Real Talk: Why constipation can be a pelvic floor issue
Constipation is one of the most common digestive complaints, yet many people do not realize that the pelvic floor muscles may play an important role in bowel function.
While constipation can sometimes be related to diet, hydration, medications, or other digestive concerns, it is not always a problem originating in the gut. In some cases, the pelvic floor muscles may not be relaxing and coordinating properly during a bowel movement.
Pelvic floor physical therapy can help identify these issues and provide treatment strategies to improve bowel function, reduce straining, and support more comfortable and complete bowel movements.
What Does the Pelvic Floor Have to Do With Constipation?
The pelvic floor muscles sit at the bottom of the pelvis and help support the bladder, bowel, and reproductive organs. These muscles must be able to contract, relax, and coordinate appropriately throughout the day.
When it is time to have a bowel movement, the pelvic floor muscles should relax to allow stool to pass comfortably. If the muscles remain tight, overactive, or poorly coordinated, emptying the bowels can become difficult.
This can create symptoms that feel frustrating and confusing, especially when traditional constipation treatments are not providing relief.
Signs Your Constipation May Be Related to Pelvic Floor Dysfunction
Some individuals experiencing pelvic floor dysfunction may notice:
Straining during bowel movements
Feeling like stool gets stuck
Incomplete emptying
Constipation that does not improve with fiber
Needing to change positions to have a bowel movement
Pelvic pressure or heaviness
Tailbone pain
Pelvic pain
Urinary urgency
Bladder leakage
These symptoms may indicate that the pelvic floor muscles are not coordinating efficiently during bowel movements.
Why Does This Happen?
Constipation related to pelvic floor dysfunction can develop for many different reasons. In some cases, the pelvic floor muscles gradually become tight, tense, or poorly coordinated over time. In others, symptoms may develop after a specific life event or injury.
Common contributing factors include:
Pregnancy and postpartum recovery
Chronic stress and tension
Prolonged sitting
Painful bowel movements
Pelvic surgery
Core weakness or dysfunction
Chronic pelvic floor clenching
Anxiety and nervous system activation
Many people are surprised to learn they have been holding tension in their pelvic floor muscles for years without realizing it.
What Is Dyssynergic Defecation?
Dyssynergic defecation is a condition in which the pelvic floor muscles and surrounding muscles do not coordinate properly during a bowel movement.
Instead of relaxing to allow stool to pass, the muscles may tighten or contract at the wrong time. This can create a situation where the body is essentially working against itself.
A helpful way to think about it is trying to open a door while someone on the other side is pushing it closed.
This lack of coordination can contribute to chronic constipation, straining, incomplete emptying, and ongoing frustration despite making changes to diet or fluid intake.
How Pelvic Floor Physical Therapy Can Help
Pelvic floor physical therapy focuses on improving muscle coordination, relaxation, breathing mechanics, and bowel function.
Treatment may include:
Pelvic floor muscle assessment
Relaxation training
Breathing coordination
Pressure management strategies
Postural education
Toileting mechanics
Bowel habit education
Mobility exercises
Gentle strengthening when appropriate
Because every person is different, treatment is individualized based on your symptoms, goals, and examination findings.
At The Healthy Pelvis, care is always one-on-one and designed to address the underlying causes of symptoms rather than simply treating the symptoms themselves.
You Don’t Have to Just Live With It
Constipation is incredibly common, but that does not mean it is something you simply have to accept.
If you feel like you’ve tried everything and still struggle with bowel movements, your pelvic floor may be contributing to the problem.
Your body is not broken.
Sometimes it simply needs better coordination, less tension, and the right support.
Pelvic floor physical therapy can help identify contributing factors, improve bowel function, and help you feel more comfortable and confident in your daily life.
Resources
For additional information about constipation, bowel function, and pelvic floor dysfunction, the following resources may be helpful:
American Physical Therapy Association (APTA) Pelvic Health
International Foundation for Gastrointestinal Disorders (IFFGD)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
National Association for Continence (NAFC)
These resources can provide helpful education, but they should not replace an individualized evaluation with a qualified healthcare provider.
Take the First Step Toward Feeling Better
Constipation can be frustrating, uncomfortable, and disruptive to daily life. While many people focus only on diet or hydration, pelvic floor dysfunction may also play an important role.
At The Healthy Pelvis, Melissa Scholl provides one-on-one pelvic floor physical therapy focused on improving bowel function, reducing straining, restoring pelvic floor coordination, and helping patients feel more comfortable in their daily lives.
The Healthy Pelvis provides in-home pelvic floor physical therapy throughout Elmhurst, Hinsdale, Oak Brook, Lombard, Glen Ellyn, Villa Park, Clarendon Hills, Downers Grove, and surrounding western suburban communities.