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Proactive Prolapse

Have you ever experienced the power of suggestion? I was six weeks post-partum after the birth of my third son. I felt good and was eager to get back to the gym. I made my way there, a small personal training boutique and Pilates studio, where I worked. I hopped on the treadmill enjoying my 2.5 mile per hour walk when a friend came up to me. She was surprised to see me there, thinking that I was only four weeks out from delivery. I reassured her that I was clear to begin with my walking. After all, I was coming back slowly and only planned to start with 15 to 20 minutes. My friend laughed, thankful for the correction, but decided to still warn me about prolapse. This was something I had never heard of, not in our birthing classes, not from my gynecologist, not from any movement course I had taken. She began describing how a woman's uterus can almost feel like it is falling out of her body and that it is usually due to beginning exercise before healing has taken place. As she started describing prolapse, it was like my treadmill slowed down to .5 miles per hour. I was walking in slow motion, listening to her description, and literally becoming aware that my uterus might be falling out of me. Could this be the power of suggestion? Was I crazy, or was this really happening to me? I was scared. I went home immediately and checked. It was true. I called my OB immediately. He assured me that I probably didn't have a prolapse, but that he would fit me in anyway.

To his surprise, it was true. I had a prolapsed uterus and slightly prolapsed bladder and rectum. I could not believe that this was happening. I was sent off to a surgeon to schedule a vaginal hysterectomy. I often say that my fourth child was a miracle. Who goes in to schedule surgery with a surgeon only to find that he talks you out of surgery? He did just that. He informed me that I was young to have a prolapse and that I did not fit the bill for his typical patient. Most were women in their 50's or women who were obese and smoke regularly. The older women tend to have prolapse with age and the latter develop prolapse from coughing so much from their smoking habit along with their unhealthy lifestyles. The hysterectomy would only fix my uterus prolapse, and the options for lifting my bladder and rectum entailed surgeries he said he would not perform on his grandmother, mother, wife, or daughter. You see, mesh surgeries had already had many complications, not to mention that they only had a life span of about 15-20 years. I was in my early 30's. I did not want to begin a cycle of reconstructive surgeries in my 50's after this one had failed. So, what were my options? The surgeon encouraged me to wear a pessary any time I wanted to do high impact activity like running or jumping. A pessary is a rubber disk that is inserted into the vagina where it opens up into a flat disc to lift and support the organs that have prolapsed. This was a life saver for me.

More so, Pilates became my Godsend. In Pilates, I was able to strengthen my pelvic floor and my core. Two years after my diagnosis, I delivered my daughter successfully, and two years after that delivery, I was told by a new OB that my uterus, bladder, and rectum were no longer prolapsed. This seems like the end of the story for me and for this prolapse discussion, but I simply can not end there. There is far more that I know about prolapse now. I often look back on my experience and wonder if things might have been different if I had been educated on these things before giving birth. I am thankful for the outcomes. I have one more beautiful child in our family and I no longer have to worry so much about my pelvic floor strength. Let me share more of what I know, so that you too can be prepared if you ever run across this issue.

Twelve years ago, when I was diagnosed with prolapse, surgery was the only option that was available to me. Since then, there have been a plethora of pelvic floor and women's health specialists and PT's that have been trained well in this niche. I discovered several years ago through the Pilates community that England is further ahead than any other country when it comes to pelvic health. There are pelvic health clinics all over their country. I also learned from another Pilates teacher, who lives in England, that there are manual therapists who can massage the fascial sack holding the contents of our digestive organs and abdominals. Often, the organ prolapse is not necessarily due to a stretching out of ligaments, but due to a space in the fascial makeup. The tensegrity of that fascia has been compromised, therefore causing the prolapse. With the fascial massage, the prolapsed organ or organs can be moved back into place. This is amazing news for some of you who may have prolapse. More Pelvic Floor Physical Therapists in the United States are being trained in these same techniques.

Where can you begin if you feel you have prolapse or have been diagnosed. I encourage you to get clearance from your doctor, seek out a pelvic floor specialist, take Pilates from a Pilates Teacher certified in pelvic floor issues, then begin with the following pelvic floor exercises for prolapse:

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