3 Tips For Holistic Prolapse Care

When clients come to us with complaints of prolapse there is so much for us to assess. Prolapse requires a head to toe assessment because we need to really understand what is going on in our client’s body to be able to help them. I like to bring a holistic approach to all my clients, even when working with a client with prolapse. While there are a ton of issues you need to assess beyond the scope of this blog post, I’d like to address some ideas that may be new to you to bring a more holistic approach to your assessment and treatment practices for prolapse.

Is It Really Prolapse?

Heaviness after birth is a common complaint and one that may be linked to prolapse or may be just the effects of birth. In my experience, the way I differentiate between heaviness from prolapse versus just the effects of birth, is by asking this one question, “Do your symptoms get worse at the end of the day?” If the answer is yes, then that is a true prolapse complaint.

Heaviness that is consistent throughout the day can often mean that the pelvis is stuck in the Open Birthing Pattern. With the bones being wider than normal, the pelvic floor muscles are more activated and the whole area feels heavier. Once the pelvic bones are treated and brought back to their original position and mobility, this symptom of heaviness goes away every…single…time.

Pressure Management, Posture and THIS for Treatment!

While pressure management and postural awareness are typical treatment strategies, another one that is just as important is the treatment of vaginal scar tissue. Anna Crowle and I did two Birth Healing Summit Interviews on the effects of scar tissue and its impact on the alignment of the pelvic organs.

I find with my clients that perineal scar tissue will have a pulling effect that can bring the pubovesical fascia and endopelvic fascia down toward the introitus; therefore, bringing the organs along with it. When you address and release the scar tissue in these fascial tissues and help release the bladder and cervical/uterine ligaments, especially the uterosacral ligament, this can shift the organs into their proper place. Stage 1-2 prolapse of the bladder and uterus can easily be treated and healed in a session as long as there isn’t a tissue defect at play.

All clients dealing with prolapse need a thorough evaluation of their scar tissue, fascial restrictions, uterine and cervical ligaments. One key step here is to make sure that the cervix is midline and in a position where you have to reach up for it in the vaginal vault. If the cervix is off to one side, gently encourage it to go to the midline while encouraging the fundus externally with your outside hand to find the midline, too. This can help the cardinal ligaments offer better lateral support to the cervix.

However, the uterosacral ligament is the key for uterine support if the cervix is sitting lower than normal. It’s best to reach this ligament using two fingers and looking for it on the posterior lateral side of the cervix. A healthy normal uterosacral ligament is hard to palpate but one in dysfunction feels like a rope. If palpation and finding the cervix is not in your assessment and treatment approach I highly encourage you to learn how to do so.

Energetics of Prolapse and a Lack of Support

Getting into the more holistic aspect to prolapse, the energetic message of prolapse is lack of support. Understanding how clients feel that their lives are lacking in support and helping them tune into what their body is telling them can be a huge opportunity for deeper healing and lifelong health.

The body is constantly trying to give us information and the organs are a big part of that messaging. The pelvic organs are all about filling/holding and releasing. The bladder can be about letting go and the fear of doing so. The uterus is our creative center and truth center. How is a lack of support showing up for your client in these areas of the body?

There may be other messages that you could help them tune into as it’s best for us to just ask questions and see what they come up with themselves. If they are able to tune into and bring their awareness to this area, see what sensations, thoughts, memories or feelings come up for them. If they don’t get anything, you can mention the support theme for prolapse and see if that resonates with them.

Helping our clients tune into their body and feel the energetic connections and sensations that are present offers a deeper level of healing for them. Learning to work with this additional information and dialogue with our clients is a skill you can learn. It’s so much fun reading the body and the tissues to see what story is being held in them. Every body has a story and our job as practitioners should be to learn to read it. Magic happens every time we do!

Working With Prolapse

When working with clients with prolapse, adding these three aspects to your treatment toolbox can offer your clients an opportunity for deeper healing. Not all prolapse symptoms are permanent as long as there isn’t a fascial or tissue defect. Some prolapse issues can be treated and healed and some may need the support of a pessary. Check out the Birth Healing Summit Podcast on All Things Pessaries! for information and resources.

Since pessary fitting is now within our scope of practice as physical therapists, I highly encourage all practitioners working with pregnancy and postpartum to become trained. As I learn more about it, I’ll share what is working for me. In the meantime, the pieces I mentioned in this post are definitely supporting my clients with prolapse and are pieces I would recommend you add to your practice.

If you are interested in additional education, the Treating the Postpartum Pelvis course will give you the skills to work with the Open Birthing Pattern as well as other most common postpartum patterns in the pelvis. You will learn how to work with scar tissue in the Holistic Treatment of the Postpartum Body course. I teach about energetics of the body and dialoguing as well as many other important topics in the Birth Healing Intensive. Thank you to all you are doing to help support your pregnant and postpartum clients! Keep up the beautiful work that is so incredibly needed!

About the Author: Lynn Schulte is a Pelvic Health Therapist and the founder of the Institute for Birth Healing, a pelvic health continuing education organization that specializes in prenatal and postpartum care. For more information, go to https://instituteforbirthhealing.com