Hi, I’m Christina Bausch. I am a physical therapist and a pelvic floor specialist here at Rebound Physical Therapy. We are an outpatient clinic located in Topeka, Kansas. Today I’m going to talk to you a little bit about pelvic floor prolapse. We’re going to talk about the three main types of prolapse and how therapy can help with those.
Anatomy of the Pelvis
First, I’m going to talk a little bit about the anatomy of the pelvis. If you look at the pelvis, there’s the pubic bone in the front, which connects to your hips that wrap around toward your spine. There is the spine and the tailbone coming down in the back. And there are muscles down in the bottom of the pelvis, which kind of form a bowl, that are the support for the pelvic organs from the underside. What we want for those muscles is for them to be strong and functioning so that they’re providing good support for all of your pelvic organs.
When I say your pelvic organs, the main three are going to be your bladder, your uterus and the bowels. Your pelvic floor muscles form a sling underneath those organs, stretched between your pubic bone and tailbone, to provide support. What we want is for those organs to stay nice and tucked up inside.
Types of Uterine Prolapse
Sometimes what can happen with prolapse is that those organs may start to sag or bulge. And depending on how severe the prolapse is, it may actually bulge down so that you can see it at the vaginal entry.
The bladder can prolapse backward against your vaginal wall, and the bowels can also prolapse forward. Sometimes you’ll see bulging into your vaginal wall from these issues, or the uterus itself can shift down. All of these scenarios can happen, but we treat them more or less in the same ways.
Symptoms of Uterine Prolapse
Some of the signs that you may be experiencing a prolapse may be dullness or heaviness within the lower abdomen. You may also feel heaviness in the perineum or vaginal area. Sometimes you may have difficulty either emptying your bladder completely or completing a bowel movement. Sometimes there’s pain, or it may just be discomfort, or you may notice some bulging at that vaginal entry that isn’t normal.
Some of the things that we can do to help in this situation are to work on improving the strength and the coordination of those pelvic floor muscles from the underside by teaching you how to isolate and contract those muscles, especially with activity. Some of the factors that can worsen prolapse are just day-to-day transitions like lifting, coughing, or anything that creates pressure or strain that pushes down on the bladder. When we’re thinking about this, we’re thinking about how much support is there from the underside compared to how much pressure there is within that abdominal cavity that is pushing down.
One way that we can work to minimize prolapse is by not only working to engage or contract the muscles from the bottom side but also working on your breathing techniques as you’re doing transitions, exercise or activity so that we’re minimizing how much pressure is pushed down on those pelvic organs. We work a lot on coordinating with breathing. Anytime you do any kind of exertion, we really want you to work on exhaling so that it minimizes how much pressure is pushing down on those pelvic organs.
Let Us Help You Get Back in Action
Common factors that may lead to developing a prolapse include people that have respiratory issues like a chronic cough. Chronic or short-term constipation can also be a factor. Of course, childbirth can definitely be traumatic on those muscles and organs. So any of those factors can lead to developing a prolapse. Once we identify what’s going on, we can put together a treatment program to improve your strength or handle it if those muscles aren’t weak but uncoordinated. Or if you’ve developed a tendency to hold some tension in those muscles, we can help with that too.
We can work to reset the muscles and then teach you how to engage them properly, coordinate it with your breathing, and minimize how much pressure is pushed down on those organs. If you’re experiencing any of these symptoms, or if you have any questions, please give us a call at (785) 271-5533. We’d be happy to sit down, talk to you, and put together a plan to resolve your symptoms using physical therapy treatment.
