Prolapse (Part 3): conservative management
Dr. Jessica Chastka, PT, DPT recently recorded a 3 part Youtube series of pelvic organ prolapse. This video is part 3! Click to listen, or continue on for a summary of “Prolapse: Common Myths & Misconceptions”. If you missed part 1 or part 2, start there and then finish up with part 3.
Today’s video is all about conservative management for prolapse. Conservative management means methods of managing symptoms that don’t include surgery. So what are a couple conservative options?
Pelvic floor physical therapy
Shocker, I know 😬
If you see a pelvic floor physical therapist for prolapse or associated symtpoms, your PT will start with an in depth conversation followed by a full body assessment. Your PT can look at the severity of your prolapse, tissue laxity and tone in the pelvic floor and abdominals, strength in the pelvic floor, abdomen, glutes and lower body, your balance, coordination… just to name a few. Pelvic floor PT is about SO much more than kegels.
If you need pelvic floor strengthening, it may include them. But it will also include managing bowel health, modifying exercise, discussing diet and fluid intake, your habits and holistic health. Besides education, PT can also include manual therapy or hands on work to help manage underlying tissue tension in the same areas listed above, helping your organs to find a more comfortable place in your abdomen. Additionally, PT can also help figure out what kind of fitness program suits your body where it is right now, and how to help guide you back to the activities you want to return to.
PT is personalized to your needs, your goals and your current tolerance to activity.
2. Pessaries
A pessary is a device that you insert vaginally that provides support to the pelvic organs. They can immediately reduce symptoms of heaviness, though not everyone finds a pessary comfortable and you may need to try a few different pessaries to find one that fits you. You must be fitted for this device so it can be sized specifically to you. This is typically done by an OBgyn or urogynecologist, although there are some classes coming out to enable physical therapists to do fittings as well!
Pessaries can also help improve bladder emptying and leakage, though this is less likely. Reducing your heaviness and managing your symptoms with a pessary can help reduce fear of movement and get people to feel more confident beginning some form of exercise program. While a pessary won’t heal the prolapse, managing heaviness symptoms can allow you to strengthen the surrounding muscles, return to activities and start gaining strength to reduce your symptoms even more over time.
To learn more about prolapse and working with a PT, call us at 512-766-2649 or contact us here. Follow @jessicachastka_dpt and @ladybirdpt for more pelvic health education!
By Dr. Jessica Chastka, PT, DPT, WCS
Jessica (she/her) earned her Bachelor’s in Exercise Science from the University of Louisiana at Monroe, while playing softball. She received a Doctorate in Physical Therapy from University of Texas Medical Branch in Galveston in August 2015. In 2019 she became Board Certified in Women’s Health, through the American Board of Physical Therapy Specialists.
For the last five years she has been working as a pelvic floor physical therapist, treating people who have pelvic pain, leakage, urgency, frequency and constipation. This includes the pregnant and postpartum population as well as people with chronic pain. She is passionate about making her patients feel heard and seen, validating those who feel that their problems are not worth mentioning because everyone has them or because embarrassed to talk about them.