Pelvic Floor Physical Therapy for Prolapse
Pelvic floor physical therapy is a highly effective, non-invasive treatment for many women with pelvic organ prolapse. A pelvic floor therapist works on your pelvic floor muscles along with your breathing, posture, and core.
What is Pelvic Floor Physical Therapy?
Pelvic floor physical therapy uses techniques and exercises to:
- Strengthen and coordinate pelvic floor muscles
- Improve overall pelvic function
- Improve breathing patterns
- Correct and improve posture
- Increase mobility and flexibility
- Address any muscle imbalances or tensions in related areas
Your sessions are with a physical therapist trained in pelvic health.
What PT Includes
Kegel exercises help, and your therapist will also work on:
- Breathing techniques: How you breathe affects how your pelvic floor works.
- Posture correction: Your posture affects the positioning and functioning of your pelvic organs and pelvic floor.
- Mobility exercises: More flexibility in your hips, lower back, and abdomen can help your pelvic floor.
- Core strengthening: Your core and pelvic floor work together to support your organs.
- Relaxation techniques: You need to be able to fully relax your pelvic floor, too, not only tighten it.
Remember
You are in control during your PT sessions. Any “internal work” is optional and needs your explicit consent. PT can still help you a great deal if you choose not to have internal work done.
Benefits of Pelvic Floor PT for Prolapse
- Improves symptoms of prolapse
- May reduce the need for further prolapse treatment
- Improves overall pelvic health
- Can improve bladder and bowel control
- May improve sexual function
- Gives you an active role in your treatment
What to Expect in a Session
A typical pelvic floor physical therapy session may include:
- Assessment of your pelvic floor muscle strength and function
- Education about pelvic anatomy and proper muscle use
- Guided exercises for pelvic floor, core, and related muscle groups
- Instruction on proper breathing techniques and posture
- Biofeedback training to help you visualize and understand your muscle activity
- Manual therapy techniques to address any pelvic misalignments or tensions
You’re in charge during your sessions. If any part of the treatment makes you uncomfortable, tell your therapist, and they’ll change their approach.
Duration and Frequency of Treatment
How often you go and for how long depends on your needs. A typical course looks like this:
- Initial sessions once or twice a week
- Treatment duration of 6-12 weeks, sometimes longer
- Gradual reduction in session frequency as you progress
- A home exercise program to complement in-office sessions
Preparing for Your First Appointment
To get the most out of your pelvic floor physical therapy:
- Wear comfortable clothing that allows for easy movement
- Be prepared to discuss your symptoms and medical history in detail
- Don’t be embarrassed. Your therapist is trained to talk about pelvic health
- Bring any questions or concerns you have about the therapy process
- Remember that you can decline any part of the examination or treatment that makes you uncomfortable
Is Pelvic Floor PT Right for You?
Pelvic floor physical therapy is a good option for many women with prolapse. It’s especially helpful if:
- You have mild to moderate prolapse
- You want to avoid or delay surgical intervention
- You want a conservative treatment
- You’re motivated to do the work yourself
Physical therapy works best for mild to moderate prolapse and for relieving symptoms such as pelvic pressure or the feeling of something coming down. It strengthens and coordinates the muscles that support your pelvic organs, but it rarely moves the prolapse back into place, so it is often used alongside a pessary or before or after surgery when those are appropriate.
Ask your urogynecologist whether pelvic floor physical therapy makes sense for you.
PT works best when you do your exercises regularly, at your sessions and at home.
References
- Hagen S, Stark D, Glazener C, et al. Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. The Lancet. 2014. doi:10.1016/S0140-6736(13)61977-7
- Barber MD. Pelvic organ prolapse. BMJ. 2016. doi:10.1136/bmj.i3853
- Wallace SL, Miller LD, Mishra K. Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Current Opinion in Obstetrics and Gynecology. 2019. doi:10.1097/GCO.0000000000000584