This is Lindsay:
4 weeks postpartum, she found out she had Pelvic Organ Prolapse.
She remembers just feeling really swollen ‘down there’, like she was sitting on a ball every time she sat down.
Her doctor told her she would have to change her lifestyle. No more running, downhill mountain biking, no lifting more than 25 pounds – which would include her daughter as she got older, and the list went on.
Her doctor gave her three different options: Kegels, Physical Therapy or Surgery. She chose to do physical therapy where he referred her to go to, but she got the feeling that her doctor thought she was hopeless.
Lindsay’s experience with her first physical therapist was awful. They did no internal pelvic floor muscle assessments, and she was seeing no improvement. After a month, she decided to find someone on her own.
She switched to another local PT who had pretty good reviews in her area. Again, after a month, though, she felt like they were not making any progress. This second therapist, did do internal exams, but mainly ultrasound to see where everything was positioned, and didn’t really give Lindsay any concrete recommendations based on the ultrasound.
Two months after her diagnosis, Lindsay still felt lost. She was referred to an acupuncturist, by a midwife who said she had heard they might be able to help her. When Lindsay was at her appointment with this acupuncturist, after hearing about Lindsay’s struggles with the two other PT’s, the acupuncturist told her about me (Dr. Kelly)!!
This time, Lindsay did her research on what she was wanting out of therapy. She gave me a call, and asked me a long list of questions.
At our first meeting, I first,gave Lindsay hope that her active lifestyle was not over.
“Kelly did more for me in that first appointment than was done in the two prior months with two other Physical Therapists. Even though I had to travel a long ways to see her, it was worth it.”
Lindsay’s first appointment with me was in late November. I did a standard pelvic muscle exam which helped us ‘map out’ where she had muscle tightness, where she had muscle weakness, and where scar tissue and adhesions could be contributing to persistent symptoms of heaviness and buldging.
Lindsay started exercises to both lengthen AND strengthen her pelvic floor.
She also was working on improving her overall muscle control of her diaphragm, abdominals and pelvic floor muscles, trying to learn to control each group together at times, but also separately at times.
After two appointments with me, Lindsay checked in with her doctor to see what their prognosis was. She had improvement on her Uterine and Rectal Prolapse, but no change in Bladder. He recommended surgery on her bladder, and Lindsay had a pressing time limit, due to an insurance limitation, on how long she could wait to see if PT would work.
At Lindsay’s next appointment with me, we discussed her options.
At that point, her deductible had been met for the year. The following year, her deductible was going to be so high that she wouldn’t be able to afford surgery, without it being a big stressor.
While I did wish that we would have had a couple of months to try PT before we had to come to a decision, unfortunately we didn’t have that kind of time. With my knowledge of the general trajectory of active individuals with triple-prolapse, I agreed with the doctor that surgery was indicated to support the damaged vaginal wall.
With that recommendation, Lindsay chose to move forward with surgery to support the bladder prolapse (anterior wall). She still worked with me in PT before her surgery, to make sure that her pelvic floor muscles were supple and strong, and that her body mechanics were optimized, to increase the chances that the surgery would be a success. Her surgery was on Dec 17.
Six weeks after Lindsay’s surgery, at the very end of January, she came back in for her first post-operative visit. We did a reevaluation to see exactly where she was at. At this point, she was still having symptoms of pressure, but nothing like before surgery.
We started in with exercises to both lengthen AND strengthen her pelvic floor muscles, based on the findings of the pelvic muscle exam. Lindsay did her own internal work 2-3 days a week at home with either her own hand, the help of her husband, or a pelvic wand from Intimate Rose (pro tip, use website intimaterose.com/kelly21 to get $5 off any product) to help with muscular circulation work.
In February, there was a landmark day, when I told Lindsay that I thought she was ready for tampon use again. Due to the feeling of pelvic pressure, she hadn’t been able to wear a tampon since the birth of her 3rd child, 8 months prior. Now, at 8 weeks post surgery, we felt she was ready.
