Restore Your Core: Diastasis Recti and Pelvic Floor Talks

Before you begin your exercise routine, it is important that you have received medical clearance by your doctor to exercise, practice patience with yourself and your body, and rest, lots of rest! I recommend waiting at least 8 weeks before beginning any strenuous exercises. After your recovery, yoga can be a relaxing and beneficial way to begin introducing exercise back into your daily regimen.

Yoga can aid in healing your abdominal muscles, building pelvic floor and core strength, improve body and organ alignment, and your mental health. As you begin adding specific yoga poses back into your daily routine, you may begin experiencing relief from diastasis recti, pelvic floor issues, tight shoulders, chest, and hips, and help you feel more energized and relaxed while caring for your new child.

In this article we hope to address any questions or concerns you may have regarding postpartum exercise.

How Soon After Giving Birth Can I Do Yoga?

We recommend taking your time to heal and bond with your baby before you start exercising. So often women struggle with feeling a need to get back into their normal regimen and daily activities without allowing proper time for rest and recovery. This can be especially true of postpartum people who experienced no pregnancy complications or delivered naturally. As stated above, allowing 8 weeks or so to begin yoga practice is important for your health and overall well-being.

Postpartum Yoga After Normal Delivery

If you had a normal delivery, you may begin feeling like yourself much sooner than other women who experienced either a c-section or complications during their delivery. However, it is still important to rest and to begin gradually introducing yoga poses into your daily routine. Make sure that you feel comfortable during your exercises and if you experience any pain or discomfort, to wait a few more days to a week before returning to your yoga practice.

When Can You Do Yoga After C-Section?

If you delivered via c-section, it may take longer for you to begin feeling yourself again. That’s okay! You experienced a lot of trauma and pain during your delivery and it is important for you to rest. We especially recommend a 5-5-5 step program during the first few weeks of your recovery – 5 days of rest, 5 days within reach of your bed, and 5 days within a short distance from your bed. Talk with your doctor before beginning any exercises or yoga poses that may affect your abdominal muscles and belly.

Can Yoga Help You Lose Weight After Pregnancy?

Although losing weight should never be the top priority in returning to yoga postpartum, yoga can help you lose some of the baby weight you’ve gained during your pregnancy. There are many other benefits to contributing yoga into your postpartum regimen:

Body knowledge: Yoga can help you become familiar with vital parts of your body as you begin the restoration process.

Body / Posture Alignment: Your body has undergone a lot of physical stress during your pregnancy and after your delivery. Many women experience shoulder, neck, bain, back, and hip pain due to delivering, carrying, and breastfeeding their child. It is also common for your organs to be displaced during your delivery. Yoga can help restore your body’s alignment and help loosen those tight muscles in your shoulders and chest!

Mental Health: Participating in a postpartum yoga program can help you get to know other people, participate in relaxing and calming practices, and reduce stress and postpartum depression.

What is Postnatal Yoga?

Postpartum yoga is a one postpartum practice you can start a few weeks after your delivery. Not only can yoga help relieve symptoms of diastasis recti and a weakened pelvic floor, but it can also be a great way to relax and gradually regain your strength during your recovery. Below we have compiled a few yoga poses we believe are beneficial in your early recovery.

Postpartum physical therapy can be a great way to restore function and strength in your core and pelvic floor muscles. Giving birth places a strain on your body and it is no surprise that many postpartum people experience pelvic pain and discomfort for weeks to months after delivery. Even after the typical 8 week recovery time, many women may require more time or a pelvic floor workout plan to help get them back on their feet, especially women who delivered via C-section.

Although you may never look how you did before your pregnancy, physical therapy post pregnancy can help relieve symptoms of pelvic organ prolapse, diastasis recti, and other postpartum symptoms.

Physical Therapy After Pregnancy

Physical therapy for pregnancy and after pregnancy can help strengthen and restore pelvic floor muscle and joint function, increase body awareness, and also provide education and instruction on how to modify your daily activities to serve you in your recovery. Some of the primary physical therapy options available include:

• Pelvic girdle and lumbar spine realignment
• Prenatal tissue and joint mobilization
• Postpartum external and internal tissue, joint, scar, and visceral movement therapy
• Strength training for pelvic floor muscles
• Pelvic floor stabilization and core strength exercises
• Proper posture, postural strengthening for back pain
• Diastasis recti rehabilitation
• Body mechanics training and education
• At home strategies and education for self-care

How Do You Know if You Need Pelvic Floor Therapy?

