What Prolapse Physical Therapy really Involves

“You know you don’t want surgery, but pelvic floor therapy is new and sounds scary.”

You don’t know what to expect.

You think:

“Is it like a Well Woman Exam?”

“Are there speculums?”

“Are there stirrups?”

“Do I have to wear the paper gown?”

“Will it hurt? That makes me nervous since I already have pain down there.”

“How long are the appointments? Are they longer than 15 minutes?”

“Will I even get to share my story?”

“Will I be told ‘it’s all in my head’ again?”

“Will I finally be listened to this time?”

“Will my voice and concerns be valued?”

“Is it worth it?”

“Am I the only one with this problem?”

“Am I too broken to get help?”

First, let me say, “I’m glad you’re here. You’re not alone. We will work through this together.”

What is Prolapse Physical Therapy?

Now, let’s chat about what to expect with pelvic organ prolapse physical therapy and what it really involves.

As a Pelvic Health Physical Therapist, I want to affirm that all your concerns are valid.

Pelvic floor PT is different from any other type of OBGYN exam and different from any other type of physical therapy appointment. There are similarities to both, but also some major and important differences. We are similar to OBGYN exams because we are able to examine the external pelvis and internal pelvic structures.

But here's how we are different: We intentionally create a welcoming, safe environment for you that doesn’t include stirrups, speculums, or paper gowns. We are mindful about draping and only reveal areas needed at that point in the exam, with consent. Pillows, extra blankets, soft music, warmers, fans, essential oils are all available to ensure comfort.

Pelvic Health Therapists purposefully create this type of environment for two reasons:

You deserve this type of care—nothing less.
In order to gain an accurate picture of your pelvic floor, we need to examine it in your natural state. If you’re nervous or overwhelmed, your pelvic floor muscles may be too tense to complete a full, accurate exam.

Is Prolapse Physical Therapy Painful or Uncomfortable?

From the start, your pelvic floor therapist will explain the full assessment using a pelvic model before you undress. This is to ensure you’re comfortable with this examination. If you aren’t ready for an internal assessment, there are external-only options available.

However, if you are needing prolapse rehab, then I highly recommend an internal pelvic exam to determine an accurate picture of the type and stage of prolapse and pelvic floor strength, so we can create a specific plan for you to reach your goals.

What Happens during an Internal Pelvic Floor Physical Therapy Session?

All internal pelvic exams are performed by the therapist with:

Gloved hands
You may notice your therapist changing gloves often throughout the exam. This ensures sanitary conditions and minimizes any risk of infection.
Lubrication is provided for all internal insertions.
ALL lubricants used are water-based, fragrance-free to avoid any skin irritation.
With your consent, one gloved finger is slowly inserted into the vaginal canal with varying amounts of pressure and depth.
This allows the therapist to develop an understanding of your prolapse, assess the pelvic floor muscles at the entrance and deeper in the canal, as well as compare the right and left side of your pelvis.
At any time, if you need to pause or stop, or if part of the exam is painful, communicate this to your therapist so adjustments can be made.

You are in control of your body and in control of the session.

Is Prolapse Physical Therapy more than Internal Exams?

You Will Be Heard

Typically, sessions are 60 minute sessions! And yes, we use the full hour to hear your full story, address all concerns, and explain what to expect in our sessions. We want to know everything: where you are at now, what happened in the past that may be relevant, and what you would like to return to.

Nothing is TMI! Many women give up certain activities or exercises simply because they don’t have the tools to perform them successfully. We want to provide you with those tools.

It’s Not Just Internal Exams

The pelvic floor is one part of the body and works together with all the other parts. To identify root causes for lasting changes, the whole system needs to be evaluated.

Similar to physical therapy appointments, we are able to treat the rest of your body with a thorough movement screen and personalized exercise prescription.

We perform manual therapy techniques to address myofascial restrictions, joint restrictions, muscle retraining, muscle energy technique for alignment, dry needling, cupping, and more.

How Prolapse Therapy Helps You Return to Exercise and Daily Life

Unsure if you’re doing your exercises correctly?

Your therapist will stay with you the entire session. The purpose of therapeutic exercise is to retrain the proper muscles. If you’re compensating with other muscles, then the exercise won’t be as effective.

Your Pelvic Health Physical Therapist Will:

Observe you perform the movement to avoid muscle compensations
Teach proper body mechanics and breathing techniques
Monitor for prolapse symptoms such as heaviness or bulging, to ensure confidence in your exercise plan

You can expect improvements in your understanding of what is happening with your body, a personalized plan of care to reach your specific goals, and confidence that your prolapse will no longer define you.

Who is a Good Candidate for Prolapse Physical Therapy?

If you're experiencing any of the symptoms of prolapse or if you're just curious whether or not you have a prolapse, reach out to our clinic today: Contact Us Here

If you'd like to read more about the symptoms or prolapse or non-surgical options of prolapse, read more in our other blogs!