Lindsay had a trip to Hawaii planned at the beginning of March, so I worked with functional strength goals to prepare Lindsay to be able to hike and surf while in Hawaii (3 months post-op). For Lindsay, at this time, it hurt to have sex, as well as to orgasm. Another functional goal of pelvic PT, was that in Hawaii, Lindsay would be able to return to painfree intimacy.
In Hawaii, Lindsay was able to hike a couple of miles and surf. She had only the most mild pelvic pressure symptoms in the evenings, and in the mornings she would feel good again. She did try having sex, and while positioning didn’t hurt, orgasming still hurt and she was very symptomatic with pelvic pressure after.
When she got home, we resumed Pelvic PT with goals of eliminating the remaining pelvic pressure complaints, as well as the pain with orgasm.
With a triple prolapse, it was slow progress, but the progress was there.
Lindsay say that “it sometimes felt like I would take two steps forward and one step back. At 3 months post operative, I was still feeling symptomatic (pressure) in the evening and all day about a week before my cycle would begin. Then the next month, it feels like I take three steps forward and 1 step back.”
Finally in June (6 months post surgery), Lindsay took a step forward…and kept waiting to take steps back… but it never came.
Lindsay was released in June (6 months post-op), to downhill mountain bike, and carry her 20 pound child for 15 minutes. This was a huge victory for her. And she never looked back.
3 weeks later, Lindsday was able to go on a downhill mountain bike trip, was carrying her daughter hiking for 45 mins, road biking weekly, doing low impact workouts, and jogging to her mailbox and back. HUGE PROGRESS from a year earlier when her doctor told her that she would never run or mountain bike again.
Early fall, Lindsay’s only remaining symptoms were mild rectal pressure 1-2 days before her menstrual phase, as well as intermittent rectal itching at eternal anus (butt hole, folks…her butt hole was itchy sometimes).
We refined transrectal work to improve tissue health of pelvic muscles near the coccyx (tailbone), did belly mobilizations to improve health of nerves that innervate the rectum, and refined impact exercises for better load management (teaching the whole body to absorb impact). When Lindsay first started doing these exercises, she would feel a little symptomatic in the evening (mild pressure in rectum). After one month of working on those exercises, that complaint stopped and Lindsday was symptom free.
This will be a lifetime journey for Lindsday, but while she is on this journey, she will be able to enjoy the things she loves.
I’m eternally grateful that I could be a part of giving that gift to Lindsay.
I REALLY wanted to include Lindsay’s story on this Blog, because while Four to of Five women can successfully manage prolpase symtoms with Pelvic Floor PT, One out of every Five will need surgery to stabilize the pelvic fascia. It doesn’t mean you’ve failed, or are weak…it means that the mechanical support to hold your va-ji-nug-bits inside of you is so changed that you really do need a surgical stabilization to fix it. Outcomes are awesome, ESPECIALLY WITH PELVIC PT.
Check out related posts on pelvic organ prolapse incidence, key questions to ask before and after pelvic surgery, are menstrual cups safe for prolapse, and new, evidence supported Blood Flow Restriction Training to reduce pelvic organ prolapse symptoms.
If time and finances allow, you can work with Dr. Kelly one on one (look for link to Jane App on main website for appointments beginning Jan 1, 2023), or find a Pelvic PT near you! Remember, in most states, you don’t need a physician’s script to see a PT.
Follow me on Instagram for other free knowledge drops! And if you want to know what exercises Lindsay did, check out this post, about beginner core awareness activities, and consider purchasing the Signature Series, to learn how you can heal your pelvic floor, naturally!
A Prolapse Specific Course will drop in early 2023, so you can mark your calendars for that gem, as well, and be sure to tell all your friends & family that Pelvic Health is a real thing, and we need to be talking about it 🙂
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Driggs, ID 83422
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All information, classes, and products purchased are for information only, and are not medical advice or physical therapy advice.
