How Pelvic Floor Therapy Relieves Constipation
Authored by Dr. Maryssa Steffen, PT, DPT, Board-Certified Pelvic Health Clinical Specialist
How does pelvic floor dysfunction cause constipation?
When the pelvic floor muscles are tense and tight, it can be more difficult to poop. Pelvic floor muscle tightness can be caused by various factors:
Breathing habits - if your breathing is habitually shallow, if you have tension in your shoulders and chest, then your pelvic floor may compensate by tensing when you move.
If your pelvic floor muscles are often tense, they can become stiff and tight over time.
If you have tight hips, your pelvic floor muscles may lack sufficient mobility over time and become tight.
If your abdominal muscles are relatively weak and your back is stiff, then the imbalance can cause your pelvic floor to compensate and get tight over time. Sufficient postural and core muscle strength also helps to initiate and complete bowel movements.
Is pelvic floor therapy for constipation different for different genders?
Postural explorations and diagnostics, core muscle strength and coordination testing, individualized breathing exercises, hip mobility assessments, and pelvic floor relaxation questions and evaluations are applied to all genders.
For bodies with vaginas, internal pelvic floor therapy can include vaginal and/or rectal treatments.
Rectal pelvic floor therapy is gentle, and used to train your body awareness and coordination with breathing.
What are the types of pelvic floor therapy for bowel issues?
Breathing exercises - your pelvic therapist will see how you coordinate breathing while relaxing your pelvic floor muscles. Your therapist will also make sure you breathe properly when bracing your core muscles.
To assess breathing for yourself, watch yourself in the mirror as you breathe. As you breathe in, keep your shoulders relaxed and don’t let them raise.
Allow your lowest ribs at your waist to expand 360 degrees when you inhale and relax your belly and pelvic floor so the pressure can gently travel to your groin. You may place your hands on your low belly and groin to feel the movement here from breathing.
Relax to exhale and avoid pushing your breath out. Simply release and let your exhale elongate naturally.
Pelvic floor relaxation - you may benefit from learning how to self massage your pelvic floor muscles
Visceral fascia mobilization - your therapist can use manual therapy techniques to train your brain to move the fascial tissues around your colon, rectum, liver, stomach, to improve how your breathing pressure moves to your pelvic floor muscles to improve digestion and core support for bowel movements.
Biofeedback - this modality uses sensors to objectively show you when your pelvic floor muscles are relaxed. It is different from electrical stimulation, you do not feel it, but it shows you how to relax your pelvic floor muscles, with the guidance of a pelvic floor therapist.
Are there stretches that help with constipation?
Yes! A daily practice can include:
Child’s pose
Happy baby
Cat/cow
Pigeon pose
Yogi squat
Does having a strong core help with digestion?
Yes, it can. When your core muscles support your posture and you can breathe well during all activities that include your abdominal muscles, then your stomach, intestines, colon, and rectum receive natural massage-like movements frequently, thus helping aid in digestion and elimination.
Are there morning habits to stimulate bowel movements?
Yes!
Give yourself at least 30 minutes of free time after waking up and before getting ready to leave your house.
During this time, practice any relaxing or gentle mindful movement rituals, including diaphragmatic breathing.
Drink a warm beverage.
Slowly eat a fibrous breakfast.
Wait for a bowel urge and avoid straining for bowel movements.
Use a squatty potty.
Breathe throughout the bowel movement and get up after 5-10 minutes of being on the toilet to avoid risk of hemorrhoids.
Always go to the bathroom when you have an urge, try to avoid postponing bowel urges for longer than 30 minutes, to avoid risk of constipation in the future.
Eat fiber to improve digestion and decrease constipation.
Eat 25-30 grams of fiber a day from food
Generally speaking, include one serving of a whole grain in every meal.
If you eat processed foods, make sure they have at least 2 g of fiber per serving.
Eat at least 5 servings of fruits and vegetables a day.
Avoid juice and eat whole fruit instead.
Soluble fibers may help to lower cholesterol and improve blood sugar levels.
Insoluble fibers may help with constipation by improving movement of food in your intestinal tract.
Always stay hydrated, especially if you increase your fiber intake. Drink water when you are thirsty.
When to see a pelvic floor therapist for constipation?
If you have tried some of the resources in this blog for at least 6 weeks and you still struggle with constipation, you may benefit from reaching out to a pelvic therapist for an individualized treatment plan.
A pelvic physical therapist is trained to consider your medical history, current medications, and can screen for other causes of your symptoms so that your movement system and bowel function is as supported and optimized as possible.
Virtual pelvic physical therapy is also effective!