The two most common conditions many postpartum people face are diastasis recti and pelvic organ prolapse. Pregnancy and delivery create an imbalance of muscles and ligament tension. This can leave the pelvic floor and abdominals unsupported potentially leading to prolapse or DRA. If you are experiencing any of these symptoms, you may need to consider physical therapy or movement therapy:

• Constipation
• Urinary incontinence
• Fecal incontinence
• Pain during intercourse
• Vaginal pain
• Rectal pain
• Low back pain
• Pelvic pain
• Diastasis Recti – separation of the abdominal muscles
• Pelvic organ prolapse
• Pubic bone pain
• Pelvic girdle pain

A physical therapist can help you recover from many of these symptoms with the education and therapy options mentioned above. If your physical therapist is specially trained to treat pelvic floor issues, they can help significantly reduce the painful symptoms you may be experiencing while also strengthening your core and pelvic floor muscles.

What Helps with Postpartum Pain?

Physical therapy can be a great way to help women recover from postpartum issues. However, not all exercise routines or core training workouts are created equal. Restoring your body’s function is not something to do quickly or forcefully. Exercise is important, but resting and pacing yourself are far more vital to your recovery than rushing it. Postpartum recovery requires a specific re-training of your body to regain strength and integrity. Long-term functionality is better than getting slim fast.

Exercise

As you begin to exercise postpartum, it is important that your focus be on the major muscle groups affected by your delivery. Short spurts of slow, simple stretches and yoga poses are a great place to begin. Shoot for around 10 to 20 minutes a day of light exercise and stretching. Many exercises can be done during your recovery, but it’s important that you don’t overexert yourself before the 8 week mark is up (and for some women, even longer). As you continue to regain strength and functionality, you can gradually increase your workout time and intensity.

Rest

If I could have a dollar for every person who wished they had rested more in order to spare themselves injury. Rest is so important for healing your body postpartum and ensuring that you do not damage your core and your pelvic floor. We recommend getting back into exercise at least 8 weeks postpartum, but even then, easing into it is key.

Post-pregnancy pain, whether it be pelvic floor pain or joint pain, is a shared experience among many postpartum people. However, postpartum pain, especially in pelvic pain, can vary in frequency, length, and intensity. Some people may only experience short-term pain that lasts the first 4 – 8 weeks of their recovery and others may suffer from pelvic pain for up to or over a year after they’ve given birth.

Pelvic organ prolapse and other forms of pelvic floor dysfunction are very common among postpartum people. Symptoms can vary in duration and severity, but many women are likely to experience a variety of symptoms during and after their pregnancy. At Restore Your Core, we’ve noticed similarities in many of our client’s stories. Some of the most common pelvic floor complications our clients experience include:

• Urinary incontinence
• Fecal incontinence
• Pain during intercourse
• Vaginal pain
• Rectal pain
• Low back pain
• Pelvic pain
• Diastasis Recti – separation of the abdominal muscles
• Pelvic organ prolapse
• Pubic bone pain
• Pelvic girdle pain

Pelvic floor pain can be treated and relieved in many ways. Whether you visit a pelvic floor physical therapist or take part in a program like Restore Your Core, movement specialist or your physical therapists will utilize exercise methods designed to strengthen and restore function to your core, pelvic floor muscles, and relieve any painful symptoms you may be experiencing.

In this article I will attempt to address the most commonly asked questions regarding pelvic pain after giving birth.

How Long Does it Take for Your Pelvic Floor to Recover After Childbirth?

After giving birth, your pelvic floor and core muscles will be in the process of healing for at least a year. Although many women may begin being active again after the first 8 weeks postpartum, often pelvic pain and the symptoms of diastasis recti may be experienced for months postpartum. Both your core and your pelvic region have gone through significant changes in order to accommodate your baby. Attempting to quickly get back into an exercise or workout routine may be unhelpful in your recovery – especially if you are already experiencing complications or painful symptoms.

Every postpartum person is different and the recovery length can change depending on many factors. Healing can take anywhere from a few months to over a year, depending on whether or not there are underlying conditions which may be increasing the pain. While there are no overnight success stories, there are many many success stories of people like you who have healed their pelvic organ prolapse by taking these steps slowly and surely.

However, there are many things you can begin doing now to help begin the healing process. Here is a video summary covering some of the steps you can take to begin healing your pelvic floor.

