At Cynergy, our pelvic floor therapists work with individuals experiencing a wide range of gastrointestinal and bowel-related symptoms. Whether you're dealing with chronic constipation, bloating, incomplete evacuation, or discomfort during bowel movements, we take a whole-body approach to uncover the root cause—often involving pelvic floor dysfunction. Through specialized assessment and one-on-one treatment, we help restore proper muscle coordination and improve digestive function, so you can feel more regular, comfortable, and confident.
The Pelvic Floor’s Role in Bowel & Bladder Dysfunction
The pelvic floor is a group of muscles that form a supportive sling at the base of the pelvis. These muscles are essential for several key functions:
- Stability of the pelvis and spine
- Support of pelvic organs like the bladder, rectum, and uterus
- Sphincter control to maintain continence and allow for controlled bowel movements
- Sexual function and comfort
- A “sump pump” effect , which helps regulate pressure and fluid movement in the abdomen and pelvis
When working properly, the pelvic floor muscles coordinate with your diaphragm and abdominal muscles to support healthy, strain-free bowel movements and continence. But when these muscles are too tight (hypertonic), too weak (hypotonic), or not firing in sync, they can disrupt these vital roles—leading to constipation, incomplete evacuation, and other digestive issues.
When the pelvic floor muscles are functioning properly, they coordinate to control urine flow, maintain continence, and support bladder health. However, when these muscles become too tight, weak, or uncoordinated, bladder dysfunction can occur.
How and Why Does Dysfunction Occur?
Pelvic floor dysfunction can develop for many reasons, often involving trauma, lifestyle, or medical conditions that affect muscle strength and coordination. Common causes include:
- Childbirth-related injury or strain that weakens or scars muscles
- Chronic straining due to constipation or heavy lifting
- Surgery or pelvic radiation that alters muscle or nerve function
- Poor posture or movement patterns that overload pelvic muscles
- Nerve damage from injury or medical conditions like diabetes
- Emotional stress or anxiety, which can cause muscle tension and impaired relaxation
These factors may cause the pelvic floor muscles to become overly tight and unable to relax (hypertonicity), or too weak and unable to provide adequate support (hypotonicity). Sometimes the muscles fire out of sync, disrupting the coordination needed for normal bowel and bladder function.
Symptoms of Pelvic Floor–Related Bowel Dysfunction:
- Chronic constipation
- Straining during bowel movements
- Incomplete evacuation
- Fecal urgency or incontinence
- Bloating and abdominal discomfort
- Rectal pressure or pain
One common cause is pelvic floor dyssynergia, a condition in which the pelvic floor muscles contract instead of relax during defecation, making it difficult to pass stool. These dysfunctions can mimic or worsen symptoms of IBS and significantly affect quality of life.
When the Pelvic Floor Is Not Working Properly, Your Bladder May Experience:
- Urinary urgency and frequency: A sudden, frequent need to urinate, sometimes soon after using the bathroom.
- Urinary hesitancy: Difficulty initiating urination due to poor muscle coordination or tension.
- Urinary incontinence: Leakage or loss of bladder control caused by weakened sphincter muscles or poor support.
- Pelvic pressure or discomfort: Especially noticeable when the bladder is full, often due to muscle tension or prolapse.
- Nocturia: Waking up at night to empty the bladder, disrupting sleep.
These symptoms are commonly linked to conditions such as overactive bladder (OAB), interstitial cystitis (IC), or pelvic floor muscle hypertonicity.
How Pelvic Floor Physical Therapy Can Help
Pelvic floor physical therapy is a highly effective treatment for addressing both bowel and bladder dysfunction. A trained therapist can evaluate how your muscles are functioning and guide you through personalized exercises and techniques to:
- Improve coordination and muscle control
- Relieve pelvic pressure and tension
- Restore normal bowel and bladder habits
- Reduce symptoms like urgency, hesitancy, and leakage
- Enhance your overall quality of life
If you're experiencing persistent bowel or bladder symptoms, a pelvic floor assessment may be a crucial step toward lasting relief and better health.
Frequently Asked Questions
Yes! Pelvic floor therapy can be very effective for treating chronic constipation, especially when it's related to muscle coordination issues like pelvic floor dyssynergia. When the pelvic floor muscles don’t relax properly during a bowel movement, it can make it difficult to pass stool—even with a healthy diet. A pelvic floor therapist can help retrain these muscles through targeted exercises, manual therapy, and biofeedback to improve coordination and support more complete, comfortable bowel movements.
Pelvic floor therapy can be a valuable part of managing Irritable Bowel Syndrome (IBS)—particularly if you experience symptoms like constipation, bloating, incomplete evacuation, or pelvic pressure. While therapy doesn’t directly treat IBS itself (which can have multiple causes), it addresses the musculoskeletal component that often contributes to or worsens IBS symptoms. Many patients report improved bowel function, reduced bloating, and a better quality of life with consistent pelvic floor treatment.
It depends on your symptoms and comfort level. An initial evaluation often begins with an external assessment of your posture, breathing, and pelvic alignment. If appropriate and with your consent, your therapist may also perform an internal exam (vaginal or rectal) to more accurately assess the strength, tone, and coordination of your pelvic floor muscles. Internal exams are considered the gold standard for evaluating pelvic floor dysfunction but are never required—you’re always in control of your care.
The length of treatment varies based on your specific condition, symptoms, and goals. Some patients notice improvement within just a few sessions, while others with more complex or chronic issues may benefit from several months of therapy. On average, most people attend pelvic floor therapy for 6–12 sessions, typically once per week. Your therapist will create a personalized plan and adjust it as your symptoms improve.
Certified Therapists:
Bridgit Shaefer
Sarah Brooks
Estella Maritza Mejia
Laurence Agénor
Paris McConnell
Struggling with constipation, bloating, or bowel urgency? You’re not alone—and you don’t have to keep living this way.
Our pelvic floor therapists can help you feel better, move with confidence, and enjoy better digestive health.