Constipation and Pelvic Floor Dysfunction: Causes & Solutions

How Pelvic Floor Muscles Impact Bowel Movements

The pelvic floor is a group of muscles that support the bladder, intestines, and rectum. These muscles play a crucial role in controlling bowel movements by helping to relax and contract during defecation. When they function properly, stool passes smoothly. However, if the pelvic floor muscles are too tight, weak, or uncoordinated, the process becomes difficult, leading to constipation.

Common Symptoms of Pelvic Floor Dysfunction-Related Constipation

If you're struggling with constipation related to pelvic floor dysfunction, you might notice these signs:

• Excessive Straining: More effort than usual is required to pass stool.
• Incomplete Emptying: A lingering sensation that the bowel isn’t fully emptied.
• Painful Bowel Movements: Discomfort or pain while passing stool.
• The Need for Manual Assistance: Some individuals may need to use their fingers to help remove stool or apply pressure to the perineum to evacuate completely.

Differences Between Standard Constipation and Pelvic Floor-Related Constipation

Regular constipation often results from diet, dehydration, or a sluggish digestive system. However, pelvic floor-related constipation happens when the muscles responsible for bowel movements don’t work in harmony. Traditional treatments like fiber supplements or laxatives may not be effective for this type of constipation, as the root problem is not slow digestive transit.

So if you have tried traditional constipation treatments and get no relief, it might serve you well that you want to explore the exercises mentioned below to help get back your health.

Dysfunctional Coordination Leading to Blockages

When your pelvic floor doesn’t relax properly during a bowel movement, stool struggles to pass through the rectum. Instead of opening up to let stool out, the muscles may contract at the wrong time, creating a blockage. This is known as dyssynergic defecation and is a common cause of chronic constipation in those with pelvic floor dysfunction.

Pelvic Floor Tightness vs. Weakness and Its Effects on Digestion

• Tight Pelvic Floor Muscles: If these muscles are overly tense, it becomes difficult to push stool out, leading to straining and discomfort.
• Weak Pelvic Floor Muscles: Weakness can lead to incomplete bowel emptying, making it feel like stool is always stuck.

Both tightness and weakness affect the efficiency of bowel movements, requiring targeted therapies to retrain muscles for proper coordination.

It is wrong to assume that your pelvic floor muscles only need strengthening as tight pelvic floor muscles get more strained if you add strengthening exercises like Kegels.

Impact of Nerve Function and Stress on the Pelvic Floor

Stress and nerve function also play a role in pelvic floor health. The pelvic floor muscles are connected to the nervous system, and chronic stress or pelvic nerve dysfunction can cause them to clench involuntarily, making bowel movements more difficult. Learning to regulate stress and improve nerve function can significantly aid in bowel regularity.

Beyond Traditional Exercises: Holistic Approaches to Constipation from Pelvic Floor Dysfunction

If you've tried conventional pelvic floor exercises, dietary changes, or even traditional physical therapy without success, you might feel frustrated and stuck in a cycle of discomfort. The truth is, constipation related to pelvic floor dysfunction often requires a more holistic approach—one that considers posture, breath, scar tissue, fascia, and even stress levels. Here’s how alternative techniques can help you find lasting relief when traditional methods fall short.

Hypopressives: A Revolutionary Approach to Pelvic Floor and Core Health

Unlike traditional strengthening exercises like Kegels, which focus on contracting the pelvic floor, hypopressive breathing works by reducing intra-abdominal pressure, decompressing the organs, and rebalancing the pelvic muscles. This technique combines deep postural activation with breath-holding maneuvers that create a natural vacuum effect, helping to:

• Improve bowel motility by stimulating the deep core and diaphragm.
• Enhance pelvic organ positioning, reducing pressure on the rectum.
• Activate the autonomic nervous system to regulate digestion and relaxation.

Here is a free youtube playlist to get started with integrating gentle foundational Hypopressives exercise into your routine. Starting with just 10 minutes/day can go a long way in helping you start to feel a difference.

Breathwork for Bowel Regulation: Calming the Nervous System

Your breath is one of the most powerful tools for improving digestion and relieving constipation. Stress and tension cause shallow breathing, which can tighten the diaphragm and pelvic floor, leading to poor bowel motility.

Effective breathwork techniques include:

• Diaphragmatic breathing: Inhaling by filling your rib-cage (front & back) and exhaling fully (called lateral breath in Hypopressives) can help.
• Extended exhales: Engaging the parasympathetic nervous system to calm the body.
• Resonance breathing: Slowing the breath to a steady rhythm (e.g., 5-6 breaths per minute) to optimize digestion.

Posture and Alignment: Setting the Foundation for Healthy Digestion

Many people overlook the role of posture in gut health. When you slouch or tilt your pelvis forward, your intestines and rectum become compressed, making bowel movements more difficult. Improving alignment through:

• Pelvic tilts and spinal elongation: Helps open up the rectal passage.
• Seated and standing posture awareness: Encourages natural abdominal engagement.
• Using a squatty stool: Mimics a natural squatting position to ease elimination.

Here are some relaxation techniques to help you. Pick 2-3 videos/week to add to your routine:

Scar Tissue and Fascia Release: Undoing Physical Restrictions

If you've had surgeries, C-sections, episiotomies, or even chronic tension in your abdomen, scar tissue and fascial restrictions could be limiting your ability to fully relax the pelvic floor for bowel movements.

Myofascial release techniques can break down adhesions and restore proper tissue mobility. Consider:

• Abdominal massage to stimulate peristalsis and relieve tightness.
• Soft tissue rolling or cupping for scar mobility.
• Pelvic floor manual therapy or visceral manipulation to release deep restrictions.

Here is a follow-along exercise to get started:

Lifestyle & Stress: The Missing Link in Chronic Constipation

Constipation isn’t just about muscles and movement—it’s also deeply connected to your lifestyle and stress levels. Chronic stress triggers the sympathetic nervous system (fight-or-flight), which slows down digestion and keeps the pelvic floor in a constant state of tension.

Holistic lifestyle adjustments to consider:

• Reducing stress through mindfulness and meditation
• Avoiding rushed eating and ensuring thorough chewing
• Balancing circadian rhythms by maintaining a consistent sleep-wake cycle
• Incorporating gentle movement practices like yoga and Tai Chi

Putting It All Together: A Holistic Plan for Relief

If conventional pelvic floor therapy hasn’t worked for you, consider shifting your focus to a more integrated, whole-body approach. A combination of hypopressives, posture correction, breathwork, fascial release, and stress reduction can help your body function optimally, easing constipation and restoring pelvic health.

By listening to your body’s cues and addressing underlying imbalances, you can reclaim regular, effortless bowel movements—and with them, a greater sense of comfort and well-being.

You can get started with our free 7-day pelvic floor challenge to get started incorporating these holistic exercises 10-15 minutes/day.

Read more & sign up for free here.

Constipation caused by pelvic floor dysfunction can be frustrating, but understanding the underlying causes is the first step toward relief. By incorporating holistic exercises, dietary changes, and behavioral techniques, you can improve bowel function and overall gut health.