Is it Normal for Your Pelvis to Hurt After Pregnancy?

Yes! Postpartum pelvic pain is very common. During childbirth, your ligaments and joints become loose as your body is adapting to your child’s weight, abdominal separation, and increased heaviness in your pelvic floor. It is common to experience pain in your pelvic girdle, hips, and joints as a result. Light recovery exercises and movement can also cause minimal pain as you begin strengthening your pelvic floor muscles. Seeing a pelvic floor physical therapist or enrolling in a yoga or postpartum exercise program can help relieve urinary incontinence, back pain, and other postpartum pelvic issues.

Giving birth takes a toll on your body – both physically and emotionally. Many postpartum people will feel overwhelmed and exhausted after giving birth, which can make it difficult to return to a daily regimen. Other people, especially those who had a regular workout plan before and during their pregnancy, may attempt to get back to their fitness regimen before they are ready. It is important to have a postpartum workout plan, but how do you know when it is the right time to begin?

In this article I hope to answer your most pressing questions regarding postpartum exercise and when to begin.

How Soon Can You Exercise After Giving Birth?

Before you begin a strenuous exercise routine, it is important that you have clearance from your medical provider to begin exercising. This is especially true if you have had a c-section or had a complicated pregnancy or birth. In most cases, people who had a vaginal delivery can begin light physical activities a few weeks post pregnancy. Yet, you should only begin exercising as you are able.

During your 8 week postpartum check up, your doctor will most-likely recommend beginning returning to your normal pre-pregnancy routine. This can include light exercise and beginning to develop a workout plan for the months ahead. It is important that during this time you take it slow. Focusing more on spending time with your baby, your mental health, and making gradual steps toward recovery are more important than trying to lose weight fast or regaining that sexy, pre-pregnancy body.

Over the first 8 weeks or more, you may gradually integrate workouts as you regain strength in your core, upper and lower body, and neck. Ensuring that you make smart choices in your workout plan can help prevent overexertion, postpartum pain and bleeding, and help you reach a safer, sustained postpartum recovery.

It is true that 8 weeks or more can feel like a very long waiting period, but your overall health is more important than a slim body. However, making sure that the early stages of your recovery are done carefully can help you get back to a more intensive postpartum workout plan safer and sooner. Rest, hydration, and nutrition should be the focus in the early stages of your recovery.

When to Start Postpartum Workouts?

The appropriate time to begin postpartum workouts varies depending on your delivery experience. As mentioned above, many women who delivered their child without any complications or if they delivered vaginally, may begin with light exercise (i.e. walking, food prep, household activities) only a few weeks after their delivery. Women who delivered via c-section or experienced complicated birth, should wait until the 8 week mark, or talk with their medical provider before starting a fitness plan. I always recommend waiting at least 8 weeks, regardless of delivery method, in order to approach recovery well and safely.

What Are the Benefits of Exercising Postpartum?

Building a smart postpartum workout plan and returning to a consistent fitness routine may help many postpartum people close their diastasis recti gap, begin strengthening their pelvic floor, and help reduce baby weight. Some women may benefit by experiencing a sense of normalcy as they begin returning to their pre-pregnancy routine, others may benefit by having time dedicated to personal health and recovery – both with their bodily and mental health.

It is not uncommon for many postpartum people to experience complications such as pelvic organ prolapse postpartum. Vaginal and rectal prolapse occur when the supporting muscle and tissue structures become weakened during pregnancy and delivery. Despite common belief, prolapse does not only affect women who have had multiple pregnancies or are outside of the advised age, but it can also affect many postpartum people as well. It can be a surprising and shocking experience for many postpartums to discover they have developed a prolapse after vaginal birth. However, in some cases, the symptoms will resolve on their own as their body recovers from delivering their child or can be managed and healed through exercise and proper postpartum aftercare.

In this article I hope to address the ways postpartum people can manage prolapse after childbirth and how you may experience a full recovery.

How Common is Prolapse After Childbirth?

