What you should know about Prolapse

Prolapse is a common issue post partum that is not talked about enough. The definition of prolapse is “a protrustion of bladder, uterus and/or rectum into the vaginal wall”. This commonly occurs during pregnancy, labor or with chronic constipation. Common symptoms are a feeling of pressure or falling out in pelvic floor, sexual discomfort and/or incontinence. These symptoms typically get worse in the afternoon or evening time and feel better in the morning.

The first thing you should know about prolpase is that it happens at varying degrees and being aware of your degree of prolapse is /the first step! Yes, prolapse can get so bad that the protrusion into the vaginal wall extends outside of your vaginal opening, BUT just because this isn’t happening to you doesn’t mean you don’t have prolapse. There are things you can do NOW to prevent your prolapse from getting worse and to limit your symptoms.

I frequently have patients coming for incontinence, pain or weakness and during the initial assessment I find they have a prolapse and no one has told them. That’s great they are in my office to learn what to avoid and how to “treat” their prolapse, but what about all the others who aren’t getting to a pelvic PT? They are being told its okay to resume normal activity and even worse RUN, not knowing they could be making their prolapse worse!

Here is what I tell my patients:

-          Your pelvic floor is under the force of gravity when standing and sitting; you need to lie down (even better on an inversion wedge) to give your pelvic floor a break.

•  In the first 3 months post partum I recommend doing this every couple hours or as soon as you feel “pressure” symptoms returning.
•   Remember if you are baby wearing then this will increase the pressure on your pelvic floor which can worsen prolapse; this includes carrying an older sibling too!  So be even more mindful of “pressure” symptoms and lie down when needed. I found this much more difficult after my 2^nd was born because all of my “down time” from the baby I spent with my 2 year old. Bottom line- make sure you are listening to your body and taking care of yourself!
•  Kegels are great for strengthening your pelvic floor and vaginal wall which will give more support to your prolapse. Do 80-100 kegels a day and even better do them lying down or on an inversion wedge.  If you still have prolapse symptoms on a daily basis then do not run or do any impact sports; this will likely worsen your prolapse.  
  
•  Keep focusing on kegels and inversion! If you get to 6 months post partum and are still having symptoms see a specialist to discuss a pessary. A pessary can help your symptoms and allow you to return to exercise such as running.
• Do not strain on the toilet!

           

            Candice Amat, PT, DPT

               candice@duffyandbracken.com

  

Six Reasons to See a Pelvic Floor Physical Therapist Postpartum

Having a baby is a joyful and fulfilling experience but also can take a heavy toll on your body. Growing and carrying a baby for nine months followed by delivery might cause new aches and pains that a Pelvic Floor Physical Therapist can help you address. 

Here are six reasons you may need to see a Pelvic Floor Physical Therapist postpartum

1.      Musculoskeletal pain

-          Growing and carrying a baby for 9 months really can take a toll on our musculoskeletal system. Some common postpartum issues include: tight hip flexors, poorly activating abdominal muscles, low back pain and instability through the pelvis.

2.      Weak Pelvic Floor Muscles (PFM)

-          Pelvic floor weakness can lead to symptoms such as poor or weak orgasm, urine leakage and/or a feeling of “falling out” vaginally.

3.      Prolapse

-          “falling down” or “downward displacement” of the bladder, uterus and/or rectum

-          This can happen in varying degrees and symptoms can include “falling out” feeling vaginally or even vaginal tissue extending externally.

4.      Diastasis Recti

-          The separation of rectus abdominis muscle which can happen during pregnancy.

-          You might notice you have this if you attempt to do a crunch and see a half football shaped bulge vertically on your stomach.

5.      Incontinence

-          Urine leakage, a common compliant post-partum, is another reason to see us!

-          Prolapse, weak PFM and poor neuromuscular control of PFM can all cause this annoying symptom.

6.      Scar sensitivity

-          A sensitive scar can be the cause of painful intercourse, can limit your ability to perform a kegel and/or can cause tension in pelvic floor muscles leaving you with pain.

We, at Duffy &Bracken PT, have the skill set and tools to help you feel like yourself again. We use biofeedback equipment to measure pelvic floor muscle strength, manual skills to treat pain and our skill and experience to teach and encourage you along the way. Let’s not forget what our bodies went through over the last nine months! We need to take care of ourselves and be proactive about our health and wellness; after all we are now responsible for a little one. See you soon!



Candice Amat, PT, DPT