If you’ve been diagnosed with pelvic organ prolapse (POP), you might be wondering if there’s an alternative to jumping straight into surgery. The encouraging news is that pelvic floor physical therapy (PT) can be a highly effective first-line approach for managing prolapse. Pelvic floor therapy is a conservative (non-surgical) treatment aimed at strengthening the muscles and tissues that support your pelvic organs. By addressing the root cause – weakness in the pelvic floor – physical therapy often significantly reduces prolapse symptoms and may even improve the prolapse’s severity.
Many women either aren’t aware of pelvic floor PT or feel unsure about what it involves. Here, we’ll explain why it’s worth considering, what to expect from therapy, and how it can make a real difference in your comfort and quality of life.
Why Consider Physical Therapy for Prolapse?
The idea behind pelvic floor PT is simple: strengthen and retrain the muscles that have weakened so they can better support your organs. Think of it like doing targeted workouts for the core of your body. When these pelvic muscles get stronger and more coordinated, they provide an internal “lift” that relieves that bulging sensation and pelvic pressure.
Research-backed benefits: Multiple studies show that pelvic floor muscle training (the core of PT for prolapse) leads to real improvements. One major review of 13 trials found that women who did pelvic floor exercises had greater improvement in their prolapse (often improving by one stage) compared to those who didn’t. Just as importantly, those women were several times more likely to report their prolapse symptoms got better – meaning less pressure and discomfort day-to-day. Because of outcomes like these, pelvic floor therapy is widely recommended as a first-line treatment for mild-to-moderate prolapse (source).
Another big plus is that physical therapy is low-risk and non-invasive. There’s no surgery or anesthesia – just exercises, education, and hands-on guidance. Even if your prolapse is more severe and might eventually need surgery, doing pelvic floor PT can help strengthen your support muscles in the meantime, which might make any future treatment easier. And if you use a pessary (a vaginal support device) for prolapse, PT can work alongside it – the pessary provides immediate support while therapy builds your long-term strength.
It’s important to have realistic expectations: therapy can manage and improve prolapse, but it might not eliminate it completely. Prolapse usually doesn’t vanish on its own without surgical repair. However, by strengthening your pelvic floor, you can often prevent it from getting worse and noticeably reduce the bulge and discomfort. Many women find that after pelvic PT, they’re far less bothered by prolapse – some even avoid surgery altogether, while others feel more prepared and stronger if surgery is needed later.
What Does Pelvic Floor Physical Therapy Involve?
Pelvic floor physical therapy is a specialized form of therapy provided by clinicians trained in pelvic health. It’s normal to feel a bit unsure about what to expect. Here’s a brief overview of what typically happens:
- Assessment and Education: On your first visit, the therapist will talk with you about your symptoms and may perform a gentle exam to assess your pelvic floor muscle strength and the prolapse. They’ll explain how your pelvic floor works and help you locate and activate the right muscles.
- Pelvic Floor Exercises (Kegels): The cornerstone of treatment is practicing targeted exercises to strengthen your pelvic floor. You’ll learn how to squeeze and lift those muscles, hold for a few seconds, then relax. The therapist ensures you do these Kegel exercises correctly – many people accidentally use the wrong muscles or hold their breath at first. Some therapists might use biofeedback or gentle electrical stimulation to help you if needed.
- Breathing and Daily Habits: You’ll also learn how to avoid straining your pelvic floor in day-to-day life. This includes learning to breathe out (exhale) when you lift or exert yourself, using proper lifting techniques, and addressing any habits that put pressure on your pelvis. It’s a very holistic approach – the goal is to strengthen your pelvic floor and also protect it during all your usual activities.
Pelvic floor PT programs typically involve regular appointments (for example, weekly or biweekly) over a few months. You’ll be encouraged to practice your exercises consistently between sessions. Many women start noticing some improvement in their symptoms after a few weeks, and significant improvement after a couple of months of diligent work. Remember, progress may be gradual, but each week of strengthening brings you one step closer to feeling better.
What Improvements Can You Expect?
So, what kind of results do women see from pelvic floor PT? In general, strengthening your pelvic floor can lead to:
- Less bulge and pressure: As your muscles firm up, they provide better support for your organs. Many women report that the “falling out” sensation diminishes or goes away during daily activities.
- Better bladder and bowel control: A stronger pelvic floor can help you stop urine leaks and improve your ability to fully empty your bladder. Bowel movements can also become easier with better support to the rectum.
- Greater confidence in daily life: You may feel more comfortable being active – whether it’s exercising, playing with your kids, or enjoying intimacy – without the constant worry about your prolapse.
Even if your prolapse isn’t completely cured, these improvements can make a world of difference in how you feel day to day. For mild to moderate prolapse (Stage I or II), pelvic floor PT is definitely worth trying before considering more invasive options. For more advanced prolapse, therapy can still be a valuable part of your treatment plan and can complement medical or surgical interventions.
If you think pelvic floor therapy might help you, talk to your healthcare provider or find a pelvic health physical therapist. You deserve relief and support – and pelvic floor PT is all about giving you the tools to strengthen your body from within. By taking an active role in your care, you’re doing something positive for your health and well-being.
In another post linked here, we’ll explore some self-care tips and simple exercises you can do on your own to help manage prolapse and support your pelvic floor every day.