https://corepelvicfloortherapy.com/pelvic-floor-dysfunction-symptoms/While factors such as poor diet and lack of activity can lead to constipation, one of the less associated causes of constipation is pelvic floor dysfunction. To better understand the relationship between pelvic floor and constipation, let’s understand more about where the pelvic floor is and how the pelvic floor can become dysfunctional leading to constipation.

Where Is The Pelvic Floor?

As the name implies, the pelvic floor is at the bottom of the pelvis but what most people fail to realize is that this muscular floor is the floor of the pelvis. With the spine, and the legs being connected to the pelvis, it is not a surprise to see how the integrity of the pelvis stability relies heavily on how stable (or unstable) these connections are. Let’s explore this a little bit.

  • Imagine a paper bag with a top representing your body from the mid-chest to the pubic area!
    • The bottom of the paper bag on the outside is the surface between the vagina or penis and the anus. This surface is a few muscles and 2 sphincters.
    • The inside of the bottom of the bag is also packed with many muscles, connective tissues, and ligaments. They all are the inner lining of what is referred to as the pelvic inlet, which is a bowl-like structure inside your pelvis.
    • The sides of the bag are the oblique abdominals.
    • The front is the abdominal area.
    • The back of the bag is the lower part of the mid-back and the lower back muscles.
    • The front and back of our hips connected to the pelvis are the 4 corners of the bag.
    • The top of the bag is the abdominal diaphragm which is rarely looked at as a player in the health of the pelvic floor and a contributor to pelvic floor dysfunction.

Every connection to the floor of the bag plays a direct role in how the bag will be; after all, the floor is not a suspended surface. When it comes to constipation and pelvic floor, the missing ingredient in the treatment is the impact of breathing on the health of the internal organs such as the intestines! Let’s explore the role of breathing in constipation.

Breathing, Pelvic Floor Dysfunction, And Constipation

If you are thinking that you have gotten the breathing down you are here for a surprise. Biological breathing is how all babies on this planet from birth to about 3 years of age do; our breathing changes to adapt to our changing lifestyles, injuries, and habits we form and that is the beginning of a decline.

Biological breathing as explained in the video below is the ‘tossing’ of air pressure between the vocal and abdominal diaphragm which in turn increases the inner abdominal pressure between the abdominal diaphragm (at the bottom of the chest bone) and the pelvic diaphragm, which is at the pubic bone area. To understand the difference between the pelvic diaphragm and pelvic floor, the blog I wrote. 

When living a sedentary lifestyle, either from work or our lack of activity in general, our posture declines. Our 2 diaphragms, the abdominal and pelvic diaphragm are no longer positioned parallel to each other and the pelvic floor. This means that the ‘tossing’ of the pressure from one to the other leading to the gentle rhythmic movement of the internal organs that is in sync with breathing is no longer taking place.

With biological breathing, when breathing in through the nose, we relax the muscles inside the pelvis (floor and the walls) and when breathing out through the nose, we strengthen the same muscles. That is true Kegel which we hear all the time.

It is no mystery that with stagnation and compression comes a lack of mobility and rigidity. When, due to our poor posture, the diaphragms are not positioned as they were designed to be, the internal organs are housed in less abdominal space and under more pressure. That means the contents inside the intestines for example will have a harder time being pushed out to be evacuated, leading to constipation. We won’t discuss the impact of constipation on the overall health here but you should not disregard this very important issue.

How To Treat Pelvic Floor Constipation?

The concepts of posture and movement, breathing and movement, and balance and movement are all the foundations of functional movement and Dynamic Neuromuscular Stabilization (DNS) specifically. DNS addresses the body of the paper bag metaphor I mentioned above. The actual floor of the ‘paper bag’ gets strengthened through kegel exercises to the best of our ability, which we’ll discuss below.

How To Practice Kegel Exercises

The obvious and subtle symptoms of pelvic floor dysfunction is a good place to learn what symptoms of pelvic floor dysfunction are and while you may have been told that your pelvic floor muscles are tight or weak, the solution to both is the same!

If you have tight pelvic floor muscles, the breathing-in component of biological breathing specifically addresses the tightness and if you are told your pelvic floor is weak, it is during the breathing out that the muscles inside your pelvis will contract to initiate the process of breathing out. Make sure to watch the video above because not every breathing is done right. That is the beauty of our body; we, as humans, are highly adaptable because we are to live a long life. The changes in our breathing patterns change if we don’t have what it takes to do it correctly!

We always have to chase the ‘why’ to address our issues for good so understanding why for example the muscles inside the pelvis are weak allows us to not keep doing the same thing. Getting older, having been pregnant, or being overweight certainly is important why is it that not every old person, everyone who gets pregnant or overweight has weak pelvic floor and pelvic wall muscles?

When you chase the why deeper, you will see that there is a collection of presentations that collectively lead to this weakness. The muscles inside of the pelvis respond to factors that impact the inside; the inside of the pelvis also responds to the outside of the pelvis. Your pelvis is double-layered with muscles for more stability.

When we manually go on the inside (through the vagina and/or penis) in an attempt to check the status of muscle strength and then to exercise squeezing the finger in an attempt to strengthen those muscles, I see the attempt but don’t see the long-term result.

If that was the way to strengthen, then nature would have provided us with that method. What it has created is biological breathing, body parts that know what their role is and are dying to show us what they are capable of but are limited by our wishes and choices. Following the principles of movement, following biological breathing, and being mindful of what we do and how we do them are the biggest players in my opinion.

In my practice, only when my patient has reached a certain point of movement correction, can breathe biologically and understands how to apply the principles of movement that I use the Emsella Chair to address the inside muscles. I use the chair to address the only musculo-skeletal muscles inside the body that I cannot touch while the diaphragm muscle performance shows its performance with biological breathing.

Once the inside of the pelvis, the second layer of reinforcement matches its integrity to the outside of the pelvis muscles, then both layers can dance together in harmony and provide the needed stability. This is the only way we can have stability in our pelvis IMO.

Taking laxatives in an attempt to address constipation from pelvic floor dysfunction is like a bandaid on a wound and not removing the cause. There are many treatments for pelvic floor dysfunction but none of them is as complete as the one that addresses all feeders of the cause of the dysfunction.

If you have chronic constipation and nothing seems to be working, you have a pelvic instability issue and that is what the focus of my practice is about. Contact me if you need help.

Dr. Shakib

Recommended Reading:

How Is the Treatment for Pelvic Floor Dysfunction?

Pelvic Floor Dysfunction Symptoms