A small blue cube made of silicone.
This little thing suddenly became as essential in my life as breathing. The Cube is in fact a vaginal pessary, which basically is a removable device that is worn inside the vagina. It is designed to add pelvic floor support when these muscles are weak and to support any pelvic organs that have prolapsed. There are LOADS of different types of pessaries out there. My specialist nurse suggested to try this when she understood how important it was to me to try and go back to running despite my newfound ‘dear’ prolapse.
I tried various types (and sizes) of pessaries before finding one that actually worked, the ring shaped ones I started off with kept falling out. Therefore I was almost sceptical to the idea, and I definitely didn’t want to get my hopes up too much. But I was also open-minded about trying if there was something that could potentially help, even if it was just a tiny bit. I was already sick of the feeling of everything falling out of me so anything that could improve it, anything really….
I really didn’t expect it would make such a difference. But now when I have used it pretty much every day for 1.5 – nearly 2 years, I realise that I have become completely dependent on it. It works the way it should by supporting / lifting up the prolapsed structures and as a result makes my day so much more comfortable. It doesn’t remove it completely, and some days are better and some worse, even if I have it. But it generally improves the prolapse when worn. The only time I don’t use the cube is at night time and when I have my period, or sometimes when I only stay at home all day not doing much (although as a mother of a toddler those days are becoming rare!) But when not using the cube I can really tell the difference. I can more clearly than ever feel what activities aggravate the prolapse and what things I need to be cautios with doing. These are things like walking too much, lifting my son, hoovering the floor, blowing up a balloon, sneezing or laughing when standing….
And on days not equipped with the cube, I could definitely not go running.
My journey back to some sort of running (i.e. jogging) has definitely been saved by my cube pessary. I don’t think I would have been able to run (jog) at all without it. I may be wrong. But it would definitely have been an even longer journey than it has already been, this I am certain about. And I am forever grateful that I had this chance.
However. Has the cube made my pelvic floor Lazy?? Is it a bad thing that I have become so dependent on it – am I just masking the problem by using it all the time? I am not sure. It has been discussed on various occassions with professionals and I have the impression it shouldn’t be a problem that I use it pretty much forever if I need to (or until a potential surgery in the future?!) if it in the meantime does the job. But I still keep thinking the thought. Am I doing my body – or more specifically my pelvic floor – a disservice (long term) by letting it get used to the cube pessary?
It would be amazing to hear from others who may have experience of using pessaries, and what your thoughts on them are. How has a pessary worked for you if you use one and how you look at the future – with or without it?
I know I have a few followers on the blog now, and would really love to hear from you!
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Who knew that you can get physiotherapy for the coccyx?!
I sure didn’t, but it turns out possible with a specialist Physio. In my case it was the same Women’s Health Physio I saw before giving birth. She was the one to later also confirm I had sustained a prolapse and I did lots of pelvic floor training with her, but the treatments she gave me were mainly to help with my coccyx issue.
I would not have been where I am today with that if it wasn’t for this physio. I went for sessions with her quite frequently in the first few months post-partum and they were often very awkward and very uncomfortable but the exercises, massage, manual therapy combined with my own homework eventually brought me to a point where the pain became manageable. It was a long and slow process, and maybe it was partly Time that ran its course in the injury healing, but I strongly believe I would not have gotten where I did without physiotherapy.
I also wish I had had the same opportunity when I first injured the coccyx 10 years earlier, as back then I was only told there was nothing to do about it, that I just had to live with it. Well, it is likely I still have to live with some degree of pain and now almost two years post-birth I still struggle to sit down for too long, it is still difficult to be comfortable on a sofa and I cannot lay down flat on my back or do certain abs exercises whilst seated/lying on the floor. I also cannot live without my dear pillow. I use it on my everyday chair at home and it comes with me when I go travelling and anytime I know I will be sitting a lot without many chances of changing position.
Socially awkward again – yes sometimes it is, but the pillow does a good job for me and I prefer to stay as comfortable as I can, especially as I now have a son now who depends on me. I am just so thankful that the initial agony I was in the first few months after giving birth eased off, as it would have been tough to cope with that for much longer.
And my lesson learnt is to not suffer in silence – there is often help to get and it can make a massive difference if you make sure to get it!
So I struggled quite lot in the beginning. I couldn’t physically sit down at all initially after the birth, as the pain in my coccyx was so intense. It was stressful as I had my little baby to care for and all I wanted to do was to sit back on the sofa with him in my arms and cuddle. This was out of the question. To breastfeed him I had to lie down, which on its own wasn’t too bad, especially at first. We stayed home anyway most of the time, as neither could I sit but nor could I walk too much (vicious circle oh yes!) so I took the time to get to know my baby in the relaxed environment of home. When I look back at those first few weeks I see myself lying on the sofa, cuddling or feeding my son. E had two weeks of paternity leave. (Actually, who am I kidding, he had 3 days of paid leave and the rest were holidays. But all that belongs in a different discussion…).
