For Episode 76 of The Anti-Macro Podcast (Apple/Spotify), I had the pleasure of speaking with Dr. Kirsten Brown, a pelvic floor physical therapist, about the connection between pelvic floor dysfunction and constipation. We dove into how lifestyle practices, combined with targeted pelvic floor therapy, can significantly improve gut motility and provide lasting relief from constipation.

Constipation is something many people struggle with, but what if there was a solution that combined lifestyle practices and pelvic floor physical therapy (PT) to improve gut motility? Dr. Kirsten Brown, a pelvic floor PT expert, shares her insights into how pelvic floor dysfunction can contribute to constipation and why a combination of therapeutic interventions and everyday habits can make a huge difference.
Understanding Pelvic Floor Dysfunction and Its Role in Constipation
Pelvic floor dysfunction is more common than many people realize and is often linked to constipation. This dysfunction can manifest as either a tight (hypertonic) or weak (hypotonic) pelvic floor, both of which can create problems during bowel movements. Additionally, nerve damage or surgical history can further complicate things. The pelvic floor muscles and their coordination play a crucial role in the passage of stool, and any issues here can lead to discomfort and difficulty with regular bowel movements.
Dr. Kirsten explains that pelvic floor dysfunction can also impact gut motility, leading to symptoms like bloating, painful bowel movements, and incomplete evacuation. A well-functioning pelvic floor is necessary to support proper bowel movements, and dysfunction in this area often requires more than just dietary adjustments to resolve.
The Power of Combining Pelvic Floor PT with Lifestyle Practices
While traditional approaches often focus on nutrition, hydration, and movement, integrating pelvic floor therapy can be an essential part of a holistic approach to addressing constipation. Here's why combining the two is such an effective solution:
Pelvic Floor Therapy: Pelvic floor physical therapy helps identify and address dysfunctions, such as tightness or weakness in the pelvic floor. Dr. Brown highlights how pelvic floor PT uses techniques like internal and external exams, breathing exercises, and manual therapy to correct imbalances and improve the pelvic floor's function. Through treatments such as diaphragmatic breathing and soft tissue mobilization, pelvic floor PT directly addresses the core of the problem—ensuring that the muscles responsible for moving stool are working as they should.
Lifestyle Adjustments: Along with PT, lifestyle practices like movement, proper hydration, and nutrition are key for improving gut motility. Dr. Brown emphasizes the importance of consistent movement, such as a 30-minute walk after each meal, to promote healthy digestion. Diet and hydration also play significant roles, as water and fiber are essential for regular bowel movements. Even small changes, such as using a squatty potty for better posture while sitting on the toilet, can have a substantial impact on how your body functions during bowel movements.
A Multi-Faceted Approach: Combining pelvic floor PT with nutrition, hydration, and lifestyle practices gives you a full toolkit to combat constipation. As Dr. Brown explains, it's about more than just one solution—it's about using multiple strategies to achieve better overall gut health and motility. Whether it's addressing scar tissue from surgeries, improving posture, or learning how to breathe properly to engage your pelvic floor, these interventions work together to ensure long-term success.
When to Seek Help: Signs You Might Need Pelvic Floor Therapy
How do you know if pelvic floor PT is right for you? Dr. Brown shares some key signs that could indicate pelvic floor dysfunction is contributing to your constipation:
Difficulty or pain during bowel movements
Chronic constipation or incomplete voiding
Pelvic heaviness, particularly after childbirth
Difficulty with core engagement or posture
A history of abdominal surgeries, like C-sections, which can lead to scar tissue affecting gut motility
If any of these symptoms sound familiar, seeking out a pelvic floor PT evaluation could be a game-changer for improving both your pelvic health and digestion.
Getting Started: What You Can Do at Home
While professional pelvic floor PT is essential, there are simple practices you can start at home to improve your condition. Dr. Brown recommends the following:
Diaphragmatic Breathing: Engage your diaphragm fully by practicing 360-degree breathing to release tension in your pelvic floor and improve motility.
Squatty Potty: This simple tool helps you maintain a better posture during bowel movements, allowing for smoother passage of stool.
Self-Release Techniques: You can use tools like a tennis ball or lacrosse ball to release tightness in the pelvic floor by sitting on the ball and using breathwork to help release tension.
Conclusion: A Holistic Approach to Relieving Constipation
Constipation can be a frustrating and often uncomfortable problem, but addressing pelvic floor dysfunction in combination with lifestyle changes can bring lasting relief. As Dr. Kirsten Brown explains, pelvic floor PT is a powerful tool that can correct underlying issues contributing to constipation, while lifestyle practices like movement, hydration, and diet further support the healing process.
If you're struggling with constipation and suspect pelvic floor dysfunction may be a factor, consider combining pelvic floor therapy with your lifestyle adjustments to see better results. It's all about taking a multi-pronged approach to improving your health and achieving the relief you deserve.
Key Takeaways:
Pelvic Floor Dysfunction and Constipation: Pelvic floor dysfunction, whether due to tightness, weakness, or structural issues, can significantly contribute to constipation. Addressing these dysfunctions through pelvic floor physical therapy can help improve motility and alleviate symptoms.
Combining Therapy with Lifestyle Changes: A holistic approach that combines pelvic floor therapy with lifestyle practices like movement, hydration, and nutrition provides the best results. These elements work together to enhance gut health and relieve constipation.
When to Seek Pelvic Floor Therapy: If you're experiencing symptoms like painful bowel movements, chronic constipation, or pelvic heaviness, pelvic floor PT may be a crucial part of your treatment plan. It's especially important if you've had abdominal surgeries or childbirth-related issues that may affect your pelvic health.
Simple Home Practices: Techniques like diaphragmatic breathing, using a squatty potty, and self-release exercises (e.g., using a tennis ball for pelvic floor tension) can be beneficial in improving pelvic floor function and relieving constipation at home.
The Power of a Multi-Pronged Approach: Constipation often requires addressing multiple factors. Combining pelvic floor therapy with other strategies like diet, exercise, and stress management creates a comprehensive treatment plan for lasting relief.
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