Can Pelvic Floor Physical Therapy help with Constipation?
Constipation is a common yet often misunderstood issue that affects at least 1 in 6 people at some point in their lives. For some, it can become a chronic problem that severely impacts their quality of life. Many people are unaware of the critical role the pelvic floor muscles play in bowel movements and how pelvic floor dysfunction can exacerbate constipation. Understanding this connection can be the key to finding effective solutions. Pelvic floor physical therapy is one such solution that can provide relief for those struggling with constipation by addressing muscle coordination, muscle tension, toileting habits, and abdominal pressure.
What is Constipation?
Constipation is typically defined as having fewer than three bowel movements per week. It is often accompanied by difficulty passing stool, straining, or a feeling of incomplete evacuation. A healthy bowel movement should ideally happen between three times a day to three times a week and take less than 10 minutes, with little to no straining.
However, constipation can take many forms. Some people may go several days without a bowel movement, while others might pass stool more frequently but still feel that they haven’t fully emptied their bowels. Several factors can contribute to constipation, including:
Poor diet: A lack of fiber and hydration in the diet can make stool harder to pass.
Medications: Certain medications, such as opioids and some antidepressants, can slow bowel movements.
Lack of physical activity: Regular exercise helps promote bowel motility.
Stress: Chronic stress can negatively affect digestive function.
But beyond these common factors, many people are unaware of the significant role the pelvic floor plays in maintaining healthy bowel movements.
The Role of the Pelvic Floor in Bowel Movements
The pelvic floor is a group of muscles located at the base of the pelvis that supports the bladder, intestines, and uterus (if you have one). These muscles play a crucial role in bowel movements by coordinating the opening and closing of the anal sphincter and helping to create the pressure needed to expel stool.
When functioning properly, the pelvic floor muscles relax to allow stool to pass easily. However, dysfunction in the pelvic floor can interfere with this process. Common ways pelvic floor issues contribute to constipation include:
Pelvic floor tightness: If the pelvic floor muscles are too tight or overactive, they can prevent full relaxation during bowel movements, making it difficult to pass stool.
Coordination problems: In some cases, the pelvic floor muscles do not coordinate properly. Instead of relaxing when they should, they contract, leading to straining and incomplete evacuation.
Pelvic organ prolapse or pain: Conditions like pelvic organ prolapse or pain from endometriosis can interfere with the pelvic floor’s ability to function properly during bowel movements.
How Pelvic Floor Physical Therapy Helps with Constipation
Pelvic floor physical therapy is a specialized form of therapy that focuses on improving the function of the pelvic floor muscles. It can be incredibly effective for those with constipation, addressing the underlying muscle dysfunction contributing to their symptoms.
1. Assessment of Muscle Function
Pelvic floor physical therapists begin by assessing the patient’s pelvic floor muscle function. They check for muscle tightness, weakness, and coordination issues. A tight pelvic floor or muscles that fail to relax properly during bowel movements are common findings in individuals with constipation. By identifying these dysfunctions, therapists can develop a targeted treatment plan to restore healthy muscle function.
2. Biofeedback Training
Biofeedback is a technique that helps patients learn how to properly engage and relax their pelvic floor muscles. Using sensors, biofeedback provides real-time feedback on muscle activity. Patients can practice relaxing their pelvic floor muscles during simulated bowel movements, improving muscle coordination and reducing straining.
3. Manual Therapy Techniques
Pelvic floor physical therapists may use manual therapy techniques to release tight areas or trigger points in the pelvic floor muscles that could be contributing to constipation. In some cases, visceral manipulation—a hands-on technique that improves the mobility of the abdominal organs—is used to enhance motility and reduce tension in the surrounding structures.
4. Posture and Toilet Habits
Proper posture during bowel movements is crucial for effective elimination. Pelvic floor physical therapists often recommend using a footstool to raise the knees and create a more natural alignment of the rectum. This position helps pass stool without straining. Therapists also guide patients on developing healthy toilet habits, such as responding promptly to the urge to go and avoiding prolonged sitting on the toilet.
5. Managing Abdominal Pressure
Managing abdominal pressure is key to preventing constipation. Pelvic floor physical therapists teach diaphragmatic breathing techniques, which help regulate abdominal pressure and relax the pelvic floor muscles during bowel movements. These techniques reduce strain on the pelvic floor and promote regular bowel movements.
6. Visceral Manipulation
Visceral manipulation involves gentle, hands-on therapy that improves the mobility and function of the abdominal organs, such as the intestines. This technique can be particularly helpful for individuals whose constipation is related to tension in the abdominal region. By improving intestinal mobility and reducing tension, visceral manipulation can enhance digestive function and alleviate constipation.
7. Practical Tips for Better Bowel Movements
Pelvic floor physical therapists provide practical tips to ease constipation. This might include dietary recommendations, such as increasing fiber intake and staying hydrated, along with exercises and stretches to relax the pelvic floor muscles. Therapists may also suggest stool softeners or laxatives, but always in conjunction with lifestyle changes and pelvic floor therapy.
Addressing the Root Cause of Constipation
One of the key benefits of pelvic floor physical therapy is that it addresses the root cause of constipation—pelvic floor dysfunction—rather than just treating the symptoms. By improving muscle coordination, reducing muscle tension, and teaching patients how to manage abdominal pressure, pelvic floor physical therapy provides long-lasting relief from constipation.
Moreover, this therapy takes a holistic approach, considering the entire body’s function. It emphasizes not only the improvement of pelvic floor muscle function but also the importance of posture, breathing, and lifestyle factors in maintaining regular, healthy bowel movements.
When to See a Pelvic Floor Physical Therapist for Constipation
If you’ve been struggling with constipation and have tried dietary changes, exercise, and medications with little success, it might be time to see a pelvic floor physical therapist. Pelvic floor physical therapy is particularly beneficial for individuals who experience chronic constipation, straining during bowel movements, or a feeling of incomplete evacuation.
A pelvic floor therapist can assess your muscle function, teach you techniques to improve bowel movements, and help you develop healthy toileting habits. By addressing pelvic floor dysfunction, you can improve your bowel movements and enjoy a better quality of life.
Conclusion
Pelvic floor physical therapy offers a comprehensive, evidence-based approach to treating constipation. By improving pelvic floor muscle coordination, managing abdominal pressure, and incorporating techniques like visceral manipulation, pelvic floor therapy provides a long-term solution to constipation. If you’re dealing with chronic constipation, consider consulting with a pelvic floor physical therapist to regain control of your digestive health.
