Understanding Pelvic Organ Prolapse

A Pelvic PT’s Perspective

Pelvic organ prolapse (POP) is incredibly common, yet many women feel confused, alarmed, or even ashamed when they first notice symptoms. As a pelvic floor physical therapist, I see prolapse not as a failure of the body—but as a signal that your pelvic support system needs care, strengthening, and guidance.

What Is Pelvic Organ Prolapse?

POP occurs when one or more pelvic organs (bladder, uterus, or rectum) descend lower into the vaginal canal due to weakened or overstretched pelvic floor muscles and connective tissues.
It may present as:

• A heavy, dragging, or bulging sensation in the vagina

• Pressure that worsens with standing, lifting, or long days

• Difficulty emptying the bladder or bowels

• Low back or pelvic pressure

• Feeling “something is falling out”

Prolapse is especially common postpartum, during peri-menopause, and after years of chronic pressure (straining, high-impact exercise, heavy lifting, or unmanaged constipation).

Why Prolapse Happens

Your pelvic floor acts like a supportive hammock for the pelvic organs. During childbirth, hormonal changes, pushing, perineal trauma, and changes in abdominal pressure can weaken this system. Over time, habits such as breath-holding, straining, or intense lifting without proper core control can also stretch these tissues.

But prolapse is not a personal failure—it’s a mechanical and muscular issue that can be improved with the right training and strategies.

How Pelvic PT Helps

Pelvic physical therapy is often the first-line, conservative treatment recommended for POP. Here’s how we approach it:

1. Pelvic Floor Strengthening (the right way)

We retrain the pelvic floor to lift, contract, and coordinate with everyday movements—coughing, lifting, bending, and exercise. This is more than “Kegels”; it’s about timing and support.

2. Pressure Management

Many women unknowingly bear down on the pelvic floor throughout the day. PT teaches:

• Effective breathing patterns

• How to avoid excessive intra-abdominal pressure

• How to use your deep core to support your pelvis

These changes alone can reduce prolapse symptoms significantly.

3. Posture & Whole-Body Mechanics

Your pelvic floor does not work alone. Hip strength, rib position, and even foot mechanics can influence prolapse. PT evaluates and optimizes your entire system.

4. Activity Modification (Not Restriction!)

You don’t stop living—you learn to adapt.
We show you how to safely lift weights, return to exercise, manage symptoms, and build confidence.

5. Manual Therapy

Scar tissue, muscle tension, or restrictions can contribute to pressure or bulging sensations. Soft tissue work helps improve mobility and comfort.

Can Prolapse Improve?

Yes—many women experience meaningful symptom reduction and improved support with targeted pelvic PT. Even if tissue position doesn’t fully reverse, function, comfort, and quality of life often improve dramatically.

What You Should Know

• POP is common, treatable, and nothing to be ashamed of.

• You don’t need to “wait until it gets worse.” Early care leads to better outcomes.

• Surgery is not the only option—and pelvic PT is recommended both before and after surgical repair.