Pelvic Floor Prolapse


Prolapse is a displacement of your pelvic organs down into the vaginal vault from their original position. A cystocele is when the bladder is out of place, a rectocele is when the rectum bulges out into the vaginal space, and uterine prolapse is when the uterus falls down. You don’t really know which organ is prolapsing until you insert your finger in and see which side of your finger the bulge is coming from. The anterior wall is your bladder, the posterior wall is the rectum, and if you feel the opening of the cervix hitting your fingertip you will know it’s your uterus.

There are four degrees of prolapse that we grade in stages.  Stage one the organs fall down into the vaginal vault, stage two the organs are right at the vaginal opening, stage 3 the organs are slightly outside the vagina, and stage 4 the entire organ is outside.

Symptoms of prolapse can vary. The most common symptom is a heaviness or pressure feeling in the vaginal area, like a tampon falling out or not in the right place.  Sometimes bladder prolapse can be connected to urine leakage and sometimes not.  With rectoceles, the biggest issue is the feeling of an urge to have a bowel movement but difficulty getting the stool out.  Using your thumb to push your rectum backwards can help with this.

PROLAPSE IS A PRESSURE AND POSTURAL ISSUE!!!

While prolapses can show up after having a baby, usually there are other precipitating factors that may have facilitated the organs descent. I say that however you use your body, you are either doing it in a way that supports your pelvic organs or not! The pubic bone is a shelf of support for your bladder and uterus when you position your pelvis in a neutral position. When you tuck your bottom under, your pubic bone becomes a slide to your organs. So what position is your pelvis in during everything you do?

When you sit, if you are on your tailbone you are tucking your pelvis under.  Sitting on your sit bones at 90 degrees will keep your pelvic organs on the shelf.

When walking, do your pull yourself forward with your hip flexors or do you push off on the ball of your foot and extend your leg behind you as you walk using your gluteal muscles?  Pushing off helps to protect your organs more.  Starting off with your pelvis in a neutral position first really helps.

While these are all postural issues, you can not help a prolapse if you can’t control and regulate your intra abdominal pressure system.

What is common after pregnancy is the lower belly muscles get so stretched out that they get turned off.  Then the upper belly muscles take over and kick in to try and stabilize you. When this happens it creates downward pressure on your pelvic organs.  It’s imperative to get your transverse abdominus (TA) muscle (lower belly muscle) and pelvic floor muscles working properly to create a lifting contraction.  Back, up, and in with your belly is the way I like to cue the TA contraction.

There are a couple of things that I find that can influence your body’s ability to create the lift and connection with your core.

After birth, your pelvic organs get all moved around. One of my clients told her friends that it was like I rearranged the furniture inside her. I thought that was a great analogy. Think about a baby coming out of your pelvis like a bull running through your living room. It shifts all your furniture around. Also, as a baby is coming out it’s creating a lot of downward force and pressure.  Helping to rearrange those organs back, up, and in can help take some of the downward pressure off the vagina. This also helps your pelvic floor muscles to be able to contract with greater ease and strength. The sooner this can happen the more the tissues remember where they should be.

It can be very helpful for your core to engage more easily when things are put back in their proper place. It’s not to say if you don’t get this work done you can’t heal, but it can really help speed up your healing ability.

Another area of your body that can use some help coming back in to place after birth is your pelvis. When the pelvic bones are stuck in an open birthing pattern, it puts a strain on your pelvic floor muscles and can inhibit them from being able to contract as strongly as they should. For prolapse having a lifting of your tissues is super helpful.  Stretched out muscles have limited ability to lift.  Closing the bones back up can allow the muscles to activate better.

While there is so much more to discuss I’m going to stop here. Dealing with prolapse takes a LOT of learning on how to manage your pressures and your movements. I tell my clients I’m not going to be the only thing that helps you heal, I’m a part of your healing process. You may need multiple different avenues in order to understand exactly what you need to do to keep your organs in place.