Pelvic Floor - Straining

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   Our user asked: "Hi, I have a question. I have mild pelvic floor dysfunction. I have seen a PT, but have less frequent appointments now. I just realized one thing that is setting it off is when I get constipated. I do take a fiber supplement, but sometimes have constipation anyway. What is the name of the muscle that a person uses to strain? It is the one in the lower abdomen or upper pelvis on both sides. How can I stretch that muscle? It feels tight and fatigued. Thank you!"

Ask a PT Response: "This question is difficult to answer because I'm not sure what you are asking. Puborectalis is the muscle that when tight can lead to constipation. When unable to relax the rectum remains 'kinked' and it is difficult to push stool out, can lead to straining, small caliber stool, constipation. While straining you are using the abdominals and some people valsalva or hold your breath and tighten abdominals. When all is working correctly the pelvic floor should relax as you are bearing down. In cases with pelvic floor muscle dysfunction there is a condition called anismus: the pelvic floor tenses as you bear down, puborectalis keeps the rectum closed off and leads to difficulty with bowel movements.

As far as constipation goes, yes, it definitely adversely effects the pelvic floor.  In addition to fiber, many practioners recommend miralax 17mg by mouth daily as needed and senna 1-2 tablets by mouth daily as needed.  Both are over the counter.  Also make sure to drink extra fluids with these medications.

You may want to consult with your PT to see what stretches he or she would recommend as your PT will know your body and situation the best. I hope this helps."

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Ask a PT Members Profile Send Private Message Find Members Posts Add to Buddy List Senior Member Joined: Jul 07 2008 Status: Offline Points: 954	Post Options Post Reply Quote Ask a PT Report Post Thanks(0) Quote Reply Topic: Pelvic Floor - Straining Posted: Apr 08 2009 at 7:58am
	Our user asked: "Hi, I have a question. I have mild pelvic floor dysfunction. I have seen a PT, but have less frequent appointments now. I just realized one thing that is setting it off is when I get constipated. I do take a fiber supplement, but sometimes have constipation anyway. What is the name of the muscle that a person uses to strain? It is the one in the lower abdomen or upper pelvis on both sides. How can I stretch that muscle? It feels tight and fatigued. Thank you!" Ask a PT Response: "This question is difficult to answer because I'm not sure what you are asking. Puborectalis is the muscle that when tight can lead to constipation. When unable to relax the rectum remains 'kinked' and it is difficult to push stool out, can lead to straining, small caliber stool, constipation. While straining you are using the abdominals and some people valsalva or hold your breath and tighten abdominals. When all is working correctly the pelvic floor should relax as you are bearing down. In cases with pelvic floor muscle dysfunction there is a condition called anismus: the pelvic floor tenses as you bear down, puborectalis keeps the rectum closed off and leads to difficulty with bowel movements. As far as constipation goes, yes, it definitely adversely effects the pelvic floor. In addition to fiber, many practioners recommend miralax 17mg by mouth daily as needed and senna 1-2 tablets by mouth daily as needed. Both are over the counter. Also make sure to drink extra fluids with these medications. You may want to consult with your PT to see what stretches he or she would recommend as your PT will know your body and situation the best. I hope this helps."

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