PHYSICAL THERAPY INSIGHTS
By Beth Shelly
Pelvic organ prolapse can have a great impact on quality of life and comfort. It can be a sensation that interferes with concentration, limits activities, and a reminder that something is just not right. There is only a weak connection between the intensity of the symptoms and the actual location of the organ. In other words, some people feel a great deal of perineal pressure with very little organ sagging and visa versa. Pelvic Physical Therapy (PT) focuses on changing the symptoms and is often successful in decreasing the sensation of heaviness or sagging. In addition, Pelvic PT works to stop the progression of the organ sagging and maybe even improve it.
Pelvic organ support relies on two main structures the ligaments above and the pelvic floor muscle below. Surgery addresses the ligaments and Pelvic PT addresses the muscles. Learning how to perform pelvic floor muscle exercises correctly, integrating breathing and abdominal muscle activity, and learning how to decrease downward pressure on the organs are all part of Pelvic PT. In some cases it is necessary to restore the ligament support (surgery). In all cases (surgery or no surgery) it is helpful to have a strong pelvic floor muscle below. In my clinical experience, approximately 50% of patients can improve their sensations with Pelvic PT alone and all patients benefit from strengthening the pelvic floor muscles. Working with experienced medical professionals increases these results.
Beth Shelly, PT, DPT, WCS, BCB, PMD
Doctor of Physical Therapy
Board certified in women’s health and biofeedback for pelvic floor muscle dysfunction.