What is a pelvic organ prolapse?

A pelvic organ prolapse is when one or more organs have fallen down or slipped lower than where they used to be. The most common types of pelvic organ prolapses are a:

Bladder: A cystocele or anterior prolapse is when the tissue between the bladder and the anterior vaginal wall has weakened to the point where the bladder is now bulging in towards the vaginal space.

Uterine Prolapse: This is when the ligaments and tissues holding the uterus in place have weakened to the point where the uterus now sits much lower in the vaginal space.

 

 

 

 

 

Rectum: A rectocele is when the tissue between the front wall of the rectum and the posterior wall of the vagina weakens to the point where the rectum now bulges in towards the vaginal space.

What can you do about a pelvic organ prolapse?

  • conservative care
  • pessaries/hormones/surgery

Pelvic floor physiotherapy helps with the conservative side of care and includes manual therapy, education and exercise. There are some movements and exercises that are better to do and some that are riskier to do.

  • Safer and Beneficial Movements/Exercises for a pelvic organ prolapse
  • Learn how to engage your pelvic floor muscles
  • Ensure that you have optimal breathing patterns as the diaphragm and pelvic floor work together
  • Know if you are accessing your transverse abdominis muscle well as this muscle works with your pelvic floorChange your posture so you are able to ‘access’ your pelvic floor muscles optimally

Less Safe Movements/Exercises for a pelvic organ prolapse

  • Sit ups, crunches and both legs up in the air. Check out my youtube videos (https://www.youtube.com/watch?v=sDHYROdjHX8) to see, via imaging ultrasound, how doing these exercises may push your pelvic organ contents downwards. This is definitely not what we want for a pelvic organ prolapse. Substitute these exercises for single leg up in the air, bridge up and then lift single leg to make it more challenging, side planks and up planks.
  • Wide legged exercises will challenge a prolapse to stay in place so use a narrower stances instead.
  • Impact will create more stress for a pelvic organ prolapse.

Keep in mind that there is no one recipe for each individual who has a pelvic organ prolapse. Many people run and lift heavy weights who have a pelvic organ prolapse. The take away message is:

  • to make sure you have good awareness of your pelvic floor and how to engage it
  • how to engage transverse abdominis
  • how to breathe well to lessen the intra abdominal pressure
  • how to progress your exercises but know if you aren’t ready

Many people will return to doing the exercise they love so try not to obsess about your pelvic organ prolapse and learn how to do all of the above so you too can return to doing what you love to do!

Check out more ideas on my youtube channel: https://www.youtube.com/channel/UCJqDcZOOLoNKdBwxmY_wawA/videos?view_as=subscriber