues, they are deeply wired into your nervous system. Here are the key players and how they may be influenced in side-lying with a ball and apnoea:
Pelvic splanchnic nerves (S2–S4):
These carry parasympathetic fibres that control bladder emptying. They also play a role in bowel and sexual reflexes. In side-lying, the angle of the sacrum and pelvic fascia shifts. If pressure from the ball influences the sacral plexus region, the pelvic splanchnic nerves may fire differently, sometimes creating sensations of increased urgency or heaviness.Hypogastric nerve (T10–L2):
This sympathetic pathway helps the bladder store urine by relaxing the bladder wall. It runs through the deep pelvic fascia and near the uterosacral ligaments. If fascial tension is released unevenly in side-lying, or if pressure is redirected forward, this nerve input can be altered, leaving you more aware of bladder filling and the sense of pressure at the front vaginal wall.Pudendal nerve (S2–S4):
This is the major motor nerve for the pelvic floor muscles, controlling closure of the urethra and anus. It also carries sensation from the perineum. The pudendal nerve runs alongside the obturator internus fascia and through the ischiorectal fossa. A soft ball in side-lying can press directly into these fascial planes. If the nerve is irritated or its glide restricted, the pelvic floor muscles may not contract reflexively during apnoea, creating a sense of downward drag instead of lift.Obturator nerve (L2–L4):
Best known for controlling the adductor muscles of the inner thigh, but it also travels along the pelvic side wall, sharing space with the obturator internus and pelvic fascia. Pressure here can create referral sensations into the groin or inner thigh, which some women misinterpret as bladder heaviness.Vagus nerve (cranial nerve X):
Although it doesn’t directly innervate the bladder, it interacts with pelvic reflexes via the gut and diaphragm. Long 3-6-9 breathing and apnoea strongly stimulate vagal tone. In side-lying, if the diaphragm can’t expand properly, the nervous system may interpret the apnoea as strain rather than release, which can increase bladder awareness or urgency sensations.
Why nerves respond to pressure shifts
Nerves glide within fascial tunnels, much like cables running through protective sheaths. When you lie on a ball, or when intra-abdominal pressure changes with breathing and apnoea, the glide space can temporarily change.
If the nerve is compressed, the signal may feel like heaviness, aching, or dragging.
If the nerve is stretched or tension is released, the new input may make you more aware of sensations in the bladder and pelvic floor.
If the reflex loop between diaphragm, pelvic floor, and sphincters is interrupted, the automatic lift is lost, so prolapse feels more exposed.
In short, your nervous system is responding to a change in pressure and glide, not to damage.
Visual Guide: Nerves Connecting the Bladder and Pelvic Floor
simplified colour-coded diagram here to show the bladder, pelvic floor, and nerve pathways
Why This Doesn’t Mean It’s “Bad”
It’s important to stress: this doesn’t mean you are damaging anything, or that the exercise is unsafe. What you are feeling is your nervous system adapting to a new pressure pathway and release pattern. For many women, with time and the right modifications, these same techniques become game-changers in reducing prolapse symptoms.
How to Troubleshoot
If you notice a bladder prolapse feels worse during this type of practice, try:
Adjust ball placement – move it higher under the ribs, not close to the pelvis.
Test without the ball – see how apnoea feels in side-lying without extra input.
Shorten the apnoea hold – build up gradually so the reflex lift can catch.
Check rib expansion first – only add apnoea when you feel the ribs widening, not pressing forward.
Compare left and right – one side may be more sensitive depending on fascial or nerve involvement.
The Bigger Picture
Bladder prolapse is not just about “weak or tight muscles.” It is about the whole system: fascia, nerves, breath, and pressure management. That is why some exercises make symptoms feel better one day and worse the next. It is feedback, not failure.
By understanding the “why,” you can make informed adjustments and work with your body rather than against it. And when you give your nervous system the right environment to find lift and support, those “light” days can become your new normal.
Takeaway:
If a position or exercise makes your prolapse feel worse, it is not a sign of harm, it is a clue about your pressure pathways, fascia health, and nerve sensitivity. With gentle tweaks, the same tools can become part of your healing.
Ready to Learn the Safe Foundations?
If you would like to explore Hypopressives in a safe, structured way, my Beginners’ Hypopressives Course is the perfect place to start.
For just £29.95, you will learn:
How to build the foundations of 360° breathing.
How to safely practise apnoea without increasing prolapse symptoms.
How to create space and lift through your rib cage and pelvic floor.
Gentle fascia mobilisation strategies to keep your support system hydrated and functional.
This is the work that helps you reclaim lightness, support, and confidence in your own body.
👉 Click here to join the Beginners’ Hypopressives Course
References
Schleip, R. (2012). Fascia: The Tensional Network of the Human Body. Churchill Livingstone.
Myers, T. (2020). Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. Elsevier.
DeLancey, J. O. L. (1992). “Anatomy and biomechanics of genital prolapse.” Clinical Obstetrics and Gynecology, 35(4), 897–909.
Bo, K., & Frawley, H. (2016). “Evidence for benefit of transversus abdominis training for women with pelvic organ prolapse: A systematic review.” Neurourology and Urodynamics, 35(6), 751–759.
Stecco, C., et al. (2014). “The fascial system and muscle function.” Journal of Bodywork & Movement Therapies, 18(2), 255–266.