The truth is, your pelvic floor and uterine wall experience a lot of stress during your pregnancy. In many cases, people will begin experiencing the complications of prolapse and other pregnancy related issues before they deliver their child. A stressful or complicated delivery is not always the culprit for POP or DR. As your child continues to grow within you, the supporting tissues and muscle structures are strained, which can lead to you experiencing complications even before birth. However, it is common for many people to become aware of these issues postpartum. The weakness in the pelvic region can cause some of your pelvic organs (bladder, bowel, uterus) to slip out into the vaginal or rectal walls. Despite many people experiencing resolved symptoms as they continue to heal after their delivery, many may still experience future complications. Some of the most common types of pelvic organ prolapse include:

Uterine prolapse –uterine prolapse involves prolapse of the cervix and uterus down into the vagina

Bladder prolapse (cystocele) -involves a prolapsed bladder into the front wall of the vagina

Bowel prolapse (rectocele) is the prolapse of the vagina into the back wall of the vagina or rectum.

In some cases, these prolapses may coexist. Example: you may experience both a uterine prolapse and bladder prolapse at the same time.

Is it Normal to Have a Slight Prolapse After Giving Birth?

In short, it is not uncommon for people to experience a prolapse after giving birth. As you undergo the many hormonal changes, physical strain and stress, and the weight of your child can weaken the supportive tissues and muscles in your pelvic floor – causing the organs to shift and become misaligned.

Along with the hormonal and physical demands pregnancy can place on your body, a vaginal delivery can also contribute to pelvic prolapse as well. The stretching and straining of the pelvic muscles beyond their limits can significantly compromise the strength and functionality of the pelvic region. Over-stretching can leave scarring and nerve damage resulting in damaged tissues and muscle structures – leading to pelvic organ alignment issues and can cause them to shift downward into the vagina.

There are a host of factors that can contribute to various forms of pelvic organ prolapse. Some of the most common include:

• A traumatic delivery
• Baby’s birth weight
• Pelvic floor muscle weakness
• Chronic straining during bowel movements, constipation
• Chronic coughing
• Multiple pregnancies, deliveries

How is Postpartum Prolapse Treated?

• There are many options out there to help you recover from postpartum pelvic organ prolapse. It is important that after your delivery (once you’ve received clearance by your medical professional), to begin a form of postpartum rehab. Offerings can range between physical therapy, physiotherapy, or movement specialists (Restore Your Core). In many cases, you would treat this condition as you would any other physical injury: REST and light movement.

It is common for many women to experience postpartum complications like a prolapse. A prolapse happens when a part of your body (intestines or tissues) bulges or "falls out" into either the rectum or vagina due to weakened muscles structures and tissues. Prolapse doesn't only affect mothers outside of the advised childbearing age, but can also affect new moms as well. Many young mothers may be surprised or shocked to hear they developed a prolapse, but it is a very common postpartum condition, especially post-vaginal birth. Managing a prolapse - whether it be a vaginal prolapse, uterine prolapse, bladder prolapse, or other kind of pelvic organ prolapse - can add to the emotional and physical stress many new mothers may already be facing.

However, it is possible to heal from a prolapse and make a full recovery! In this article I hope to address postpartum prolapse and how you can experience a full recovery.

How Common is Prolapse After Childbirth

During the postpartum period, it is common to experience a pelvic organ prolapse. The tissues and muscle structures that support your pelvic floor may have been weakened over the course of your pregnancy and during delivery. The weakness in the pelvic region can cause some of your pelvic organs (bladder, bowel, uterus) to slip out into the vaginal or rectal walls. Yet, though it is common for women to experience a prolapse post-pregnancy/childbirth, pelvic floor therapy can help improve the condition. In many cases, the initial presentation of prolapse can resolve on its own as you continue to heal - yet, there can still be complications in the future. Some of the most common types of pelvic organ prolapse post-childbirth include:

Uterine prolapse –uterine prolapse involves prolapse of the cervix and uterus down into the vagina

Bladder prolapse (cystocele) -involves a prolapsed bladder into the front wall of the vagina

Bowel prolapse (rectocele) is the prolapse of the vagina into the back wall of the vagina or rectum.

In some cases, these prolapses may coexist. Example: you may experience both a uterine prolapse and bladder prolapse at the same time.

Prolapse After Delivery - Causes

Pregnancy is the most common contributor to the development of a prolapse. The hormonal changes, physical stress and strain, and the additional weight of your baby can soften the supportive tissues and muscles in your pelvic floor. This can cause your pelvic organs to shift and move from their normal alignment.

Along with the hormonal and physical demands pregnancy can place on your body, a vaginal delivery can also contribute to pelvic prolapse as well. The stretching and straining of the pelvic muscles beyond their limits can significantly compromise the strength and functionality of the pelvic region. Over-stretching can leave scarring and nerve damage resulting in damaged tissues and muscle structures - leading to pelvic organ alignment issues and can cause them to shift downward into the vagina.

