Constipation

What it is

Constipation is clinically defined as hard, difficult bowel movements fewer than 3 times per week. The most common reasons people seek out a physical therapist for constipation is if the root cause is either slow transit or outlet dysfunction (aka Dyssynergia).

How it is treated with physical therapy

Behavior modification and education are the primary first line treatments for this condition. Therapist will give a detailed explanation of the anatomy and physiology of the bowels, how they relate to the pelvic floor, and how your daily activities and diet can severely effect the ability to defecate.
Therapist will perform visceral mobilization throughout the abdomen, as well as manual therapy internally in the pelvic floor. For women therapist will typically work vaginally, and for men therapist will work rectally to access the deep pelvic floor muscles.
You will be coached through how to voluntarily and consciously relax the pelvic floor – this being the most critical skill to master.

Your Homework

You will be given specific behavior and diet modifications for your daily life as well as pelvic floor relaxation exercises. You will be taught how to perform visceral mobilization on your own to encourage bowel movements.

How many sessions

Therapy for this typically lasts between 4-8 visits depending on how well you can make the necessary changes in your daily life to facilitate normal bowel movements. Some patients come for much longer because they feel the manual therapy is a critical part of staying on top of this condition. Many patients come for a monthly “tune-up” because it makes them feel better.