Pelvic Organ Prolapse: Physiotherapy Assessment & Conservative Management
Pelvic organ prolapse occurs when one or more pelvic organs (such as the bladder, uterus, or bowel) descend and place pressure on the vaginal walls. While prolapse can feel confronting or distressing, many women successfully manage symptoms with evidence-based pelvic health physiotherapy.
At Fit 2 Function Allied Health, we provide individualized, conservative prolapse management focused on symptom control, function, and long-term pelvic health.
What is pelvic organ prolapse?
Pelvic organ prolapse happens when the tissues supporting the pelvic organs are stretched or weakened. Common types include:
-
Anterior prolapse (cystocele): bladder support changes
-
Posterior prolapse (rectocele): bowel support changes
-
Uterine prolapse: descent of the uterus
Symptoms vary between individuals and may include:
-
A feeling of heaviness, pressure, or dragging in the pelvis
-
A bulge or sensation of something “coming down” vaginally
-
Worsening symptoms with prolonged standing, lifting, or exercise
-
Difficulty with bladder or bowel emptying
What causes prolapse?
Prolapse is often multifactorial and may be influenced by:
-
Pregnancy and vaginal birth
-
Menopause and hormonal changes
-
Chronic constipation or straining
-
Heavy lifting or high-impact exercise without adequate support
-
Genetics and connective tissue factors
Importantly, prolapse is common and not a sign of failure or damage - and many women live active lives with appropriate management.
How is pelvic organ prolapse assessed?
Pelvic health physiotherapy assessment may include:
-
Detailed discussion of symptoms, triggers, and goals
-
Comprehensive Pelvic floor assessment (with consent), utilising a combination of observations, real-time ultrasound and internal assessment techniques
-
Postural, breathing, and movement assessment
-
Education around prolapse grading and what it means functionally
Referral for medical review or imaging may be recommended in some cases, particularly if symptoms are complex or progressive.
Physiotherapy management for prolapse
Conservative physiotherapy management is recommended as first-line care for many women and focuses on:
-
Pelvic floor muscle strengthening to improve organ support
-
Load and pressure management during daily activities and exercise
-
Breathing and core coordination to reduce downward strain
-
Bowel and bladder strategies to minimize straining
-
Education and reassurance to support confidence and self-management
Pessary management within a shared care model
For some women, a vaginal pessary may be recommended as part of prolapse management. A pessary is a removable device inserted into the vagina to provide mechanical support to the pelvic organs and reduce symptoms of heaviness or bulging.
Pelvic health physiotherapy can play an important role within a shared care model, working alongside GPs or gynecologists to:
-
Support women using a pessary during exercise and daily activity
-
Optimize pelvic floor muscle function alongside pessary use
-
Provide education on movement, lifting, and load management
-
Monitor symptom response and functional goals over time
Pessary use does not replace the need for rehabilitation - instead, it can be combined with physiotherapy to support symptom control, confidence, and ongoing pelvic health.
Exercise, lifting and daily activity with prolapse
Having prolapse does not mean you need to avoid movement or exercise entirely. Instead, we help you:
-
Modify high-pressure activities safely
-
Return to strength training and fitness with confidence
-
Understand how to lift, exercise, and move with pelvic support
Our approach supports long-term pelvic health - not fear-based restriction.
Learn more about women’s pelvic health & physiotherapy
Explore our other pelvic health condition pages to understand evidence-based assessment, rehabilitation, and life-stage–specific care:
Urinary Incontinence | Pelvic Organ Prolapse | Overactive Bladder & Urgency | Pelvic Pain | Pregnancy Physiotherapy | Birth Preparation | Postpartum Recovery | Constipation & Bowel Dysfunction
Our expert pelvic health physiotherapists provide private, individualised care focused on restoring comfort, confidence, and long-term pelvic health across pregnancy, postpartum, and beyond.
Book a pelvic organ prolapse assessment
If you are experiencing pelvic heaviness, bulging, or concerns about prolapse, our pelvic health physiotherapists can help you understand your diagnosis and create a personalised management plan.
Beyond rehabilitation
Many women benefit from progressing into our Women’s Strength Program, where pelvic floor-safe strength training supports long-term symptom control and confident return to exercise.