There are a host of factors that can contribute to various forms of pelvic organ prolapse. Some of the most common include:

• A traumatic delivery
• Baby's birth weight
• Pelvic floor muscle weakness
• Chronic straining during bowel movements, constipation
• Chronic coughing
• Multiple pregnancies, deliveries

How Do You Fix a Prolapse After Giving Birth?

There are many options out there to help you recover from postpartum pelvic organ prolapse. It is important that after your delivery (once you've received clearance by your medical professional), to begin a form of postpartum rehab. Offerings can range between physical therapy, physiotherapy, or movement specialists (Restore Your Core). In many cases, you would treat this condition as you would any other physical injury: REST and light movement.

A uterine prolapse occurs when the pelvic floor becomes weakened and the surrounding tissues, muscles, and ligaments are unable to provide proper support to the uterus. This may lead to the uterus descending down or into the vagina. In more severe cases, the uterus may protrude out of the vaginal opening.

Although uncommon, some complications may arise if left untreated. An ulceration of exposed tissues or additional prolapses may occur: rectal or bladder.

However, there are many different treatment options available to you! In this article we address uterine prolapse and how you may find treatment without the need of surgery.

What is a Prolapse?

A prolapse or a pelvic organ prolapse, happens when 1 or more organs become displaced. They can either bulge into the vaginal canal or into the rectum. The most common forms of prolapse are uterine prolapse, bowel (rectal) prolapse, and bladder prolapse.

These conditions are not life threatening, but may cause painful or uncomfortable symptoms.

In many cases, we at RYC®, have noticed that these symptoms are often relieved and treated through corrective exercise and various lifestyle changes.

What is a Prolapsed Uterus?

Uterine prolapse is a particular kind of pelvic organ prolapse. Although it is more common during pregnancy and childbirth, a uterine prolapse can occur in women of any age and stage of life. Women who are postmenopausal or have had multiple deliveries may be at a higher risk of developing a uterine prolapse.

However, in many cases, surgical treatment is not required. A mild or minor prolapse may resolve through minor lifestyle, exercise, or diet changes. Some providers recommend surgery when prolapse causes pain or unbearable discomfort that interrupts your daily life.

Stages of Uterine Prolapse

A uterine prolapse is often categorized in two different ways: incomplete or complete.

An incomplete uterine prolapse is defined by a partial displacement of the uterus into the vagina, without protrusion.

A complete uterine prolapse is defined by a partial or full protrusion of the uterus out of the vaginal opening. A complete prolapse is then graded in severity, depending on how far the uterus has descended.

• 1st grade: when the cervix has descended into the upper vagina
• 2nd grade: the cervix has descended to the vaginal opening
• 3rd grade: the cervix has protruded outside of the introitus
• 4th grade: the uterus and cervix have both descended out of the vaginal opening

In many cases, exercise may be able to help. In severe cases there may be a need for medical treatment. If you have concerns, it is always best to consult a health professional for a diagnosis.

Symptoms of a Uterine Prolapse

There are many different symptoms that may arise depending on the severity. The most common symptoms of uterine prolapse include:

• a feeling of heaviness or pulling in the pelvic floor muscles
• increased vaginal discharge or bleeding
• painful or difficulty having sex
• urinary incontinence or urinary retention
• chronic constipation, bowel movement difficulty
• lumbar spine pain
• bulge or protrusion from the vaginal opening
• feeling or sensation of something falling from the vagina or like sitting on a ball
• weak vaginal tissue

What is Rectal Prolapse?

Rectal prolapse is another form of pelvic organ prolapse. Rectal prolapse occurs as a result of the rectum (the last part of the large intestine) being displaced or forced from its normal position. This can lead to the rectum descending or protruding out of the anus.

Rectal prolapse is often more common in older adults, more often in older women, who have experienced prolonged issues with constipation or pelvic floor issues. However, rectal prolapse can affect men and women in various stages of life. Although it is reported to be more common in women postmenopause, it can also occur in people much younger as well.

In this article we will address some of the most pressing questions regarding rectal prolapse and how it may be treated.

Types of Rectal Prolapse

As with other forms of prolapse, rectal prolapse is often a term that defines various stages of a herniated anus. The three types of rectal prolapse include:

• Stage 1: the rectum has become displaced, but does not protrude out of the anal cavity (also know as an internal prolapse)
• Stage 2: the rectal lining begins to descend into the anal cavity
• Stage 3: the rectum extends out of the anus entirely.

