01/13/2026
Prolapse isn’t just a muscle issue
I think a lot of people assume that prolapse is strictly a pelvic floor muscle weakness issue, when in reality it can be so much more than that. It’s very possible to have a strong well functioning pelvic floor, but still have prolapse. Oftentimes, prolapse is actually the result of ligament laxity or ligament rupture—- ligaments that support the pelvic organs.
There are several different ligaments that attach the pelvic organs to the pelvic wall and essentially anchor the organs in a supported fashion. These ligaments can become very stretched or completely ruptured often occurring during a va**nal birth or in some cases people with ligament laxity (such as Ehlers Danlos).
In these cases, pelvic floor strengthening can only help so much. If the prolapse is past the level of the pelvic floor muscles, then strengthening the pelvic floor is often not helpful because the muscles aren’t able to get under and lift the prolapse up— they essentially contract around the prolapse instead. In these situations, a pessary or other similar device is needed to help get the prolapse up past the level of the muscles so when you contract the muscles, it’s actually lifting and supporting the organs.