He did so much for us though. When I got up in the morning he had prepared me breakfast, usually a fruit salad – my favourite! When he came home from work he would take over the care for the baby and he cooked dinner. Although the eating itself was enjoyable I always feared the moment I had to move over to the table, as I knew how painful it would be to sit down on the chair.
For my relationship with the baby it didn’t matter too much that I could only lie down. I enjoyed his company and he enjoyed being fed, in a way it was a win-win situation going on! But when it came to socialising it became a bit of a struggle, how could I go out if I had to lie down every time I had to feed my baby?! I soon became that really awkward mum who either didn’t come out at all or when I did it had to be brief so I could get back home again in time to feed my little one. And with feeds every 90min that lasted for at least half an hour each? Well, there wasn’t really time left for much else. And further, when I did come out I had to bring my super specialised – and essential – pillow to sit on as there were no chances in the world I could sit on a chair without it. Heaven was when I could visit someone else’s home where I could use a bed or sofa to lie down on to breastfeed. Sometimes I breastfed standing up in a baby sling when we where out, me and my son developed a certain technique where this was possible. Anything to avoid sitting down.
Sounds awkward doesn’t it?
Some might wonder why I just didn’t endure it and sat down to feed him anyway. But the truth is that the first couple of months post birth the pain was simply too intense. I couldn’t! In that pain I also wouldn’t be holding my baby safely throughout the feed and it was simply out of the question. Some also wondered how I didn’t give up the breastfeeding and started bottle instead when it was such a problem, but when I thought about this option I soon realised that also with bottle feeding I wouldn’t get away from the part of Sitting with the baby.
The sight of a chair sometimes made me panic. It was absurd that a thing that in reality was so normal i.e. to sit on a chair, could affect me so much. My realistic me said that of course it would get better, but I didn’t know how much better it could get? Was it temporary, or was my life going to be like that from now on, and forever?
But more than anything it made me feel like a horrible mum. When I looked at other mothers I felt I stung of jealousy as I just wanted to be able to sit like a normal person and enjoy cuddles my newborn. Whenever I tried I lasted for a few seconds but the agony was always too intense and I had to give up. What a failure.
I was on a ski holiday with friends and at the end of the last day I did that thing you are not supposed to do. I took the ski lift up the mountain again and went downhill for that ‘last one’. I was tired, the slopes were icy, with bulky patches of snow around. And I fell. I fell and landed very badly on my bum. I had done this millions of times since starting snowboarding, but I felt that this time it was different. I knew it was bad.
To make a long story short I have since then always struggled with tailbone/coccyx pain. The first 6 months post-injury were almost unbearable, the first year horrible and then it got to a point where I could start live with it but it affected my life quite a lot. I struggled sitting down for too long, cinema was something to endure rather than enjoy and travelling in a car or an aeroplane was a mission, and I would never be particularly comfortable in a sofa or an armchair.
So when I got pregnant 10 years later this whole thing of giving birth concerned me a little. Could the coccyx injury affect the process? Could the pain get worse by a vaginal birth?
I saw my Women’s Health Physiotherapist a few weeks before the due date to discuss the issue, and she gave me exercises to carry out in preparation for the birth and we discussed birth positions. As I usually found it painful to lie flat on my back, I soon understood that this position was not going to be an option for me in any part of the labour process. I would need to give birth for example on all fours, standing up or any other way as long as I wouldn’t put pressure on the tailbone. That obviously didn’t happen.
My prolonged labour and complex birth aggravated the tailbone pain to an unbelievable extent. When the effect of my epidural wore off I quickly realised that it was something that would affect mine – affect our life massively. I had experienced that coccyx pain a decade earlier so I just knew this wouldn’t be easy to recover from, and even worse was that this time the pain was on a totally different level.
So there are good days and bad days when it comes to my motivation. On the good days I try to forget about the negatives and almost pretend I physically am like pre-pregnancy. I just get on with the training, it is usually a spin class or a strength workout either at home or down at the gym. I close myself in the moment and just go for it. I happily set the alarm to get up in the early hours before my family wakes up, just to make the most of the day and to get my training sessions in. I innocently fantasise that I am doing intervals on a track or running a half-marathon – yes it’s almost as if I pretend in front of myself that this is what I am actually training for. I do enjoy a good spin class and all respect for that also those sessions can give me an adrenaline kick, but in reality the only thing I wish I was doing all the time, is running. I have built my jogs up slowly and have reached a distance of about 5-6K as a maximum so far, and I generally feel ok when I am out there. In terms of fitness level I could do more, it is the sensible part of me that stops me from running any further (yet). And on those good days, I pretend that ‘these are just early days’ and I am just building my running up from here. That I will run properly again!