In many cases, people have found relief without the need of medical or surgical attention. However, in severe cases, medical attention may be necessary.

Causes of Rectal Prolapse

A rectal prolapse may occur due to various health conditions or as a result of aging. In some cases, it may be a result of complications during pregnancy or injuries to the pelvic or bowel region. Below are a few possible causes of rectal prolapse.

• Chronic constipation or diarrhea
• Prolonged or chronic history of straining during bowel movements
• Old age: as you grow older, it is common to experience a weakening of the rectal and anal muscles and ligaments. It is also common to experience similar weakening in the pelvic floor, which can create additional weakness in your core.
• Weakening of the anal sphincter
• Injury or past surgical procedures to or near the anal and pelvic regions
• Nerve damage: If the nerves that control your ability to contract the rectum or anus are damaged, rectal prolapse may occur. This can be due to complications during vaginal delivery, paralysis, a spinal injury, lumbar spine surgery, or other surgeries in the pelvic area.
• Other diseases, conditions and infections: There are many other possible causes for rectal prolapse. These can include health conditions such as diabetes, cystic fibrosis, parasitic infections, or other diseases. Or, it may be caused by other corrective surgical procedures, such as a hysterectomy.

Rectal Hernia Symptoms

The most common symptoms of rectal prolapse is the feeling of a bulge or ball extending out of the rectum. This can look like a reddish-colored mass extending outside of the anus, or, in the case of an internal prolapse, feel as if something is stuck in your rectum. These symptoms are often experienced during or after a bowel movement. In many cases, the symptoms will resolve quickly. However, if you have a moderate to severe rectal prolapse, over a prolonged period of time, you may experience the rectum protruding out of the anus at the end of the day. This is often spontaneous and may not require force or straining.

Other symptoms may include:

• Anal pain
• Rectal bleeding (may appear like a hemorrhoid)
• Fecal incontinence (mucus, blood, stool)

The symptoms you suffer may change depending on the severity and progression of your prolapse.

Diagnosis

A rectal prolapse requires a proper diagnosis in order to rule out conditions that may correlate. In order for you to receive a proper diagnosis, your doctor will have to perform a rectal exam. Your doctor may ask you to sit on a toilet and attempt to perform a bowel movement in order to see the prolapse.

The uterus is one of the most important support structures in the pelvic floor. It provides support for the vagina and can help prevent conditions like vaginal prolapse or bladder prolapse. A hysterectomy removes the uterus, thus, removing additional vaginal support. In 2008 and 2014, two studies were conducted to determine whether or not the risk of prolapse developing increased once the uterus was removed. Both studies concluded that the possibility of developing vaginal prolapse 1 to 2 years post surgery is greater than not having the procedure done at all.

The most common form of vaginal prolapse associated with a hysterectomy is called enterocele – the small intestine herniating down toward the vagina. However, depending on the type of hysterectomy and your recovery, there is a risk of developing various types of vaginal prolapse.

Prolapse After Hysterectomy Symptoms

Although a hysterectomy is often recommended as a way to treat uterine prolapse. However, even a surgical procedure that seeks to resolve one issue, may run the risk of presenting complications during or post recovery. Removing the uterus may put you at a higher risk pelvic organ prolapse. Below are a few symptoms you may experience if this is the case.

The Most Common Prolapse Symptoms

Oftentimes, when a person is suffering from a vaginal prolapse, they may experience a feeling or sensation of pressure or heaviness in the vaginal region. This may present as a throbbing pain or a slight discomfort. Some people also report:

• A sensation of fullness (like something is stuck, or like sitting on a ball)
• Feeling as if something is falling out of the vagina.

Other Possible Prolapse Symptoms

• Your pelvic organs are all supported by each other. If one is removed or if you are recovering from a previous prolapse, it may affect the ability for the other supporting organs to function properly. In some cases people report:
• Difficulty performing bowel movements
• Urinary incontinence, or retention (difficulty emptying the bladder)
• Secondary prolapses – especially rectocele and cystocele
• Pain, discomfort during sex
• Difficulty using tampons

Pelvic Organ Prolapse After Hysterectomy

After a vaginal hysterectomy, many women are at risk of prolapse developing. The pelvic organs may become unsupported and slip (such as the bladder or intestines) and descend or herniate into the vaginal region. If you are experiencing increased pelvic pressure after your hysterectomy, it may be best to consult your doctor for a proper diagnosis, as this may be a sign of prolapse.

