Prolapse Early Postpartum?
Feeling heaviness in your perineum area?? Maybe a sensation of something is there. Must be prolapse, right? Not necessarily!
Pelvic floor heaviness can sometimes be the result of pelvic floor tension rather than a pelvic organ prolapse. The pelvic floor is stretched pretty significantly during vaginal birth, and even after just pregnancy is healing from months of increased loading and work! As a response, the pelvic floor may guard, or clench, a bit to help with the healing process to prevent further damage during the first few weeks postpartum. The pelvic organs also sit lower immediately after a vaginal birth! Over a few weeks, they will lift back upwards if we are able to optimize our healing during the first few weeks postpartum.
If you feel heaviness during the first few weeks postpartum, or even during pregnancy or beyond postpartum, it could be pelvic floor tension rather than a pelvic organ sitting too low! The good news is that there is a lot we can do to release pelvic floor tension, and you should feel pretty immediate relief from the feeling of heaviness.
If we begin activity too quickly, it could inhibit this healing process and cause more guarding (aka increasing tension in the pelvic floor). Or, if we favor certain postural tendencies, such as sitting with our butt tucked under a lot, or favoring one leg most of the time, we could find that there is uneven tension in the pelvic floor causing that heaviness feeling, rather than a pelvic organ prolapse.
Breathing Drills: Move the Pelvic Floor
Sometimes, we find tension in the pelvic floor due to gripping or decreased range of motion. This can occur if we are constantly gripping or purposely clenching in an attempt to maintain continence (not leaking urine), trying to stay upright as a stabilization strategy, or if we are fatigued and no longer able to meet the demand without compensation (standing for long periods of time with baby in your arms, for example).
We may also find a decreased or limited range of motion in certain areas if the pelvic floor has uneven tension. Uneven tension could be due to a postural tendency (anterior pelvic tilt with rib thrust or a posterior pelvic tilt with rib sway back), or favoring one leg over the other.
If we can find a way to release the gripping and also the tension from the postural tendency, we may find relief! A good starting point is with breathing drills. We may want to try multiple positions to see which ones feel like they provide the most release.
Gravity Supported Positions
If being more upright is increasing the heaviness sensation, it could be that being upright for prolonged periods of time is too fatiguing. Pelvic floor gripping or clenching can also occur if we are fatigued, and as a stabilization strategy (a less optimal one, that is), the pelvic floor grips in an attempt to stabilize. Finding positions that are less challenging, such as supine, side-lying, or even hips elevated could help as you are doing your breathing drills. Throw your feet up the wall for a few minutes and see how the heaviness feels when you get up!
Adjust Your Stance
Another thing to try is to adjust your stance or posture! If you are favoring an arched back or sway back posture, switch to the opposite extreme. If your back is arched, try tucking your butt underneath to breathe here. If you are always tucking your butt underneath, try arching your back or shifting your weight around to feel some “stretching” when you breathe.
There are so many more techniques that we can utilize to help release tension in the pelvic floor from mobilization (both internal and external work, depending on your week postpartum), movements that shift the stance and position of the pelvic floor, and more. Working with a pelvic floor physical therapist, even virtually, could be so helpful!