Tips to Decrease Straining While Pooping and Support Pelvic Floor Health

By Dr. Christine Martirez PT, DPT on 11/5/2024

Straining while pooping is not only uncomfortable but can also have serious long-term effects on the pelvic floor, especially when it becomes a chronic issue. Constant straining to have a bowel movement puts excessive pressure on the pelvic organs, leading to potential issues such as prolapse, anal fissures, and a decreased sensation to initiate bowel movements. Here are practical tips to help make bowel movements easier, as well as ways pelvic floor physical therapy can assist those dealing with chronic constipation and straining.

The Impact of Chronic Straining on the Pelvic Floor

When bowel movements require frequent or forceful straining, the pelvic floor muscles and surrounding structures endure repeated stress. Over time, this can lead to:

• Pelvic Organ Prolapse

  Straining increases intra-abdominal pressure, which can push pelvic organs (like the bladder or rectum) down toward the vaginal or rectal opening. This may lead to prolapse, where organs press into or out of the pelvic floor area, causing discomfort, pressure, and in some cases, a visible bulge.

• Anal Fissures

  Excessive pressure while pooping can tear the lining of the anus, resulting in painful fissures that may bleed and make bowel movements more uncomfortable, increasing the likelihood of more straining.

• Decreased Sensation to Have Bowel Movements

  Chronic constipation and prolonged straining can also dull the body’s natural urge to have a bowel movement. This decreased sensation can make it even harder to establish a regular, healthy bowel movement routine, leading to further constipation.

Tips to Make Bowel Movements Easier

1. Use a Stool for Proper Alignment

   Positioning your feet on a small stool or footrest while sitting on the toilet (so that your knees are higher than your hips) can significantly help reduce strain. This position mimics the natural squatting posture, which relaxes the puborectalis muscle — a sling-like muscle that wraps around the rectum. By giving the puborectalis more slack, the rectum straightens out, making it easier for stool to pass through without needing excessive pushing.

2. Use Your Breath to Coordinate Pelvic Floor Relaxation

   Practicing breath work while pooping can also help avoid strain. To do this:

   • Inhale

     deeply into your abdomen, allowing your belly to expand.

   • Exhale

     slowly while gently pushing through your abdomen with an extended belly, instead of forcing or bearing down. This exhale should be long and controlled, helping to naturally release pressure in the pelvic floor.

   This method reduces strain on the pelvic muscles and facilitates a smoother, more natural bowel movement by allowing the pelvic floor to relax in coordination with gentle abdominal pressure.

3. Stay Hydrated and Eat Fiber-Rich Foods

   Staying hydrated and eating a diet rich in fiber helps maintain regular bowel movements. Fiber adds bulk to the stool, making it softer and easier to pass, while water keeps the digestive system moving. High-fiber foods like fruits, vegetables, whole grains, and legumes support a healthy stool consistency, making bowel movements less likely to require straining.

4. Develop a Regular Bathroom Routine

   Setting aside time each day to sit on the toilet (without rushing or distraction) helps establish a healthy routine. Waiting too long to go can make stool harder and more difficult to pass, increasing the chances of needing to strain.

How Pelvic Floor Therapy Can Help with Chronic Constipation and Straining

For those who struggle with chronic constipation and straining, pelvic floor therapy can be an invaluable resource. Pelvic floor therapists use various techniques to improve muscle coordination and reduce the need for straining, helping to establish healthy and efficient bowel habits.

1. Pelvic Floor Muscle Assessment and Training

   Pelvic floor therapists assess the strength and flexibility of your pelvic floor muscles, identifying areas of tension or weakness that might contribute to constipation and straining. Training exercises target muscle relaxation and strengthen coordination to support natural and strain-free bowel movements.

2. Manual Therapy for Muscle and Tissue Release

   Manual techniques help release tight pelvic muscles, especially in cases where chronic straining has led to hypertonicity (excessive muscle tightness). This helps improve circulation, muscle relaxation, and stool passage.

3. Biofeedback for Improved Muscle Awareness

   Biofeedback can help increase awareness of pelvic floor muscles and train you to relax them effectively during bowel movements. This is particularly useful for those who may unintentionally tighten their muscles while trying to have a bowel movement, which can worsen constipation.

4. Education on Toilet Positioning and Breathing Techniques

   Pelvic floor therapists provide education on proper positioning and breath work, helping you learn and apply the tips above to prevent straining. They also assist in training patients to properly coordinate the abdominal and pelvic floor muscles to create gentle pressure that facilitates easier, strain-free bowel movements.

By working with a pelvic floor therapist, you can learn effective ways to support natural bowel movements, reduce the risk of pelvic floor dysfunction, and prevent the need for chronic straining. Combining these techniques with a healthy diet, hydration, and proper toilet positioning can make a significant difference in your pelvic health, especially when dealing with chronic constipation.

Suffering from constipation or chronic straining on the toilet? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at receptionmadison@pelvichealthnj.com.

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