Does Pelvic Floor Physical Therapy Actually Heal Prolapse?!

Prolapse and pelvic floor weakness: This is something I have been marinating over and I think it deserves some conversation. . . .so here goes:

Unicorn goal: prolapse completely heals, everything goes back to the way it was and you have zero symptoms. Right? After two babies, that is my ideal too! (as I pull my jeans up over my mom pooch- har har)

Maybe a more realistic prolapse goal is: no symptoms with a return to function and fitness (patient determined level). So if you are asymptomatic and fulfilling all of your life duties (work, home, carpool, etc), you are able to exercise in a satisfactory way, sex is good, control and passage of urine and feces all good...then I say rehab has achieved its goal. That is a tough pill to swallow for some . . .

I do think this may come with some form of continued prolapse of your organs. However, you have been able to restore the forces and structures that support the pelvic organs in a way that has rebalanced the system and no longer triggers your symptoms or reduces your function.

The body is incredibly adaptable, and this new balance may be achieved through pelvic floor stabilization, better breathing patterns, motor recruitment patterns, and posture. Likely this balance will change the position of the prolapse to a more elevated position, but does it go back to zero in everyone who eliminates symptoms? We would need some studies for sure, but I think it is reasonable to think that no, not everyone goes back to baseline. 

Prolapse is tricky in that, for a lot of women it is really scary. Hearing the grade/ severity of your prolapse may change your perception of how bad it actually feels. Note: I am not saying you are crazy or that this feeling is in your head- but the brain is a sneaky player! Most women I see for prolapse are terrified it won’t get better and that they will have to live with this for the rest of their life- rest assured- not the case!

Together, we consider the demand on your system- everybody bodies are different and we all live our lives differently. Your activity or fitness level, may be low impact, you may have lots of time to maintain your physical balance, finances to have a maid instead of having to deep clean the tile in the bathroom yourself, or your kids are old enough to no longer need to be carried.

You may be someone who has low demand on the system. So your brain/system may be able to tolerate a prolapse at a level 2. Contrast this with a young mom with three little ones, no maids, no sleep, no time, and the desire to run a marathon....that’s a different demand on the system.

So my job is is to train the system to meet each individual’s functional demand and help you get back to doing what you want to do!