Rectocele
Condition Overview
Pelvic Organ Prolapse (POP) is when the pelvic organs push into the vaginal walls. There are various types of prolapses but the most common are bladder (cystocele), rectum (rectocele), and uterine. This can occur with weakening of the pelvic floor muscles and connective tissues or with repeated or prolonged pressure on the pelvic floor. Specifically a rectocele is when the rectum pushes into the posterior wall of the vagina.
Causes of prolapse/rectocele:
Pregnancy/postpartum
Straining/constipation/chronic coughing
Poor pressure management
Constant heavy lifting with poor body mechanics
Aging/menopause
Symptoms of rectocele:
Heaviness, pressure, or feelings of something falling out of the vagina
Straining during a BM
Incomplete bowel emptying
Fecal smearing or staining
What Can Physical Therapy Do For Me?
During a physical therapy evaluation, we will assess your bladder/bowel habits, exercise routine, and pressure system through the abdominal wall and diaphragm. We will perform an in-depth muscle examination including and external and internal pelvic floor assessment with your consent. With this, we can determine your abdominal, hip, and pelvic floor muscle tone, strength, endurance, and coordination.
Despite people thinking that kegels are the solution to a prolapse, many people with a prolapse actually have an overactive pelvic floor leading to functional weakness due to tension.
In addition, many people lack coordination, meaning despite the strength of their pelvic floor, they are not performing a pelvic floor contraction aka kegel at the appropriate times so they do not get the support they need when performing activities such as jumping, running, lifting, carrying.
Specifically with a rectocele, people tend to be bearing down while having a BM inappropriately causing more strain through these tissues leading to a further rectocele. It is important to make sure you have a good bowel routine, soft and formed stools, and use of a squatty potty to prevent rectocele or worsening of your symptoms.
After initial assessment, we will set-up a treatment plan depending on your pelvic floor characteristics!
We will educate you on optimal bladder and bowel health all while improving your pressure management. Manual treatment will be provided as necessary and we will give a home exercise program to set you up for independent success.
Manual treatment can include but is not limited to dry needling, myofascial release, cupping, and connective tissue mobilization.
Exercises can include but are not limited to kegels, hip and abdominal strengthening, downtraining/pelvic floor stretches, functional mobility exercises and improving body mechanics. With each session we will reassess and progress as appropriate.