When constipation persists despite diet and fluid changes, the cause is often how the pelvic floor muscles coordinate and that can be retrained.
Most people try more fibre, more water and more exercise first. When those do not resolve it, the reason is frequently mechanical: the pelvic floor muscles that should relax to allow a bowel movement are instead tightening, a pattern known as dyssynergic defecation.
This is a coordination problem, not a willpower problem and it responds well to retraining. Physiotherapy addresses the mechanics, how you sit, how you breathe, how you generate pressure and how those muscles behave when you go.
Every pelvic health appointment takes place in a private treatment room. We explain everything before it happens, internal assessment is always optional and you can pause or stop at any point. You are welcome to bring someone with you.
Any combination of these is worth having assessed. You do not need to be certain what is causing it before you book.
If you have been living with this for years, that does not reduce the chance of improvement. Long-standing symptoms still respond to treatment.
Constipation is usually benign but see your doctor promptly if you have:
Usually a combination rather than one single factor. Identifying which apply to you is what shapes your treatment.
The muscles tighten when they should release, effectively closing the exit while you push.
Sitting upright on a standard toilet works against the anatomy; a simple footstool often changes everything.
Bearing down against a closed throat raises pressure without helping the stool move.
Repeatedly deferring the urge dulls the signal and disrupts the natural reflex.
Pain, scarring or fear of pain can lead to guarding that persists long after healing.
Genuine contributors and worth addressing but rarely the whole story on their own.
A private conversation covering symptoms, diet, routine and what you have already tried.
External assessment of breathing, abdominal and pelvic floor coordination. Internal assessment is optional and often unnecessary.
Learning to relax the pelvic floor and generate pressure correctly, the core of treatment for dyssynergia.
Establishing a daily routine that works with your body’s reflexes, with follow-up to refine it.
Pelvic health assessment can include an internal examination, which gives the clearest picture of how the muscles are working. It is always optional, never a condition of treatment and many people begin with external assessment only. Nothing happens without your explicit agreement and you can change your mind at any point.
Your plan is built around your assessment. Depending on what we find, treatment may draw on a combination of these.
Practical coaching in position, breathing and pressure so the muscles release rather than grip.
Simple, immediate changes such as a footstool and posture that make a measurable difference.
Techniques that support bowel motility, useful for adults and children alike.
Reducing resting tension in muscles that have become chronically tight.
Working with the gastrocolic reflex rather than against it, at consistent daily times.
Practical adjustments alongside the mechanical work, not instead of it.
Private, consent-led care for bladder, pelvic and postnatal concerns.
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Hands-on assessment and treatment to identify contributing factors of your pain.
Learn moreOur friendly team is happy to help. Reach us during clinic hours. We are open 8:00am to 8:00pm on Tuesday and Thursday, and 9:00am to 6:00pm on Monday, Wednesday, Friday, Saturday and Sunday.
Book an appointmentBecause for many people the problem is muscular coordination, not diet. Retraining how the pelvic floor behaves during a bowel movement addresses the actual mechanism.
Yes. Constipation is very common in children and responds well to age-appropriate care. Assessment for children is entirely external.
Usually not. Most treatment for constipation works through external assessment, position and coordination retraining.
Many people notice a difference within a couple of weeks of changing position and retraining the pattern, with continued improvement after that.
These conversations are routine for us and they are the first step to something very treatable. Book privately online or call and speak to our team.