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Pelvic Organ Prolapse

June is Pelvic Organ Prolapse Awareness Month!

What is pelvic organ prolapse, or POP?

Pelvic organ prolapse is when 1 or more of the organs in the pelvis descend down from their normal position and press into the vaginal wall. The most common types of prolapse are the womb (uterus), the bowel or rectum and/or the bladder. A prolapse is not life threatening, but it can contribute to discomfort or other pelvic health complaints such as leakage and constipation.

Though a POP is not normal, it is very common. Just because you have a POP doesn't mean you are broken, it doesn't mean that you have to have surgery, you may not even have symptoms or they may be very mild. It can be scary to talk about but we need to! Knowledge is power and when we are educated about what is going on in our bodies we are empowered to make the right decisions regarding our care.

Let's talk about the facts...

  • 1 in 2 women have some degree of pelvic organ prolapse

  • 12% of women with POP will choose to have surgery based on their symptoms and impact that these symptoms have on their daily life

  • The most common causes are childbirth and menopause, but POP can happen to any woman from mid-teens to end of life for a variety of reasons including chronic constipation, chronic coughing or sneezing (hello allergies!), high impact sports

  • Symptoms may include feelings of pressure, pain, or heaviness in the pelvic region, urinary or fecal incontinence, urinary retention or constipation, back pain, painful intercourse, and pain or difficulty with insertion of menstrual products, feelings of menstrual product falling out

These facts are not meant to scare you, but to inform, educate and break the silence of this common condition. There are SO many things we can do to relieve symptoms, support your pelvic organs and ease your mind.

Let's get started!

Diaphragmatic breathing

How does breathing help relieve my symptoms "down there"? Because of the connection with our diaphragm and our pelvic floor.

In a true diaphragmatic breath, when we inhale, our diaphragm and pelvic floor drops and our abdominal wall expands. When we exhale our diaphragm and our pelvic floor return to their resting position. This coordination of movement, allows for both contraction and lengthening of our pelvic floor muscles. And just like any other muscle, in order for a muscle to function properly, we need to work that muscle through its full range of motion.

Let's use your biceps muscle as an example. Imagine walking around all day with a weight in your hand and holding that weight up towards your shoulder with your elbow bent? Your biceps would be tight, fatigued and probably very sore. When you would need to actually use your biceps muscle it more than likely wouldn't function properly. This is why we rarely recommend ONLY kegels to help relieve prolapse symptoms and if we do it is only after a pelvic health exam to ensure that you do need to work on an isolated contraction of your pelvic floor. We would be working on contracting an already tight and overworked muscle.

Symptom relief exercises

Since a prolapse is when a pelvic organ sits lower into the vaginal canal, a good way to counter that downward motion is to perform mini inversions so that your hips are slightly elevated higher than your abdominal wall or shoulders. This is to relieve the stress and strain of the prolapse and to encourage a better position of the pelvic organs.

Check out these options for symptom relief. And, don't forget to perform some diaphragmatic breathing along with the exercise to maximize the symptoms relief.

In addition to these exercises for pressure relief, we also need to address a common symptom... Constipation!

Ideally, we should be having bowel movements at least once per day. When we don't have a bowel movement every day, or pass even small amounts, this can be a sign of slow colon motility or constipation. When we are constipated, this can put pressure on our pelvic floor, thus causing pain or discomfort, contributing to urine leakage and potentially worsening our prolapse.

Tips and tricks to reduce constipation include:

  • Eating a diet high in fruits, veggies and high quality fats and protein

  • Staying hydrated, we recommend drinking half of your body weight in ounces

  • Use a squatty potty

  • Diaphragmatic breathing

Mobility exercises

Due to the close relationship of our lumbar spine, hip and pelvic floor muscles, having adequate mobility within our spine and hip muscles can help to promote the full range of motion that we discussed earlier. It's also important to have lumbo-pelvic dissociation, which means we want these two structures (lumbar spine and pelvis) to be able to have separate, yet coordinated movements.

Check out these options for pelvic mobility:


 Seated Hip Mobility on the Ball

Strengthening exercises

As with any injury, it's important to incorporate strength training in a safe way to start to strengthen and stabilize, but to do this in a way that we prevent things from getting worse. Unfortunately most of the advice out there is to avoid lifting or high impact activity due to the concern of making symptoms worse. That is not always the case!

We are here to educate and empower you so that you can continue or return to activities that you enjoy without exacerbating your symptoms. This can be done by slowing down and returning to the basics first (i.e. diaphragmatic breathing and proper core activation) and then progressing back into higher levels of activity.

Here are some foundational strengthening activities that will also promote pressure relief for your pelvic floor:

Bridge with Overhead Lift

Hovering Table Top

In conclusion...

Though prolapse is a common condition that affects 50% of women, it doesn't have to mean the end of all activity and movement. We are here to break the stigma and bring awareness to prolapse. We are here to support you and guide you. Small changes and subtle shifts can lead to a big impact in your health.

Let's work together to get moving :)

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