How Pelvic Floor Therapy Can Help With Constipation

by Sylvie Le , DPT, PYTC January 15, 2024
Women Doing Pelvic Floor Exercises with a personal trainer | Specialized Physical Therapy

First, the bad news: constipation is, unfortunately, a fact of life. The good news: pelvic floor physical therapy can help eliminate and alleviate chronic constipation for good!

Hopefully, when we experience constipation, it only lasts a few days. But for many people, the condition is chronic, meaning they defecate less than three times a week regularly. Regardless of your gender, pelvic physical therapy can help address the underlying cause of constipation and manage the symptoms.

The Link Between the Pelvic Floor and Constipation

The pelvic floor is a collection of muscles, ligaments, and connective tissues located in the pelvic bowl. Their job is to provide physical and functional support for the pelvic organs and parts of the digestive system, including all aspects of bowel function, control, and health. 

If everything is working well, when you need a number two, the pelvic muscles coordinate to relax the anal sphincter… and voila! But if, for some reason, this process is compromised, the result can be constipation.

Get to Know Your Pelvic Floor

One way to consider the pelvic floor is by its openings: the urethral opening, the anal opening, and, for women, the vaginal opening too. When you have good pelvic floor control, you should be able to contract and release the muscles surrounding these structures independently of each other. To identify the anal pelvic muscles, contract and lift the muscles surrounding your anal sphincter as if you are trying to hold in gas. 

Don’t worry if you can’t—some people struggle to locate and engage the muscles, and other people end up tensing the other muscles of their pelvic floor or buttocks. 

A pelvic health PT can help you identify and correctly engage these muscles, improving your overall pelvic health.

Conditions and Causes of Chronic Constipation

Dyssynergic defecation is when the muscles and nerves of the pelvic floor do not coordinate properly (dyssnergy refers to the disturbance in muscle coordination resulting in maladaptive function). This lack of synchronicity across the muscles of the abdomen (affecting the digestive tract) and pelvic floor (affecting the bowel) means the necessary actions to create a bowel movement don’t occur. It has been shown to cause chronic constipation.

Irritable Bowel Disease (IBD) is a challenging condition to treat and manage. Constipation and fecal incontinence are common symptoms of those who have it. A small-scale study of male and female participants who received monthly pelvic physical therapy targeting bowel function reported that ‘significant symptomatic improvement occurred in a majority of patients.’    

Sometimes, constipation is a symptom or side effect of specific medical conditions or treatments; it’s common for people with Irritable Bowel Syndrome (IBS), or we can experience chronic constipation without knowing why. What people may not realize is that stress and impacted mental health can also cause constipation—and constipation can also impact people’s mental health, too! A review paper determined that constipation substantially affects quality of life and can lead to depression. The wide-ranging implications of chronic constipation are why treating it is so important!

Pelvic floor physical therapy for constipation can offer a medication-free, holistic treatment method by retraining the pelvic floor to manage, reduce, or eliminate constipation for good!

How Physical Therapy Helps With Constipation

There are several techniques and exercises a PT can offer. These include assessing pelvic floor function and teaching you pelvic exercises that stimulate the muscles and nerves needed for successful bowel evacuation. Retraining the pelvic floor may also help with the connection between the brain and pelvic muscles so they work in synchronicity. Manual techniques and abdominal massage, such as visceral mobilization, have been shown to be effective in alleviating constipation as it mimics and stimulates peristalsis. 

For digestion to work properly, we need to be relaxed and in our parasympathetic state (the ‘rest and digest’ branch of the nervous system). I use my training as a yoga therapist to teach patients relaxation techniques, working with both the body and the breath, which can help improve overall wellbeing!

We offer specialized pelvic health treatment for men and women. So, if you are suffering from constipation, get in touch today.

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