Being diagnosed with pelvic organ prolapse (POP) can feel extremely overwhelming. But the good news is, being diagnosed with a prolapse does not mean you are guaranteed to have long term prolapse symptoms or require surgery. In many cases, relief from POP is completely achievable without surgery and may even be able to be improved.
What is Pelvic Organ Prolapse?
Pelvic organ prolapse happens when the muscles, fascia, and connective tissues supporting the pelvic organs (the uterus, bladder, or rectum) become weakened or lax. This allows one or more of the pelvic organs to descend or press into or out of the vagina. With POP, the pelvic organs themselves are not actually damaged, it is simply the supporting structures like fascia and connective tissue that are stretched and/or injured. Read our full article about pelvic prolapse here to learn more.
Symptoms of prolapse The symptoms often experienced with POP include:
vaginal pressure or bulging
feeling of the vagina falling out
low back pain
pelvic heaviness/dragging that is worse at the end of the day
Depending on the type of prolapse, some people may also note:
urinary leakage
difficulty emptying with peeing or pooping
need to splint or reposition during bowel movements
How can I support my prolapse?
Although there is no way to prevent prolapse completely, there are strategies that you can use to reduce the symptoms, prevent worsening, and even improve a prolapse!
Practice diaphragmatic breathing Try placing your hands in a c-shape underneath your rib cage. Inhale and allow your breath to flow in, feeling 360 degrees expansion into your back, sides, and belly, like an umbrella opening. Utilize this breathing as an opportunity to check in with your body throughout the day to let go of any tension you may be holding onto!
Improve pressure management Holding your breath when something becomes physically challenging can increase the pressure in your pelvic floor. Utilize a slow exhale with exertion when working out and with daily activities such as rolling over in bed, getting up from the floor, or lifting your little ones. If you feel too much pressure during an activity, let your voice do some work. Try “tsss” through your teeth to make the sound of popping open your favorite bubbly drink in a can. This “depressurizes” your abdomen and lets your diaphragm work with your pelvic and abdominal muscles.
Healthy bathroom habits Avoid straining or pushing your pee and poop. Use a stool or squatty potty to get your knees higher than your hips. This allows your pelvic floor muscles to lengthen for you to empty more easily. Exhale as you gently lengthen your pelvic floor muscles during a bowel movement. Improve your stool consistency and avoid constipation. Proper hydration, fiber intake, and 30 minutes of activity daily can help get a regular bowel routine going.
Posture and positioning Think about keeping your ribcage stacked directly over your pelvis in both sitting, standing, and with activities to allow your core canister to best support you.
If you feel increased pressure at the end of the day or with prolonged activities, lie down and elevate your pelvis on some pillows.
Allow yourself to rest in this position – take deep breaths, relax your jaw and hands, unclench your bum. This position will help reverse the effects of gravity and relieve pressure on your pelvic floor.
Mom life is busy, but allowing yourself 5-10 minutes to lie on your back with your feet a bit higher than your heart will also provide rest for the muscles and provide easier flow of blood from the legs to the heart.
Update your wardrobe. Purchase compression bike shorts or leggings from Belly Bandit, Amazon, Old Navy, or Target or specific postpartum brands like:
https://www.blanqi.com/collections/postpartum **This does not offer as much compression as the others but is very soft!
We suggest a short that is more of a bicycle short instead of a "short" booty short. It will also provide compression to the vasculature and muscles of your legs.
Also the V2 Support, or Belly Bandit V-Sling can be worn over your undies and under yoga pants or leggings. While not the most sexy fashionable item, it is helpful for both prolapse and vascular pressure during and after pregnancy! A belly support during pregnancy is also a great option to decrease pelvic pressure from a growing baby and also helps to reduce strain on your lower back.
Consider a pessary. A pessary is a device that sits inside of the vagina to provide support for your pelvic organs – think of it like a sports bra for your pelvic organs. Pessaries can be a fantastic non-surgical option to reduce symptoms of POP such as pressure, heaviness, bulging, dragging, urinary incontinence, and lower back pain.
Not only do pessaries help mitigate symptoms of prolapse, but they also help to support our organs as we heal postpartum, prevent worsening of prolapse with aging and hormone changes, and allow you to move, exercise, and participate in activities that you enjoy with confidence! Pessaries come in many different shapes and sizes, and may not be appropriate for everyone, so it is important to speak to a professional with training and experience to make sure you get the right pessary and the right fit.
{image from https://www.gcu.ac.uk/hls/pessarypsp/}
Be your best advocate. Make an appointment with a urogynecologist and pelvic floor physical therapist if you have not already. A urogynecologist is a gynecological specialist, not an OBGYN, who specializes in pelvic floor conditions such as perineal injury, prolapse, bladder health, and pessary management. Pelvic floor physical therapists can educate you on proper breathing and pressure management with day to day activities and exercise, advise on return to exercise and modifications for activities, and screen for potential pelvic floor muscle dysfunction to optimize your pelvic health!
Images used with permission from Pelvic Guru®, LLC www.pelvicglobal.com
In the South Jersey area and want one on one care with the Breathe Life Team? Schedule an appointment for your complimentary 15 min phone call to see how pelvic therapy can help you!
Dr. Becca Jones, PT, DPT, CSCS, is a 2016 graduate of New York University with her Doctorate of Physical Therapy. Her passion for supporting people through their pregnancy and/or post partum journey inspired her to specialize in pelvic health. Dr. Becca believes in providing holistic, individualized care in order to restore comfort and build confidence to get people back to what they love.
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