It may be helpful to understand how this happens and why you may be at a higher risk of prolapse after having a hysterectomy. Each of the organs located in the pelvic region are all supported and attached to the pelvic wall by the same ligaments, muscles, and tissues. If the uterus and cervix are removed, support structures must be added in order to maintain the normal support that was previously there. This may actually leave the pelvic area less secure and more vulnerable to prolapse.

If prolapse does present post-hysterectomy, there are a few that are more prone to occur. These include:

• Vaginal vault prolapse: This occurs when the vaginal vault (the top portion of the vagina) descends into the lower part of the vagina. In very severe cases, the vagina may actually turn inside out and protrude outside of the person’s vaginal opening.
• Cystocele: Also known as bladder prolapse, this occurs when the supportive tissues between the vaginal wall and bladder are stretched or weakened, causing the bladder to descend into the vagina.
• Rectocele: Rectocele occurs when the tissues and muscles that separate the rectum from the vagina are compromised. This can cause a bulge in the back vaginal wall.
• Enterocele: This occurs when the small intestine herniates and drops into the pelvic cavity, pressing against the vagina. This may occur simultaneously with rectocele after a hysterectomy.

You did it. You birthed a bouncing baby and your body is in recovery from enduring the sheer awesomeness that is childbirth. As the months that follow unfold and that baby starts to grow, you can’t help but shake the feeling that something is not quite right down there. Why is peeing so weird now? When did my body decide it was okay to just leak out said pee every time I cough? Am I supposed to just wear panty liners all day every day just in case someone makes me laugh? Why does it feel like there is a bulge in my vagina?

Though it is a common post-birth issue, the first time you hear that you have pelvic organ prolapse may be frustrating and quite upsetting. I mean, your body was made to have babies. Why would something so natural cause such an issue?

Avoiding the S Word

Your doctor may suggest many treatment options to help prevent your prolapse from advancing to the point where they begin to start talking about surgery. Surgery is a SCARY word that we would like to help you avoid. Prolapse reconstruction surgery, or Vaginoplasty, may be recommended in advanced cases. However, if you aren’t severely prolapsed, there are steps you can take that may help you avoid surgery all together. Yes, early prolapse can be corrected without ever ending up under the knife. Even a grade 3.

Popular less invasive treatment offered can include vaginal pessaries and Kegels as the only form of pelvic floor treatment. Don’t hear me wrong, these can be very helpful, but I am more a fan of using a functional, whole body exercise approach to healing core and pelvic floor issues. Here at Restore your Core®, we are fellow partners of your health-focused team and are seriously invested in empowering you to make every movement throughout your everyday life healing. We believe and have seen first hand with many clients, that our 12-week program can train you to bring symptom relief and avoid the discussion of surgery altogether. No matter when you discover a prolapse, we always recommend 1 year of pelvic floor rehab before deciding on more drastic routes. 

Pelvic Organ Prolapse: What is it?

First things first, let’s make sure we are all speaking the same language here: pelvic organ prolapse is the injury in which one or more of your pelvic organs “drop” from their normal position. Though bladder prolapse is the most common, any pelvic organ (bladder, uterus, rectum) can make the descent. This injury happens for a variety of reasons and sometimes, it is really not known why. Birth injury, core and pelvic floor muscle imbalances, postural misalignments, and excess intra ab pressure are all reasons one might sustain a prolapse.

If pelvic organ prolapse is allowed to advance to its fullest potential, the prolapsed organ will make its way down the path of least resistance into the vaginal canal. Eventually, the organ may exit the vaginal opening.

Different types of Pelvic Organ Prolapse include:

• Bladder prolapse- Cystocele (the most common)
• Rectum prolapse- Rectocele
• Uterine Prolapse 
• Vaginal Vault Prolapse
• Small Intestine Prolapse- Enterocele

Though pelvic organ prolapse can be caused by obesity, aging, and other stressors on the floor muscles, vaginal birth is the leading cause of prolapse. As you can imagine, vaginal birth does a number on those pelvic floor muscles because of the amount of stretch the pelvic floor muscle must undergo to make way for the baby’s grand entrance into the world. This is why it is pretty common to pelvic floor prolapse after childbirth.