Pelvic Pressure or Heaviness? What it Means and When to See a Pelvic Floor PT

If you experience a sense of heaviness, pressure or feel like ‘something is falling out’ of your pelvis, you may be experiencing pelvic organ prolapse. These symptoms can be common during pregnancy, postpartum and/or perimenopause but they are not something you have to just live with!

At Harbor Strength Physical Therapy, we work with individuals experiencing pelvic organ prolapse and help them return to exercise and daily life without symptoms. 

What is Prolapse?

Pelvic organ prolapse occurs when the pelvic floor muscles do not adequately support the internal organs (bladder, uterus, rectum). When this happens, one (or multiple) organs can descend into the vaginal canal causing that heaviness sensation. This is often due to a pressure management issue between our core muscles, our breathing muscle and our pelvic floor.

This commonly happens due to:

  • Pregnancy and childbirth (especially with prolonged pushing during labor)

  • Chronic straining (constipation or heavy lifting)

  • High impact exercise (running, jumping)

  • Hormonal changes during perimenopause and menopause

Because pelvic organ prolapse exists on a spectrum, early symptoms are very treatable. 

Common Symptoms to Pay Attention To

You may be experiencing some degree of prolapse if you experience any of the following symptoms:

  • Heaviness or increased pressure in the pelvis

  • Symptoms that get worse towards the end of the day

  • Symptoms that are aggravated by running or lifting heavy objects

  • A noticeable bulge at the vaginal opening 

How Pelvic Floor PT Helps

One of the biggest misconceptions around pelvic organ prolapse is that kegels will help symptoms. While prolapse is due to a lack of adequate support of the internal organs, it does not mean that strengthening the pelvic floor muscles is the answer to managing symptoms. Prolapse is often due to a combination of things including:

  • Lack of coordination between the pelvic floor and core

  • Poor breath control (holding breath or not bracing properly)

  • Decreased strength of the glute and hip muscles 

In some cases, doing kegels may actually worsen symptoms.

At Harbor Strength Physical Therapy, we take a whole body, individualized approach to treating prolapse. This can include:

  • Assessment of pelvic floor muscle strength, tension and endurance

  • Assessment of breathing mechanics

  • Core and pelvic floor coordination 

  • Education on symptom management 

  • Guided return to running/exercise

When to Seek Help

If you are experiencing any symptoms of pelvic organ prolapse- even if occasionally- we can help. Pelvic PT can help prevent the progression of prolapse and helps to improve symptoms. With the correct support, many women are able to return to running, strength training and impact activities without any symptoms. If you are in Natick, MA or the MetroWest area and experience symptoms, reach out today to get started! We can help you feel supported again. 

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