Hi, I’m Cristina Bausch. I’m a physical therapist and Pelvic Floor Specialist here at Rebound Physical Therapy. We are an outpatient clinic, and we’re located in Topeka, Kansas. Today, I’m going to talk to you a little bit about constipation and how physical therapy can actually help to treat constipation.
Anatomy of the Pelvis
First, it’s important to understand a little bit about the anatomy of the pelvis. In the front of your body, low on your abdomen, you have your pubic bone. It connects to your hip bones, which curve around back toward your spine. At the base of your spine is your tailbone, which sits parallel to the pubic bone. If you look at a model of the pelvis, it almost looks like a bowl. At the bottom of this bowl in women, you have the pelvic floor muscles. These are what support all of your pelvic organs.
What we want for those muscles is that when you’re just at rest, those muscles should be fairly relaxed. If you imagine your arm muscle, when it’s just hanging there, it’s relaxed. There’s a little bit of muscle activity going on but not very much. When you move around, we want that muscle to be able to engage in work. It’s going to contract and provide support. But then once it’s done, you should go back to that relaxed state.
Causes of Pelvic Floor Muscle Tension
Now when you want to either empty your bladder or have a bowel movement, you want that muscle to be able to go from that relaxed state to actually shut off even more. We want it to be able to relax and lengthen down, and that’s going to help to straighten that bowel angle and help you to be able to empty your bowels easily.
For some people, there may be a couple of different things going on. Maybe that muscle is not relaxed at rest. For some people, they may be holding a little bit of tension in that muscle all the time, and so it’s not really able to relax well enough to allow a bowel movement to occur. Also for some people, maybe that muscle is okay at rest, but then when they want to empty their bowels, there’s some discoordination going on; and instead of that muscle relaxing, maybe it’s actually tightening and helping to close off and preventing that bowel movement from passing through.
Physical Therapy for Pelvic Floor Muscles
One thing that we can work on in physical therapy is to help to retrain those muscles to do the right thing at the right time. We can help to reset that resting level and then help to teach you how to coordinate that muscle to be able to relax and to be able to empty your bowels without that muscle kicking in and fighting you.
One of the tools that we use for that is called biofeedback. That’s a computer system that we can use where we use little electrodes that monitor what those muscles are doing, and it shows you on a computer screen so that you can see in real-time, “Okay, are my muscles tensed? Are they relaxed?” Because with those internal muscles, sometimes it’s really hard for you to just know what’s happening.
We can work on other strategies too. Sometimes there are restrictions in the fascia (the thin tissue that covers your muscles and organs) throughout the abdominal cavity where your colon and intestines are that slow things down.
We can work on anything there that may be contributing to your symptoms too. Some people may be experiencing pain or difficulty with a bowel movement. Some people may have incomplete emptying, where it seems like they need to go several times before they’re able to empty. For some people, they may not realize that they’re having an issue with constipation, but they have a lot of abdominal pain. And it may be that they’re going a little bit at a time, but it’s generally just not emptying completely enough.
Let Us Help You Get Back in Action
Depending on what the scenario is, we can work on all of the factors that are contributing to it to get to the root of it and help resolve your symptoms. So if you’re having any of these symptoms, or if you wonder if maybe your pelvic floor could be playing into it, just reach out and contact me at (785) 271-5533. We can do a consultation and discuss your symptoms and see if that’s something that physical therapy would help with.
