Prolapse: 3 Ways To Heal Beyond Kegels

Are you newly postpartum and have been diagnosed with prolapse?

Have you heard of the term pelvic organ prolapse but want to understand it better?

There is so much information on the internet nowadays and often times it can be confusing or inaccurate.

There are many claims that there are “right” things to do and “wrong” things to do when it comes to prolapse. The reality is that there is much more nuance and individualization that needs to applied to this diagnosis.

Prolapse, in its most simple definition, is when an organ housed in the pelvic bowl (bladder, uterus, rectum) begins to descend downward from its normal resting place.

This is most commonly seen during and after pregnancy, but can also be seen in folks over time who have poor pressure management (breath holding patterns), chronic constipation, heavy weight lifting, or hyper mobility in their history.

Prolapse has been over-simplified as “organs falling out” and that “your pelvic floor is too weak”. This is not the full story.

A more accurate way to think of prolapse is like a ship on water with ropes holding it to a dock. The ship in this metaphor is the organ, the water is the pelvic floor, and the ropes are the ligaments that hold the organ in place. The water (pelvic floor) plays an important role in keeping the ship (organs) up, but the ropes (ligaments) play a very important role of keeping it in place as well. 

This is why doing 100 keels for prolapse will never be enough. If the tensile strength of the ligaments and the pressure above the organs is not managed, prolapse will persist.

Prolapse at its core is not a weakness problem it is a pressure management problem. 

Aspects such as posture, core coordination, and breathing patterns can have just a much, if not a stronger, effect on prolapse and the potential recovery.

Here are 3 ways, beyond kegels, to begin managing your prolapse:

ONE: Consider Using an Estrogen Cream

If you are newly postpartum and currently breastfeeding/chest-feeding, or if your estrogen levels are known to be low, you may want to talk to your MD about a topical estrogen cream. Estrogen levels remain decreased during breastfeeding/chest-feeding and this directly affects the ligaments that hold the pelvic organs up by keeping them a little more relaxed. While you wait to wean when it is right for you, using a topical cream directly in the area can promote healthier local tissue and ligaments that may decrease laxity and decrease uncomfortable sensations associated with prolapse.

TWO: Manage Your Constipation

Because prolapse is primarily a pressure management issue, if you have bowel movements that are hard to eliminate, this will contribute to pressure downwards. 

Consider how much fiber you are getting in your diet as well as water. If you stools are hard and dry they will be difficult to eliminate. You may consider adding psycilium husk to your diet as this is a natural and sustainable way to promote better BMs.

Consider purchasing a squatty potty so that you can have ideal biomechanics when eliminating.

Avoid holding your breath when bearing down to have a bowel movement. If you feel this is difficult to do or you are not sure how to coordinate this, pelvic floor physical therapy can help train you.

THREE: Decrease Pelvic Floor Tightness 

Since the assumption with prolapse is a weak pelvic floor, many people are now walking around with a pelvic floor that is too tight and over-recruited. This can actually make prolapse worse because of a concept called biotensegrity.

To understand this, grab a piece of clothing you are currently wearing and pull on it from a corner. You will see how some parts of the fabric get tight and other parts actually look more slackened. The tension of the fabric is no longer evenly distributed. This is essentially what can happen in your pelvic floor at the fascia when certain areas are held more tightly than others. The uneven tension creates laxity somewhere else, which can result in a worsening of the prolapse.

Internal pelvic floor work can be helpful in targeting the specific areas that are held and helping them to soften. This in combination with very specific coordination training at the pelvic floor can ensure that pressure is more evenly distributed and can reduce symptoms of prolapse.

At the end of the day, prolapse is more common than what our culture would have us believe. Many people are walking around with low grade prolapse and have no symptoms at all. It is only when it starts to become symptomatic or interfere with your function that true intervention is needed. 

Prolapse does not mean you are damaged. 

Prolapse does not mean you need surgery. 

Prolapse can reduce with the appropriate treatment. 

There is hope for management with the right approach.

At Bodyful, we will teach you more than just kegels.

Book now to learn more about our methodology and get the care you deserve.