If it weren’t uncomfortable enough feeling like organs are migrating down and potentially outside of your body, we can sometimes develop secondary symptoms such as pelvic floor pain.

And this issue is NOT that rare.

Let me explain.

If you have lived on this planet for at least 30 years or have ever been pregnant, you will VERY likely have been told to “do your kegels”.

Not once.  Not twice. Probably between 3 and a gazillion times.

The word “Kegel” is handed out liberally by medical professionals and well meaning friends and family as if it were the MAGIC PILL for ALL PELVIC AILMENTS.

Is anyone EVER talking about making sure you don’t clench so much that the muscles get stuck in a perpetual state of tension?  Nope.

So when a woman suddenly feels a sense of pressure or heaviness in their pelvic region and fears she may have a prolapse (or has been told she does), it’s no surprise that the one and only thing she starts doing is to clench her pelvic floor.

Throw in the fact that most women are accustomed to already constantly sucking in their abdominals, and you’ve got a recipe for pelvic floor pain and spasm.

It is not uncommon for women to begin to feel as though their organs will truly fall out if they allow their muscles to unclench for even a short while.  And when their pelvic PT tells them to try to relax or even drop or bulge their pelvic floor muscles…

They are terrified.

So let’s clarify some things so that we can all agree that relaxing the muscles on the outside of our pelvis will not in fact be the same as pushing organs out.  ESPECIALLY while we are laying down for the exercise or muscle assessment.

1.   For the pelvic floor muscles to function properly, it is essential that we are able to contract, relax, and lengthen them.  To do their job and work with the rest of the core muscle team, they have to be able to be pliable and responsive. Being stuck in a perpetual contraction does not work.

2.   Pelvic floor muscles do NOT feel good when they are in spasm.  Trust me, I’ve lived through it!

3.   It is physically impossible for pelvic floor muscles to “push” our organs out as they are on the OUTSIDE of the body.  They are on the wrong side! So allowing them to relax, especially while laying down for coordination or relaxation exercises will be just fine.

4.   Worsening of prolapse symptoms is more a function of how long we are on our feet, what activities we are doing and HOW we are moving our entire body throughout the day.

Having really bad posture, patterns of breath-holding and straining to lift heavy items with bad form and alignment or doing excessive amounts of anything that compresses downward on the pelvic floor will be the main issue.

So when it comes to pelvic organ prolapse, realize that symptoms can vary by the day and depend upon our activities.  The position of our organs can shift and change. It’s NOT a set or fixed position where the organs are only going to go down from here.  They can move back upward as well!

What Do We Do If We Have Pelvic Organ Prolapse AND Pain??

First, it is REALLY important that we consult with a pelvic musculoskeletal expert, or pelvic PT to help you sort out what is going on with your symptoms.  They can help to pinpoint the source of pain with a physical exam as well as determine if the pain is related to your muscles being stuck in that tense state without being able to relax.  And they can help you retrain your muscles to work properly to best support you with all activities.

Treatment may actually start with ONLY working on reducing tension in your belly, hip and thigh muscles as well as your pelvic floor.  There may be hands-on work to stretch out or massage tight hip muscles and exercises to help you reset your tension as well as including breathing exercises.

Kegels or strength exercises will HAVE to wait while you restore normal muscle coordination as jumping into strength exercises too soon will result in a relapse of muscles going back to their clenched state.

As much as I would like to say that releasing tense pelvic floor muscles is as simple as saying “relax”, it is certainly NOT.  That would have saved ME from having pain for almost 8 years of my marriage. Be sure to find a pelvic expert that listens to you and is skilled in helping resolve pelvic pain.

So if you believe you have pelvic organ prolapse, but are also having pain, put the kegels on hold and check in with your pelvic physical therapist first!