By Dr. Ashley Wozniak, PT, DPT
1. What is pelvic floor prolapse?
Your pelvic floor muscles are part of your body’s core muscles – a bowl shape that helps support all around your lower body, from the vaginal to anal areas. These muscles support all of your pelvic organs – your bladder, uterus, plus your colon on the backside. Prolapse occurs when there is weakness in the pelvic floor muscles and they can begin to protrude or fall down a bit. There can be bladder, uterine or anal prolapse.
Some women may not know they have a prolapse because they may not see or feel anything out of place at the time. Or it may be more obvious, with pelvic organs actually starting to protrude into the vaginal canal. Many women describe it as “heaviness” or feeling like something is falling out of them. That feeling might happen during weight-bearing movements such as picking up or carrying babies or young children – or even things such as coughing, sneezing or getting back into exercise that involves running or jumping.
2. When might a prolapse begin to happen?
After childbirth is the main time I see clients with pelvic floor prolapse, but prolapse can begin to happen during pregnancy as well. During pregnancy, there are a few issues that might cause problems to start – constipation, which is common in pregnancy, might cause a pregnant mom to strain more during bowel movements, which can weaken the pelvic floor muscles.
During childbirth, especially vaginal birth, the pelvic floor muscles become lengthened, so they don’t support the pelvic organs as well. In postpartum, a prolapse might be present due to labor, certain pushing positions, length of time pushing, or degree of straining during pushing. Or a prolapse might develop over time during postpartum due to muscle imbalances in the core and pelvic floor following pregnancy and birth – and then show up months after giving birth.
3. What can you do if you suspect you may have a prolapse?
Talk with your OB or midwife and begin working with a Physical Therapist who specializes in women’s postpartum pelvic floor therapy. Some treatments your Physical Therapist may offer will be to first take a look at your posture – checking that your postpartum posture is stacked properly, with the ribcage over the hips. I also talk with my clients about their everyday movements with their babies – bending, lifting and carrying – to ensure proper alignment during those activities.
Good alignment can help reduce the amount of pressure impacting your pelvic area and muscles. We review breathing techniques and how to properly contract the core and pelvic floor muscles together. There’s also internal work and assessments to determine where areas of weakness and/or tightness exist in the pelvic floor. In many postpartum moms, I often find there’s an initial imbalance between the front and back part of the pelvic floor.
4. What are the goals of Physical Therapy in addressing prolapse?
The main goal is to help manage your symptoms – that feeling of heaviness or of something falling out. We work to help moms strengthen and contract the pelvic floor to the best of their ability. If you have a more severe degree of prolapse (where pelvic floor organs are actually protruding into the vaginal canal), we first work to address everything from posture to joint mechanics to how your muscles are working and determine whether that helps to reduce your symptoms and manage the issue. Sometimes, in more severe cases, surgical options may be necessary if symptoms persist after pursuing initial Physical Therapy options and interventions.
It’s key to get assessed early on following birth to find out how your core and pelvic floor muscles are starting to coordinate and re-strengthen. One tip for early postpartum is to be aware of how you’re breathing and moving as you care for your baby – as you’re breastfeeding, carrying the baby’s carseat, setting your baby on the changing table, and caring for other children or toddlers. Preventing prolapse all starts with good body mechanics and proper internal core pressure management through the right breathing patterns.
Talk about your pregnancy or postpartum goals with our Physical Therapist, Dr. Ashley Wozniak. Learn more about our studio, wellness programs and Physical Therapy offerings at www.inspiredmaternity.com.
Inspired Maternity is a one of a kind Pregnancy and Postnatal Health, Wellness and Fitness Studio located in Peoria, Ill. We offer in-studio prenatal and postpartum fitness programs and Physical Therapy assessments throughout the calendar year, as well as virtual options and telehealth visits.