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Rubrica di Jasmine R.

Working Out Postpartum - POP (Pelvic Organ Prolapse)

Nov 5, 2019

POP is not that uncommon as most may think and it doesn't only occur in older women. In fact, research shows that about 50% of mothers who are still at child-birthing age experience pelvic organ prolapse to a certain degree. 

What is POP? 

There are 5 types of pelvic organ prolapse: cystyocele (when bladder drops), rectocele (large bowel or rectum drops), enterocele (intestines), vaginal vault, and uterine prolapse. There are 0-4 degrees depending on the severity of the problem. 0 means good condition and no prolapse, 1-2 is mild or moderate which could be controlled from escalating via exercise and 3-4 are more severe. 4 means that an organ is actually protruding outside of the body and requires surgical intervention. 1-2 hardly require any surgical help but they do require rehabilitation exercise in order to help them heal, keep it under control and not degrade. 

What causes POP? Why does it happen to moms?

POP, as well as Diastasis Recti is caused by intra-abdominal pressure which pushes outwards and downwards. Often times POP and DR go hand in hand. When such pressure cannot be withheld by abdominal and pelvic floor muscles these things happen. Pregnancy and weak pelvic floor aren’t the only reasons, there is usually something else at play as well. Sometimes a prolonged labor, pushing too hard (sometimes not knowing when or how hard to push due to an epidural analgesia side effect), or medical intervention during or post labor (like ventouse, manual revision or uterine cavity, episiotomy, forceps…) can increase the risk of POP.

Alright, so how can I know if I have POP?

These are some symptoms which may imply prolapse:

1. Feeling pressure or fullness in the vagina or rectum;

2. Feeling that your uterus might “fall out” when you strain;

3. Abdominal pain or even bulging in the vagina;

4. Urinary incontinence (leaking) or urine retention (cannot empty the bladder fully);

5. Fecal incontinence (cannot control passing stool) or constipation;

6. Painful sex.

What can you do if you suspect to have POP?

First of all, find a doctor and get a full diagnosis if you do have it and to what degree. Next, work on your alignment - if your back is slanted or your butt tucked in, this doesn't only prolong the recovery, but it could also make the symptoms worse. It is very important to have good posture and alignment. Next, you need to find and activate your pelvic floor muscles. Kegals are very useful here as they help you reconnect to this part of the body. Most of the time Kegals aren’t enough but they are a good start. The next step would be to incorporate isometric abdominal contractions with Kegals, but all in good time..

Here is how you can do Kegals: Sit upright, stand or lie down. As you inhale relax completely and let your muscles expand. As you breathe out, don’t only squeeze the pelvic floor, but also try to lift it up, as if you were about to pick up a tampon with your vaginal muscles. Inhale, relax. Exhale, do the same thing in the rectum area: squeeze and lift, as if you were about to stop wind. Inhale and relax. And now when you exhale, squeeze and lift the area at your urethra (as if you were about to stop the flow of urine). Repeat 3 sets of 10 reps every day. Don’t give up if you cannot feel or locate the muscles right away, you will in time.

If you do have POP you need to be careful until it heals: you shouldn’t lift heavy objects, strain too hard, jump, run or do any kind of hard exercise. You will also need to modify your everyday movement and exercise. There will be more information on this in my upcoming articles. Stay tuned.

Thank you for reading. Don’t hesitate to leave a comment or contact me directly for questions.


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