The Truth About Managing Constipation, Urinary Incontinence, and Pelvic Floor Dysfunction

Constipation and urinary leaking are two of the most common pelvic floor complaints we see at Empower PT. They are also two symptoms that people often brush off as “normal” or “just part of getting older” or “just how I’ve always been.” The truth is that these issues are incredibly common, but never something you have to simply live with. They are signs from your body that your pelvic floor, your pressure systems, your nervous system, and your daily habits need more support.

Unfortunately, many people have tried pelvic floor physical therapy for leaking or constipation and still have symptoms. This often happens because the treatment approach focuses almost entirely on the pelvic floor itself. A client might get some breathing exercises or be told to practice kegels, drink more water, eat more fiber, etc. when those changes do not provide adequate symptom relief and in some cases can even make the symptoms worse. 

These approaches rarely look at the whole picture. They fail to consider how the various parts of the body and the nervous system interact. They may overlook hip and rib mobility, pressure mechanics, bowel habits, and movement patterns that directly impact both leaking and constipation. When treatment does not consider the rest of the body, people are left following treatment plans that do not actually change their symptoms.

At Empower PT, we look at the whole picture. Pelvic floor dysfunction rarely occurs in isolation. It is tied to hip strength and mobility, rib cage and diaphragm mobility, abdominal and thoracic pressure system management, stress levels, toileting habits, nutrition, lifestyle habits, and patterns of tension that build over time. We assess how all of these interact rather than chasing symptoms.

How Empower PT Treats Constipation and Stress Urinary Incontinence

We build your program around your exact symptoms, history, and daily life. A typical session includes a blend of individualized movement training, hands on support, and education that helps you understand the “why” behind your symptoms. Nothing is cookie cutter. Every decision is made with your real life needs in mind.

For constipation, we look far beyond the pelvic floor. We explore how you are eating, not just what you are eating. This includes making sure you have time to eat without distraction, that you are chewing thoroughly, and that you are eating full meals rather than grazing on the go. We address nervous system regulation because stress can slow digestion and contribute to constipation. We look at how you are pushing during bowel movements and teach strategies that help you avoid straining. We refine toileting position, pressure mechanics throughout your whole body, and ensure that you are getting regular opportunities to move during the day.

For stress incontinence, we focus on the moments where leaking actually happens. We look at the positions, movements, and activities that trigger symptoms, along with what your pressure system is doing in those moments. Many people hold excess tension in the pelvic floor which prevents the muscles from contracting when they need to. Others attempt to contract but lack the coordination or timing to do so successfully. We help you retrain that system while also building the hip, leg, and trunk strength that supports the pelvic floor during real life tasks.

Treatment timelines vary. Some people notice changes within a few sessions once they understand what their body needs and begin adjusting daily habits. Others with longer standing symptoms, a history of abdominal or pelvic trauma, chronic stress, or long term movement patterns that have been hard to break may need more time. What stays consistent is that progress comes from individualized care, a plan that reflects your real life, and the steady practice of improving your movement patterns, pressure mechanics, and daily routines.

A Simple Starting Point to Support Your Pelvic Health

A helpful way to begin improving your pelvic health is to explore how your body manages pressure while you hold load. The goblet hold is a great starting point because it recruits your hips, legs, trunk, and pressure system without over isolating the pelvic floor. You can use a dumbbell, kettlebell, or even a household item like a water bottle.

Goblet Hold:

Stand with your feet hip width apart. Hold the weight at eye level with your elbows in front of you. Take note of where you feel pressure in standing - if there is pressure in your low back, you may be leaning back slightly. Try to stack your posture so that your head is directly about your shoulders, your shoulders are directly above your hips, and your hips are directly above your ankles. Take a slow inhale through your nose and notice how your ribs and abdomen expand under the load. Exhale through pursed lips and feel your trunk gently support you without gripping. Stay tall and avoid shrugging. Hold for five to ten breaths. If you feel you can do this successfully, try repeating this on one foot. 

Why this helps:

The goblet hold teaches your system how to manage pressure under load, which is directly relevant to both constipation and stress incontinence. It helps you practice rib expansion, reduce unnecessary abdominal or pelvic floor gripping, and build the trunk stability needed for daily tasks like lifting, carrying, and toileting without breath holding or strain. The load is also good feedback for your system as it tries to change it’s pressure management strategy.

These drills are not about tightening or strengthening any one muscle. They help you understand how your system works under load and give you a foundation of stability and coordination that supports both bladder control and healthy digestion.

The Impact of Pelvic Health on Constipation and Leaking

Your pelvic floor does not function on its own. It works in partnership with your hips, rib cage, diaphragm, abdominal muscles, digestion, nervous system, and the daily habits that shape how you move and live. When these systems are not coordinating well, symptoms like constipation and leaking can appear or become more persistent.

The good news is that these symptoms are changeable. When you receive an evaluation that looks at the entire picture, you can understand why your symptoms are happening and what your body needs in order to improve. This may include shifts in strength, mobility, pressure management, stress regulation, nutrition, or daily routines, all of which influence how well the pelvic floor can do its job.

You do not have to navigate this alone. With the right support and a plan that reflects your real life, meaningful change is absolutely possible.

Want to learn more about working with us? Book a consultation call today!