The pelvic floor and constipation: What clinicians need to know

[@andrewcouper770]

I've noticed in my experience of pelvic floor pain over a long period that looking at the whole structure is something rarely touched upon. It was a lot of testing the pelvic floor and abs, which ultimately for me resulted in no relief. My issues were resolved by addressing my ribcage which was flaring and pelvis which was tipping forward (a very common postural issue, exacerbated by sitting). A tipping pelvis will result in a tightening pelvic floor and a diaphragm that doesn't function correctly with the pf. Once this was addressed, symptoms resolved almost immediately. Just a thought point to bring the discussion of addressing this as a whole body issue rather than just the pf, in much the same way we should probably look at any pain/dysfunction in the body. Trying to breathe away a problem when not structurally in the correct positions also led to a lot of anxiety! I hope people know these problems can be fixed and to stay positive, I know how lonely, miserable and helpless these issues can feel.

[@melissahines1629]

Yes this is very true Andrew! The pelvic floor is certainly just a component to the problem. We 100% agree about working on external dysfunction that can be contributing as well. Abdominal trigger points are certainly an area that must be addressed. It's so great you have learned so much about your body through this process.

[@ODessa002]

​@themona.4082Same

[@kate7837]

This was excellent information as I am suffering from this situation and have been for a few weeks. The laxatives only create further discomfort and pain and adding more fiber through Metamucil, doesn't really work. My diet is very good to begin with - what I need is a way to relax my pelvic floor. I would love if you could demonstrate the proper manner to breathe and how often should you do those exercises throughout the day. THANK YOU!

[@InstituteforPelvicHealth]

Lie down with a pillow underneath your head Bend your knees, keeping the feet hip width distance apart and keep the feet parallel Take a yoga block, tissue box or book; place it on your low belly Keep sacrum flat on the mat, floor or bed Let all your air out Inhale from in between your hip bones/ pelvis Allow the breath to travel all the way up the abdomen to the costovertebral angle (where the rib cage meets just underneath the breasts); watch the yoga block rise Exhale allowing the breath to travel back down to the hips/pelvis; allowing the entire abdominal cavity to draw back towards the spine; watch the yoga block fall Alternatively you can place the yoga block on the upper chest and as you practice the diaphragmatic breathing, try to keep the yoga block still Take 10 deep breaths 3x/day Pelvic Drop Also known as pelvic floor relaxation As you take a deep breath, imagine the breath traveling all the way down to your pubic bone. As this happens, feel your sit bones widen or spread and you should feel the vaginal and rectal opening gently soften or release down to your feet. It should feel like you are passing gas or gently releasing urine. It is subtle! On the exhale, the pelvic floor will gently lift back in the direction of your belly button. Try 10 breaths focusing on the pelvic floor. Look at the image of breathing and see what happens when you take an inhale--the pelvic floor descends or drops even more into that nice bowl shape. On the exhale it gently flattens up to your belly button.

[@charmainestevens8754]

Really benefited from this explanation. Thank you.

[@InstituteforPelvicHealth]

We're so glad!

[@veronicaalvarez4214]

Pelvic floor therapy changed my life and set me on my journey to pursue my WHNP. I'm scheduled to graduate in June 2022 and look forward to connecting with you both professionally! Love your videos!

[@InstituteforPelvicHealth]

Wow Veronica! Congratulations to you and we look forward to connecting with you. You will do great things!

[@Umangthe2024]

What was your problem constipation?

[@LionofJudah7771]

This is so helpful!! Thank you ❤

[@InstituteforPelvicHealth]

Glad it was helpful!

[@1TakoyakiStore]

Has there ever been a case to your knowledge where a tethered spinal cord has caused a permanently tensioned pelvic floor muscle? If wo how would that be tested for?

[@InstituteforPelvicHealth]

Please speak with your provider about this and find a pelvic floor therapist to help you

[@tonyawhitten5199]

Sigh. I would be a perfect subject for you. My pelvic floor issues are heartbreaking. My bms rule my life. I had five children vaginally. Ive had two rectocele repairs , two hemorrhoidectomies, a hysterectomy and pelvic sling. My last surgery was done robotically. I felt things fall before my six week recovery was over. I have internal hemorrhoids and it feels like my entire pelvic floor has completely collapsed. None of my muscles work. I have to take everything in the book to keep my stools thin enough to even feel the urge to go. It feels like my colon is at a 90 degree angle being kinked off. I have to push up to be able to evacuate. Im tired of going from Dr to Dr. Im tired of my stomach hurting from taking stool softeners that really dont even work. Everything I try blows up my stomach. I constantly suffer with gas and bloating. Ive tried them all. The only thing that seems to help is linzess, but it also blows up my stomach. Ive used magnesium oxide, but even it has stopped helping. By now, even if my issue was fixed, my intestines have become lazy. Is there any help for me at all? Im in Fredericksburg Va. Can you advise me on what kind of action I need to take at this point? Im just a patient. I do have some medical background as an LPN, but I am retired. I am a fit and young 61 year old other than my pelvic floor which is about 90 years old. lol

[@InstituteforPelvicHealth]

We are so very sorry to hear this! You have been through a lot. Unfortunately, we see a lot of people like you who have tried many different treatments and do not improve. If you have not tried any pelvic floor therapy, I would incorporate it into your toolbox. A pelvic floor therapist can do both internal and external manual work to help with bloating and stimulate the pelvic floor muscles to build proprioceptive awareness. www.pelvicrehab.com has a list of providers and I do believe there are some great ones in your area! Thinking of you

[@janetrobb5788]

Love your videos! Can't wait to take your course!

[@InstituteforPelvicHealth]

So glad you find them helpful! We love making them :)

[@Meee22222]

This video was very informative. Thank you!

[@InstituteforPelvicHealth]

You are so welcome!!