Are your organs falling out? What to know about prolapse to put your mind at ease

When a doctor says the word “prolapse” and then starts talking about organs falling out of your body, it can be extremely alarming.

As pelvic floor physical therapists who see all types and levels of pelvic organ prolapse, we’re here to take some fear out of prolapse and reassure you that you have options when it comes to healing.

If you’re in the Kansas City area and are looking for a pelvic floor physical therapist who can help with prolapse, schedule an evaluation with us today.

What is prolapse?

Pelvic organ prolapse happens when the muscles, ligaments, and tissue in your pelvic floor can no longer support the organs they’re responsible for supporting, so those organs start to make an escape through your vaginal opening.

Don’t worry, your organs will not fully “fall out” and usually, this condition isn’t even painful. However, it is extremely important to address because if left unattended, it can cause additional problems including infection.

There are three different types of prolapse: bladder, uterine and rectal. Only a urogynecologist can truly diagnose you with a specific type of prolapse. 

Typically, a pelvic floor physical therapist or a gynecologist can tell through a vaginal exam if you have anterior (front) or posterior (back) tissue descent which means that some or all of your organs are descending into the vaginal canal.


Prolapse severity is graded on a scale from one to four, one being incredibly minor and four being the organ is completely coming out of the vaginal opening. If you have a grade four prolapse you will likely need surgery fairly quickly as we do not want your organs to get infected. 

Grades one through three are usually treated conservatively at first using pelvic floor physical therapy, over-the-counter prolapse supports, or pessaries (a device placed into your vagina to support your organs).


How can pelvic floor physical therapy help prolapse?

Think of the pelvic floor like a hammock being held up on either end by two trees (our legs/glutes). Our organs sit inside the hammock and are supported by the hammock and the trees. If we add pressure to the hammock (jumping, sneezing, coughing, not managing pressure well with weightlifting, etc.) this can make the organs feel heavier in the hammock or put strain on the hammock itself. 

If we have weak trees on either side of the hammock (or the hammock itself is weak) this is also going to add pressure and the organs may sag in the hammock. This typically gets worse as you stand or do a lot of physical activity throughout the day.

In physical therapy, we teach you how to manage pressure, how to strengthen the hammock and the trees, and how to manage symptoms in the meantime. We can’t change what exactly is going on with the organs, but we can strengthen the pelvic floor, legs, and hips to have a better chance of supporting them.


What else can you do?

Over-the-counter prolapse supports: These can be super helpful as a temporary support for your symptoms while you are working in pelvic floor physical therapy! Here are some of our favorite options:


Pessary: This is a device that is fitted for you personally and can be used just for exercise or activities, or it can be in place for a full day or as a more permanent option. If the options above don’t work well for you, or your prolapse is more severe but you are not ready for surgery, this may be a great option. Warning, these look a little scary but they aren’t, and once you get used to placing/taking them out, people LOVE them!


Well + Core does not reserve the rights to this image. 

Surgical options: Surgery options are always best discussed with your provider. Typically, for bladder or rectal prolapse, some sort of sling is recommended which is placed surgically to help tack the bladder/rectum back in place. Physical therapy is recommended before and after surgery for best results. If you are not supporting the hammock/trees, this surgery may not be as effective for as long. It also helps to stay on top of your exercises!

If you have a uterine prolapse, you may be a candidate for a hysterectomy. This can increase your chances of a bladder/rectal prolapse post surgery because you are removing a structural support, so make sure you talk to your doctor about the pros and cons. And of course, do your physical therapy!


Frequently asked questions about prolapse

Can I still have kids if I have a prolapse? YES!! Based on the severity of the prolapse, your physician may make recommendations on how you deliver, but prolapse in itself does not limit you from having kids. Pelvic floor physical therapy can help resolve symptoms during and between pregnancies. We can also teach you how to push during delivery to try to limit the amount of downward force/pressure during delivery. 


I’m having heaviness now, is there anything I can do before my appointment with the PT?

YES!  Here’s a recovery position we highly recommend when you’re experiencing heaviness or at the end of the day.

You can put your legs up on a couch, up on the wall, up on your headboard in bed, whatever is most comfortable. Try relaxation breathing, listening to a meditation, or watching a show to relax and let gravity assist with bringing your organs back into place

You can also work on your diaphragmatic breathing and connection with your pelvic floor/deep core muscles

If you have any additional questions about prolapse or pelvic floor physical therapy as a treatment option, please feel free to email us at or schedule a free 15-minute consult with one of our providers.

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