Many people silently struggle with bowel problems—constipation, difficulty fully eliminating, fecal urgency, or accidental leakage. These issues can affect comfort, confidence, and daily quality of life. What many don’t realize is that specialized pelvic floor physical therapy can play a major role in restoring healthy bowel function.

Pelvic floor therapists are trained to assess how your muscles, breathing, posture, and movement patterns influence the way your bowel works. With the right approach, therapy can reduce symptoms, improve comfort, and help you regain control.

Common Bowel Issues Physical Therapy Can Help Address

1. Constipation

Constipation often involves more than just “slow motility.” Many people unknowingly tighten their pelvic floor or core muscles during bowel movements, making it harder for stool to pass. PT can help by:

• Teaching coordinated pelvic floor relaxation
• Improving posture for easier elimination
• Training abdominal and diaphragmatic breathing
• Offering strategies to reduce straining and protect pelvic tissues

These techniques support a smoother, more complete bowel movement.

2. Difficulty Fully Eliminating

Some individuals feel like they can’t empty completely, or they experience a sensation of “blocked” stool. This can be related to:

• Pelvic floor muscles not relaxing
• Poor coordination between the abdomen and rectum
• Habitual straining
• Nerve or pressure sensitivity

Physical therapy can retrain the muscles and improve rectal awareness using education, manual therapy, coordination drills, and sometimes balloon retraining to help the body relearn healthy patterns.

3. Fecal Incontinence

Accidental stool leakage is more common than you might think, and it’s treatable. Causes often include weak pelvic floor muscles, poor sensory awareness, or difficulty holding during urgency.

Pelvic floor PT helps by improving:

• Strength and endurance of the pelvic muscles
• Coordination between the sphincters and abdominal muscles
• Awareness of early sensations of urgency
• Bowel habits, diet, and toileting positions

With consistent care, many patients experience significant improvement or full resolution of symptoms.

What to Expect in Pelvic Floor Physical Therapy

A trained therapist uses a whole-body approach that may include:

✔ Pelvic Floor Muscle Training

Learning when to contract and when to relax is key. Proper timing—not just strength—matters most for healthy bowel function.

✔ Breathing and Core Coordination

The diaphragm, deep core, and pelvic floor work together. PT teaches how to use this system effectively during daily activities and bowel movements.

✔ Manual Therapy

Gentle techniques can help reduce pelvic tension, improve mobility, and decrease discomfort.

✔ Toilet Mechanics and Habit Training

Small changes—like foot positioning, breathing during elimination, or avoiding straining—can dramatically improve bowel success.

✔ Balloon Retraining

This evidence-based technique helps improve rectal sensation, urge control, and coordination for elimination.

Why Physical Therapy Works

Bowel function relies on the muscles, nerves, posture, and pressure management in the pelvis and core. When one part of the system isn’t working correctly—too tight, too weak, or poorly coordinated—it can lead to chronic symptoms.

Physical therapy treats the root cause, not just the symptoms. Instead of relying only on medications or procedures, PT empowers you with tools, exercises, and awareness that support long-term bowel health.

Who Can Benefit?

You may benefit from pelvic floor physical therapy if you experience:

• Chronic constipation
• Straining during bowel movements
• Sensation of incomplete emptying
• Fecal urgency or accidents
• IBS-related bowel difficulties
• Pelvic pain that affects bowel function
• Post-surgical or postpartum bowel issues

Taking the First Step

Bowel issues can feel embarrassing, but they’re incredibly common—and very treatable. A pelvic floor physical therapist provides compassionate, evidence-informed care to help you regain comfort, control, and confidence.

If you or someone you know is struggling with constipation, elimination difficulties, or fecal incontinence, physical therapy may be the missing piece to long-term relief.

References

1. Rao, S. S. C., et al. (2015). Diagnosis and Management of Defecatory Disorders. American Journal of Gastroenterology, 110(1), 16–31.

2. Heymen, S., et al. (2007). Randomized, controlled trial shows biofeedback to be superior to laxatives for normal transit constipation. Diseases of the Colon & Rectum, 50(4), 428–441.

3. Bharucha, A. E., et al. (2013). Pelvic floor disorders. Gastroenterology, 144(5), 1233–1246.

4. Wald, A. (2017). Management of fecal incontinence in adults. New England Journal of Medicine, 376(7), 664–672.

5. Bo, K., et al. (2017). Evidence-based physical therapy for the pelvic floor. Elsevier.

6. American Physical Therapy Association (APTA). Pelvic Health Physical Therapy Clinical Practice Research.