Pelvic organ prolapse is a condition in which the support mechanism of organs in the pelvis start to fail, slip out of place and fall downward. This usually occurs due to overstretching of the supportive structures like pelvic floor muscles that become weak or overstretched. The bladder, urethra, uterus and rectum are structures most affected. The prolapse typically occurs from overstraining with childbirth or chronic constipation. Pelvic surgery like a hysterectomy can also change organ support.
Surgery can be indicated if the prolapse is severe enough but conservative treatment can include physical therapy to help increase strength of the pelvic floor and other pelvic muscles to reduce pressure/pain. At Rebalance Physical Therapy, our treatment for prolapse consists of a holistic approach beyond strengthening pelvic floor muscles. We differ from traditional therapy treatments by looking at the whole body to identify contributing dysfunctions with individualized evaluation and treatment. We use the Integrated Systems Model (ISM) for Pain & Disability (Lee & Lee, 2007) as framework for treatment to interpret the unique picture of each individual patient. The goal of the ISM approach is to facilitate better strategies for posture and functional movement to eliminate the prolapse symptoms.
An underlying postural dysfunction often accompanies prolapse. The consequent muscular gripping patterns that accompany it cause greater intra-abdominal pressure on the pelvic organs. This pressure causes falling of the organs in the pelvic cavity increasing strain on the support structures. Because all areas of the body are linking and interacting with each other during total body function, by treating the underlying postural and movement dysfunctions, the prolapse can be better reasoned, explained and treated appropriately.