Pelvic Organ Prolapse (POP)

pelvic floor prolapsePelvic Organ Prolapse is usually caused by damage to the tissues (muscles, ligaments, and connective tissue) that support the pelvic organs. Damage or stretching of these tissues allows the organs to move out of their normal positions. This causes them to press and/or move against  the inside walls of the vagina.

According to her recent article printed in the Globe and Mail, Pelvic floor physiotherapist Julia Di Paolo of PhysioExcellence in Toronto has seen a consistent increase in prolapse and believes it is caused in large part by our increasingly sedentary lifestyles, the rise of challenging exercise programs such as CrossFit and boot camps, and the lack of awareness about core exercise in pregnancy and postpartum recovery.  “Crunches are a part of every ‘hard-core’ exercise program out there and are often one of the first exercises a new mom will choose in an attempt to get her body back,” Di Paolo says. “New moms, and most people who sit for a living – which is most of us – do not have the core strength or stability to withstand the demands of most mainstream fitness programs and they end up in my office with a condition that will dramatically affect their quality of life and which activities they can do.”

Wonder if you may have prolapse? Here is a simple questionnaire from Marianne Ryan, PT that will help you find out. 

You can also get a sneak preview of her upcoming book Baby Bod®  (makes it easy to figure out whether your body has fully recovered from childbirth) by downloading a FREE section called “Why You Should NOT Do Sit Ups to Flatten Your Tummy” by clicking here.

According to an article from Kiera Brown at Fitness Republic, there are five types of POP including:

Cystocele: when the bladder herniates into the vaginal canal

Rectocele: when the rectum herniates into the rear of the vaginal wall

Uterine prolapse: when the uterus herniates into the vaginal canal

Enterocele: when the small intestine sitting behind the uterus prolapses

Vaginal vault prolapse: when the vaginal canal herniates into itself

Once a woman experiences one type of prolapse, another type often presents itself. There is rarely a single cause of pelvic organ prolapse. It is usually the result of a combination of things.

According to NHS Choices, the risk of developing pelvic organ prolapse can be increased by: 

  • Age: prolapse is more common as you get older 
  • Childbirth: particularly if you had a long or difficult labour or gave birth to multiple babies or a large baby 
  • Menopause: change that occur such as weakening of tissue and low levels of the hormone oestrogen 
  • Overweight: or obese, which creates extra pressure in the pelvic area 
  • Pelvic surgery: such as a hysterectomy or bladder repair 
  • Heavy Lifting: and manual work 
  • Long-Term Coughing: – for example, if you smoke or have a lung condition
  • Excessive Straining: when going to the toilet because of long-term constipation 

Activities to Avoid for Prolapse or a Weak Pelvic Floor

  • Lifting heavy objects, or children improperly (need to stabilize/breathe properly) 
  • Squatting deeply – lunges
  • Carrying heavy weights up steps or over your head
  • Straining to defecate (take stool softeners if you need to-it is important that you are not straining when having a bowel movement)
  • Kegels – Many women do not do Kegels correctly when they are asked to-and in fact,can actually do a motion that causes a worsening of prolapse! So until your therapist has taught you how to activate your pelvic floor – doing Kegels is probably not a good idea.

Studies have shown that physical therapy treatment can reduce or resolve POP for some women. So finding the right physical therapy program can help prevent surgery. Consider going to a physical therapist who specializes in women’s health and has advanced training in pelvic physical therapy. 

Suspect you may have Pelvic Organ Prolapse? This article by Mary O’Dwyer may help you figure it out.

This is a great video on prolapse as well from Methodist Health System.

This article from Michelle Kenway will discuss some safer exercises for those suffering with prolapse.

These 10 principles, also from Michelle Kenway are designed to help you safely strengthen your body AND protect your pelvic prolapse as you do so: