A prolapsed organ of the pelvis (bladder, uterus, rectum) is one which has fallen too low within its cavity. Sometimes this situation is totally benign, where the patient has no symptoms and the doctor has no concerns. However, sometimes the change in position of the organ changes its ability to function optimally or your ability to function optimally. A person may experience urinary or bowel frequency, urgency, or conversely, may have difficulty eliminating. An organ moving into an area which was a space (like the vaginal cavity) may make sex difficult as if ‘something is in the way.’ For some, sitting is uncomfortable and for others, exercise increases the sense of ‘something falling out,’ so women decrease the amount of exercise they do. Unfortunately, this structural problem is often associated with a strong emotional response, so effectively addressing prolapse should consider the emotional effects as well as the physical.
At Radiant Physical Therapy, we’ll work together to optimize the position and support for the pelvic organs.
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I may use hands-on techniques to remove any barriers which may be pulling down on the organs or any structures that are hindering the upward lift needed to counter the prolapse. For example, there is a ligament called the round ligament of the uterus which goes from the uterus into the labia. If it is short on one side, the ligament may be ineffective in helping the uterus stay in its preferred position. So we’ll even out the tension on the ligaments with the intent to restore organ position.
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We assess alignment of many areas which affect the pelvic organs;- of course, the pelvis, the hips, the ribcage relative to the pelvis, the sacrum, the tailbone, and the feet to name a few. If any one of these areas is not in alignment, it may affect the forces contributing to the strains placed on the organs. Usually, we can create a harmony within the alignment to maximize the potential of each structure to hold its own and to contribute to the coordinated effort of the whole body.
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Posture affects the health and position of the organs. Poor posture contributes to increased downward pressures and forces; a prolapsed organ already has too much downward forces acting upon it, which is why it is too low. Sitting up tall has more upward forces which counter the downward force of gravity acting upon the organs. Also, there is an optimal length in which the muscles and the ligaments of the body work best to create support; good posture allows that optimal length tension relationship to occur, where poor posture does not.
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The alignment may be okay and a person looks like she is sitting up straight, but with movements and strong forces, the muscles do not respond appropriately. For example, place your hand on your abdomen and cough or sneeze…what happens to the abdomen? Does it push into your hand or draw inward away from your hand? If it pushes into your hand, there are too many outward forces into your abdomen and pelvis, which will probably make the prolapse worse. If however, the abdominal muscles move in and up when you cough or sneeze, you will have a more effective cough or sneeze to get rid of the bad stuff AND you will protect your pelvis from the excessive downward and outward forces noted above. So I teach you how to coordinate the core muscles with exhalations (especially strong exhalations like coughing, sneezing, laughing) and coordinate the muscles with movement (like going up steps, lifting, exercising).