How Pelvic Floor Therapy Can Help With a Prolapse

What can I do for my prolapse?

There are many treatments for prolapse, besides surgery. Often medical doctors will tell you to just give it time until it is bad enough, and then get surgery.

Time can sometimes heal, but there are many other things you can do, as well.

• Pelvic floor therapy

• Kegels

• Lower body strength training

• Stretching

• Wearing supportive underwear or leggings

• Getting fit for a pessary

Pelvic floor therapy:

I recommend for everyone who has prolapse symptoms to see a pelvic floor therapist. The therapist can evaluate your pelvic floor muscles to see if you need to do kegels or if you have tight pelvic floor muscles. Then we can give you a specific program to help your symptoms.

Kegels:

Some of my patients have tight pelvic floor muscles and we never do kegels. This is more common than you think. For these people, we do a lot of hands on muscle release and stretching.

Some patients need to do kegels, and that is what we focus on. Sometimes the position that we do kegels in is what makes the difference. For example, some patients with bladder prolapse feel better doing kegels while lying on their stomach. In this position the bladder is more supported by the pelvis, so they can use their muscles better this way.

The only way to know what exactly you need when it comes to kegels, is to get evaluated by a pelvic floor therapist.

Lower body strength training:

The majority of my patients need lower body strengthening as well to support their prolapse, not just kegels or pelvic floor training, and many of them feel better just by doing hip and leg strengthening.

I like exercises like:

• clamshells

• bridges

• sideways walking (add a resistance band for an extra challenge)

• leg lifts

Stretching:

For my patients who have tight pelvic floor muscles, we focus more on stretching.

Some of my favorite stretches for prolapse and pelvic floor tightness are:

• butterfly stretch

• happy baby

• figure 4 stretch

Supportive leggings and undergarments:

For some people, exercise and pelvic floor therapy aren't enough, but there are still options to help!  There are a lot of different supportive undergarments, leggings and other supports. Here are a few of my favorites:

• Hem supportwear

• SRC 

• the pelvic bra

There is no best one, it is mostly just personal preference and comfort.

Pessary:

A pessary is a small device that inserts into the vagina to hold the organs up. There are different shapes for different kinds of support. The most common is a ring shape. 

Most pessaries you can take in and out yourself. For many of my patients it is temporary. They can use it less often as they get stronger and heal. Some people may need it only for a short time, some people will only need it when they exercise or are on their feet all day (hello Disney days!) and some people will need it long term to help their symptoms.

I advise all my patients who haven't gotten better with the other things on this list to at least try a pessary and to think of it as temporary. I think often in our USA healthcare system once a doctor prescribes something it seems like you will need it forever, but that isn't always true with a pessary.

Conclusion:

I hope this helps you understand your options better. There really are a lot of things you can do besides just having surgery. Even if pelvic floor therapy doesn't completely heal your symptoms, there are still other options.

If you have any questions, reply to this email and I will try to answer them for you. 

Prolapse can be a scary thing and when you google it, the pictures are always the worst case scenario, but the majority of patients I see with prolapse have only a mild prolapse and they get better with physical therapy.

I also have some exercise videos and classes that can help:

I have a 4 week strengthening program for new moms.

If you aren't a new mom, my pelvic floor membership has lots of pelvic floor and prolapse friendly exercise videos in it.

Schedule an in-person or virtual appointment with me.