Can Pelvic Floor Physical Therapy Help My Constipation?

By Jennifer Joslyn PT, DPT

You may be surprised to know that the answer is yes!

Constipation is defined as the inability to have a normal bowel movement. Normally, you should have a bowel movement anywhere between three times per day or three times per week (2). Constipation is often paired with abdominal pain, low back pain, bloating, feeling of incomplete emptying, and increased pressure in the pelvic region, making it difficult to perform your daily activities. Additionally, it may feel like your stools are hard, so that you must push or strain to empty your bowels.

These symptoms are certainly not fun, but pelvic floor PT can often help!

Tight pelvic floor muscles can sometimes be a contributing factor in the reason for your constipation. Your pelvic floor muscles help to support your rectum and control your anal sphincter. In order to have a bowel movement, the muscles surrounding the anal sphincter must relax. If these muscles are tight, this can become quite difficult and you will find that you are unable to pass stool.

When treating constipation in pelvic floor physical therapy, we often train the pelvic floor muscles to relax. Additionally, internal or external soft tissue techniques can be utilized to facilitate muscle relaxation and movement of stool. Toileting strategies are also often taught to ensure you are sitting on the toilet in an optimal position and using your pelvic floor muscles appropriately.

 What Can I Do at Home?

Firstly, it is most important to avoid pushing or straining when trying to have a bowel movement. Pushing and straining allows for an inappropriate amount of pressure placed on your core and pelvic floor muscles, making it hard for them to relax. Instead, focus on taking deep breaths and imagine lengthening through your pelvic floor as you inhale, allowing for your anal sphincter to relax and open. It can also help to place your hands on your sides and imagine breathing into your hands to ensure you are breathing and lengthening throughout your entire abdomen. Leaning forward or placing your feet on a stool can also help to place your rectum in a better position and allow your belly to totally relax.

The key word here is RELAX! Having a bowel movement shouldn’t feel like a workout! If you are unable to go, I often recommend stepping away from the toilet and trying again later.

Another way to relieve bloating, abdominal pain, and facilitate the movement of stool is to perform abdominal massage (2):

  • Lay on your back and take deep breaths
  • Starting on your left side, underneath your ribs, gently stroke your belly downward toward your pelvis 10 times
  • Starting on your right side, underneath your ribs, gently stroke directly across to your left side, and then downwards toward your pelvis. Repeat this L-shaped pattern 10 times
  • Starting on your right side, start at the bottom of your belly (just above your hip bone) and stroke directly upward to your ribs, then directly across to your left side, then downward to just above your left hip bone. Repeat this upside-down U-shaped pattern 10 times

Lastly, ensure you are drinking enough water, exercising regularly, and eating fiber throughout the day. This will also help to improve the mobility of your stool and increase the ease of having a bowel movement. It is also important to check in with your doctor to rule out any underlying gastrointestinal issues that may be contributing to your symptoms.

Have Questions or Need a Little Help?

Feel free to give us a call at 651-348-7428

 

(1) Kendra L Harrington, Esther M Haskvitz, Managing a Patient’s Constipation With Physical Therapy, Physical Therapy, Volume 86, Issue 11, 1 November 2006, Pages 1511–1519, https://doi.org/10.2522/ptj.20050347

(2) Thompson, W. G., Longstreth, G. F., Drossman, D. A., Heaton, K. W., Irvine, E. J., & Müller-Lissner, S. A. (1999). Functional bowel disorders and functional abdominal pain. Gut45 Suppl 2(Suppl 2), II43–II47. doi:10.1136/gut.45.2008.ii43

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