Do I Need Physical Therapy for Pelvic Organ Prolapse?

Physical therapy can offer long-term relief from your pelvic organ prolapse symptoms by strengthening core muscles. These exercises are used in addition to Kegels to strengthen muscles on your pelvic floor. Together, they can help improve the symptoms of mild to moderate prolapse.

You may need physical therapy (PT) for pelvic organ prolapse if you:

  • Can see or feel a bulge coming through your vagina
  • Have urine leaking from your bladder or have a hard time peeing or pooping
  • Feel different during sex
  • Don’t feel quite right as you go through your daily routines

Your OB-GYN will examine you. She’ll ask about your symptoms and how much they bother you. If she recommends PT, she can also help you find a physical therapist who specializes in exercises for pelvic organ prolapse.

How Does It Work?

Physical therapy for pelvic organ prolapse involves special exercises for the abdominal muscles (“abs”) and lower back. These make up what doctors call your “core.” Your physical therapist will teach you the exercises and breathing techniques. You’ll also learn about proper posture.

Exercises to work the core include things like side planks. To do them, lie on your right side so that your head and feet are in a straight line. Your elbow should be directly under your shoulder. Using your ab muscles, gently lift your hips off the floor, keeping your hips and spine straight. Repeat two to three times, then shift sides.

Typical ab workouts such as crunches or sit-ups may make your symptoms worse by putting more pressure on the pelvic floor.

In addition to the exercises, your physical therapist may teach you how to move through your typical day without making your prolapse worse.

Physical therapy is most effective for minor pelvic organ prolapse. Your doctor will likely recommend surgery if your prolapse is more severe.

Do I Still Need Medical Treatment?

You can also do PT if you use a pessary. That’s a plastic device that’s inserted into your vagina like a diaphragm. It provides support for vaginal or uterine prolapse.

In addition to exercises, your PT may use pelvic floor electrical stimulation.

Continued

Percutaneous tibial nerve stimulation (PTNS) delivers an electrical impulse to your ankle. The impulse travels up a nerve in your leg to the nerves that control your bladder. If you get PTNS, you’ll probably start with a 30-minute treatment at the physical therapist’s office during 12 weekly visits.

Your therapist may also recommend you lose weight or seek treatment for things like ongoing (chronic) constipation or a cough that won’t go away. Both of these things strain your pelvic floor muscles.

How Will I Know if It’s Working?

The goal of PT is to reduce your symptoms and stop your prolapse from getting worse. You’ll know it’s working if your symptoms improve.

Even with physical therapy, your doctor will probably tell you to stay away from high-impact activities like running, jumping, or jumping jacks.

You’ll see a physical therapist until you’ve mastered the exercises and can do them the right way on your own. This generally takes about 6 weeks.

Afterward, you’ll need to keep doing the exercises to keep up the benefits. If you stop, the muscles will weaken and your symptoms could get worse.

WebMD Medical Reference Reviewed by Nivin Todd, MD on February 15, 2017

Sources

SOURCES:

Megan Schimpf, MD, University of Michigan.

Karyn Staples, PT, PhD, ProHealth Physical Therapy and Pilates Studio, Peachtree City, Georgia.

American Urogynecologic Society: “Physical Therapy” “Vaginal Devices – Pessary.”

National Association for Continence: “Pelvic Organ Prolapse.”

Mayo Clinic: “Pelvic Organ Prolapse.”

Cleveland Clinic: “What to Do About Dropped Bladder?”

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