In the previous blog post, pelvic organ prolapse: part 1, I got into what exactly is a prolapse, how it’s defined and what are some common signs and symptoms.  In this post, Pelvic organ prolpase part 2:  what you can do to help yourself, I am going to go over what are some causes of a prolapse and what you can do to help prevent and treat it.


Firstly though, I’d like to share some of my clinical thoughts when someone comes in with a suspected prolapse.   My initial thought is “there is some dysfunction going on with the pelvic floor and core”.  The whole system can be weak, it can be over engaged, it may not work together, there may be something going on in the back, hip or SI joint….these are some considerations when I’m doing an assessment.  All of the above can lead to a prolapse and the whole system can appear “weak”.  This is the role of the physiotherapist.  To determine what is going on in the system and address it through manual techniques, posture, body mechanics and exercise.  The other thing I think about, is that the pressures coming from inside the abdomen are too much for this system to handle.  This is where you come in.


The pressure in the abdomen, aka ‘intra-abdominal pressure” is the pressure exerted on the pelvic floor and core from the inside.  Slouched or sway back posture, holding your breath while lifting, heavy  or repetitive lifting, constipation can all put pressure on your pelvic floor.  Correcting one’s posture, exhaling while you lift and minimizing the amount of lifting you do can all lessen intra abdominal pressure and help prevent and/or decrease the severity of a prolapse.


Correcting constipation can also be very helpful.  The less bearing down you have to do, the less pressure on your pelvic floor.  Using a stool under your feet to bring your knees higher than your hips when having a bowel movement can also be helpful.  Avoid staying too long on the toilet as well.


Another big culprit of increased intra abdominal pressure is sit ups or overdoing ab work, specifically external obliques.  There is a place for core work in one’s exercise routine.  But, making sure you’re doing correct exercises, the correct amount and that they are at an appropriate level is where you need to start.  It’s not a one size fits all approach and working with a physiotherapist can help you determine where you need to be.


High intensity exercise can also create large amounts of pressure.  As someone who loves to exercise and incorporates it into every day of my life I truly believe that exercise can be worked into everyone’s life, in some form for everyone.  Finding what works for you, which incorporates what you like, what you can fit into your lifestyle and what works with your body is important.  Making sure your form is correct, exhaling while lifting and not lifting more than your core can handle are key components to making exercise work.


To summarize, a prolapse is a symptom of the core and pelvic floor not working properly.  Try to address your posture while your sitting, standing and lifting.  Pay attention to what do when you lift and what your toilet habits are.  A physiotherapist can help guide what you need to do to improve function of your core and work with your exercise routine to get you feeling better!