%20(1).avif)
Feel like something is falling out of your vagina, especially when you're standing, exercising, or toward the end of the day? This sensation can be a sign of pelvic organ prolapse, including bladder prolapse (cystocele), and Low Pressure Fitness (LPF) may help you better manage pressure and support your pelvic floor. In this article, we'll explore common prolapse symptoms, how LPF may help, and how the interconnected anatomy of the pelvis—including the urachus and the concept of biotensegrity—can help us understand the body as a whole.
If this sounds familiar, contact us at Activcore Physical Therapy to get help now.
What Does a Bladder Prolapse Feel Like?
A bladder prolapse doesn't always feel like a noticeable bulge. Symptoms can be subtle and may change throughout the day.
You might notice:
- A feeling like a tampon is slipping out even when you aren't wearing one
- Pressure, heaviness, or fullness in your vagina or pelvis
- A sensation that something is “dropping” or “falling”
- Symptoms that get worse after standing, walking, exercising, or lifting
- Pelvic pressure that increases as the day goes on
- A noticeable bulge in or around the vaginal opening
- Difficulty completely emptying your bladder
- Needing to urinate more frequently
- Urinary leakage
- Increased pressure with coughing, sneezing, or straining
One common clue is that symptoms may feel better when you're lying down and become more noticeable when you're upright or active.
If you've ever thought, “Why does it feel like something is falling out?”—your body may be giving you an important signal worth having evaluated.
Your Pelvic Floor Is More Than Just Kegels
When people hear “pelvic floor,” they often immediately think about Kegel exercises.
But your pelvic floor doesn't work in isolation.
Your diaphragm, abdominal wall, pelvic floor muscles, spinal muscles, fascia, and connective tissues all contribute to how your body manages pressure.
Every time you breathe, cough, sneeze, lift, squat, run, or jump, pressure changes inside your abdomen.
The goal isn't to eliminate pressure.
It's to help your body manage pressure efficiently.
This is one reason whole-body approaches to pelvic health can be valuable.
How Can Low Pressure Fitness Help?
Low Pressure Fitness (LPF) combines specific breathing patterns, postural positioning, and hypopressive techniques to work with the relationship between your diaphragm, abdominal wall, and pelvic floor.
Rather than simply telling you to “tighten your pelvic floor,” LPF focuses on coordination, posture, breathing, and pressure management.
During an LPF session, we work with:
Posture → breathing → diaphragm → abdominal wall → pelvic floor → pressure management
The goal is to help you become more aware of your body and develop a better connection between your breathing, abdominal wall, and pelvic floor.
Research on hypopressive exercise has found potential benefits for pelvic floor function and symptoms of pelvic floor dysfunction. A 2024 systematic review of randomized clinical trials reported improvements in pelvic floor strength, tone, and pelvic floor dysfunction symptoms following hypopressive exercise, while noting that more high-quality research is needed.
Learning the Vacuum Takes Practice
One thing I tell my clients is don't get frustrated if you don't feel the connection right away.
The LPF vacuum is a skill.
For some people, the first few sessions feel completely foreign. You may not immediately feel your pelvic floor respond, understand what your abdominal wall is doing, or know whether you're performing the vacuum correctly.
That's normal.
When I train clients 1:1, it can take multiple visits to understand the breathing pattern, find the correct posture, and learn how to perform the vacuum properly. We take the time to teach the body rather than simply telling you to “suck your stomach in.”
Once the technique starts to click, the goal is to make it something you can practice independently.
For many clients, I recommend working toward approximately 20–30 minutes of LPF practice, 2–3 times per week, while continuing to focus on the fundamental posture principles.
The goal isn't to perform a perfect vacuum every single time.
It's to understand the posture, breathing, pressure, and body connection so you can carry those principles into your everyday movement.
What Does the Urachus Have to Do With It?
This is where pelvic anatomy gets particularly interesting.
The urachus is an embryological structure that originally connects the developing bladder to the umbilicus. After birth, it typically becomes a fibrous structure called the median umbilical ligament, extending from the top of the bladder toward the belly button.
That means there is an anatomical relationship between:
Bladder → connective tissue → anterior abdominal wall → umbilicus
Your bladder isn't simply sitting independently inside your pelvis.
This is where the concept of biotensegrity becomes interesting.
Understanding the Pelvis Through Biotensegrity
Biotensegrity looks at the body as an interconnected system in which muscles, fascia, connective tissue, and bones work together to distribute tension and compression.
Think of your body less like a collection of individual parts and more like an interconnected network.
A change in tension or movement in one region can influence how forces are distributed throughout another region.
Because the bladder has connective-tissue relationships with surrounding structures—including the tissues associated with the urachus—it gives us another reason to think beyond simply “strengthening the pelvic floor.”
There is preliminary research exploring a biotensegrity-based approach to pelvic organ prolapse. A small retrospective case series involving 23 women, 14 of whom had cystocele, reported improvements in prolapse symptoms following a biotensegrity-focused treatment approach.
However, this was a small case series, so more research is needed.
Importantly, there is not currently research proving that LPF treats cystocele specifically by changing tension through the urachus.
Instead, the urachus and biotensegrity provide an interesting anatomical and biomechanical perspective for understanding why the pelvic floor may be better approached as part of a whole-body system.
You Don't Have to Stop Moving
A cystocele doesn't automatically mean you have to stop lifting weights, running, exercising, or doing the things you enjoy.
Instead, you may need to learn how to manage pressure differently. Pressure management can help you feel stronger, more supported, and more confident in your body.
Your pelvic floor is part of a much larger system. LPF offers one way to explore that connection through posture, breathing, movement, and pressure management.
Feel Like Something Is Falling Out?
If you've ever thought, “It feels like a tampon is falling out, but I don't have one in,” don't ignore that sensation. It may be worth having your pelvic floor evaluated.
Contact us at Activcore Physical Therapy to get started now.
%20(1).avif)
.avif){kind=spacer}
.svg)