There are the bad days though. That’s when it feels like there is no point in doing all this. Of course training and keeping fit will always ’do me good’, and if anyone knows that it’s me! But motivation fails me when I start analysing the possibility that this might be all I ever will be able to do. Spin classes and the odd 5K jog – that is not the runner I want to be, not the runner I am supposed to be, is it?! Sure, the prolapse usually feels ok when I do my little run but I have learnt that when I jog in the morning and then also walk quite a lot during the rest of the day then it will be so much worse in the evening. I have also learnt that I cannot run in the evening. The pelvic floor muscles are tired from the day and they don’t cope with the running impact if I wait until the evening to go out. I have always liked running in the morning so in a way I don’t mind, but it has come to a point where if I don’t get it done in the beginning of the day, it is not like in the past and I have a chance later on to do it. Run in the morning, or don’t do it at all, basically.
So if I have overdone things a bit (by a jog in the morning and then lots of walking during the day) and when I later that evening sense that heaviness and chafing down there just by walking around at home it is hard not letting the bad thoughts take over, and feel disheartened. When these periods come I loose myself in a bad spiral. I miss one training session and the next day my thoughts go along the lines: What difference will it make if I miss another one? I’m not a runner anymore anyway. Not really doing a half-marathon or a steeplechase race in this life again am I? So why bother. One session missed, two sessions missed, three sessions missed. So? It won’t change anything. Whatever.
This is not ok. And it’s so unlike me! I have never before in my life felt like giving up would be an option when it comes to exercise and training, and I hate myself for that I now let it happen.
The good days come back though and when they do I recognise myself again – and the good periods are when I generally feel at my best, also in other aspects of life.
I just need to hold on to those days, day after day…
There are so many things I cannot do anymore because of the massive change my body went through due to pregnancy and childbirth. It is sometimes hard to accept I am not the person I used to be. I became a mum, but I lost a little bit of Me on the journey. There are things I would like to do that I cannot do anymore.
But I am now a mum, a mother. I have a son that brings joy to my life every day. I have a family.
And there are so many New things that I CAN do! <3
The Physio had now suddenly told me something interesting. She said that starting to jog a bit could (potentially) positively teach the pelvic floor how to respond to this new impact. The muscles had become weakened and stretched and they were definitely not used to this kind of activity since a very long time. But starting it back (slowly and easy of course) might just remind them of what they have to do/how to react when put under that sort of pressure.
It took me two weeks after the first run (to build up courage? To go easy on myself and not do too much too soon? I am not too sure) and then I was back on the running trail again. Same procedure, a walk there together with my family before I ventured off to try this once again. I still had mixed feelings about it all as I wasn’t sure what to expect from my body, but my plan was to stick to the same session.
1 minute jog, 1 minute walk. Six repetitions.
And? Well, the physio was maybe right! This time it felt…….well, definitely not good but it kind of felt better than last time. The sensation was that the pelvic floor was still very vulnarable and without doubt not up to the task properly yet but it was also not quite as much in ‘shock’ as it was last time.
So maybe even if it was just the second attempt, the muscles already realised what I was trying to tell them we were going to do from now on. But I surely did not feel like a runner as I carefully plodded along for my repetitions of 60 seconds slow jogging. It may have felt a tiny bit better than the first time, but I knew there would be a long journey before I could do anything even close to what I really wanted.
But maybe things were going in the right direction..?!
So let’s get into detail a little more. What is a prolapse?
A pelvic organ prolapse is when the bladder – or any other pelvic organ (for example the uterus, cervix or bowel) has dropped down from its normal position and bulges into the vagina. I can happen when the supporting muscles (the pelvic floor) get damaged, weakened or stretched due to for example pregnancy and childbirth. The symptoms can include a feeling of heaviness – as if things are about to ‘fall out’, a bulging sensation, pulling, aching or pressure in the lower abdomen and pelvis, urinary incontinence or disturbed bowel movement, problems inserting tampons or applicators, sexual difficulties, lower back pain….
The risk of getting a prolapse increases with age, if you are overweight, if you have a job requiring lots of standing and lifting heavy, family history of prolapse, chronic cough and finally of course pregnancy and childbirth and especially prolonged and/or assisted labour.
I tick a few of the above boxes. Several women in my family have a prolapse, my labour was very long and ended with a forceps delivery. I also suspect that all the running I have done in my life may have brought me towards the ‘risk zone’. Especially training for steeplechase, which puts even more pressure on the pelvic floor as it is high impact. A lot of my sessions the last few years of training involved running over hurdles, i.e. jumping whilst running. I look back at it now and understand that even if I really enjoyed that kind of training, it probably didn’t do very good for my body.
Could I have avoided getting a prolapse? If I hadn’t run throughout my life and potentially put myself at a greater risk..?
Well, this I will never know.
My gut feeling says I would still have got the prolapse due to the complicated birth. Maybe less, maybe the same? But had I not been a runner it would probably not have affected my life as much. I have a feeling I would have come to terms with it easier if I only had to get back to live my everyday life. But that discussion is pointless. It doesn’t matter if the running contributed to me getting a pelvic organ prolapse. Had I never been a runner I would have missed out on so much – and if I will never get back to where I used to be at least I have the running experiences, memories (and a few achievements!) in my backpack.
If you are interested in finding out more about different types of prolapses and treatment options I recommend visiting for example: