Constipation Isn’t Just About Food: What Your Pelvic Floor and Nervous System Have to Do With It
Got Constipation? 5 Surprising Reasons You’re Still Struggling (And What to Do)
Constipation can feel like an embarrassing topic—but let’s be real: if you’ve ever spent way too long in the bathroom wondering why things aren’t moving, you’re not alone. In fact, nearly 1 in 5 people struggle with chronic constipation at some point in their lives.
And for many of our patients at Practically Perfect Physical Therapy, it’s not just an occasional annoyance—it’s a daily battle.
What’s worse? You’ve probably tried all the usual suggestions. Drink more water. Eat fiber. Take a laxative. But what if you’re doing all the “right” things and STILL feel backed up?
Let’s talk about five lesser-known causes of constipation—and most importantly, what you can actually do about them.
1. You’re Not Pooping in the Right Position
That’s right—how you sit on the toilet matters.
The modern toilet isn’t designed with your anatomy in mind. Sitting at a 90-degree angle can actually pinch off your rectum, making it harder to pass stool. That’s where a footstool or Squatty Potty can be a total game changer.
👉 Try This Tip: Elevate your feet with a small stool, lean forward with a straight back, and breathe into your belly. You want your knees above your hips to allow the puborectalis muscle to relax and let things flow.
2. Your Pelvic Floor Might Be Too Tight
Wait… isn’t a strong pelvic floor a good thing?
Yes, but here’s the catch: many people who suffer from constipation have a pelvic floor that’s too tight—especially the muscles around the rectum. These muscles need to relax to allow you to have a bowel movement. If they’re always clenched (from stress, poor posture, or trauma), that “let go” reflex gets stuck.
At Practically Perfect, we see this all the time—especially in patients who also have urinary urgency, painful periods, or tailbone pain. If any of that sounds familiar, you might benefit from pelvic floor physical therapy.
3. Your Nervous System Is Stuck in “Fight or Flight”
Stress doesn’t just live in your head—it literally affects your digestion.
When your body is constantly under stress, it prioritizes survival over digestion. That means slowed motility, tighter pelvic floor muscles, and yes… constipation.
We’ve even had toddlers and children as young as 2 with constipation that resolved once we addressed their nervous system regulation.
That’s why we focus not only on physical strategies, but also breathwork, movement, and mindfulness to calm the nervous system and restore regularity.
4. You’re Not Getting the Right Kind of Fiber
Not all fiber is created equal.
Soluble fiber (like oatmeal, chia seeds, and apples) absorbs water and forms a gel-like substance. Insoluble fiber (like veggies and whole grains) adds bulk and keeps things moving. You need both types in the right balance to prevent constipation.
Too much of one without the other—or introducing too much too fast—can actually make things worse.
👉 Try This Tip: Track your intake for a few days with a food journal or use our free Fluid & Fiber Tracker. We can help you adjust based on your unique digestion.
5. You’ve Been Holding It Too Long
Sometimes constipation isn’t about what you’re eating or drinking—it’s about what you’re ignoring.
Kids, busy parents, teachers, healthcare workers… we see it all the time. People delay going to the bathroom until it’s “convenient.”
But when you ignore the urge, your body starts to adapt. The rectum stretches. The nerves desensitize. The stool dries out.
Before you know it, you’re going days without going.
👉 Try This Tip: When you feel the urge, go. Don’t delay. And aim for a regular schedule—after meals is ideal, as your colon is most active (thanks to the gastrocolic reflex).
Bonus: What Else Can Help?
We’ve helped countless patients—from toddlers to grandparents—find relief using:
Constipation exercises
Manual therapy
Abdominal massage
Breath training
Toilet retraining protocols
Pelvic floor therapy
Sensory regulation support for kids
We even offer fun, movement-based therapy for little ones and adults alike! If your child struggles with chronic constipation, check out our “Baby + Me” class or ask about our occupational therapy services.
For adults, pelvic floor therapy is often the missing piece.
Ready to Get Things Moving?
Don’t let constipation keep running your life—or your family’s. Our team can help you figure out what’s really going on and create a custom plan that works for you.
📌 Download Our Free Constipation Freebies
Or call us today to set up an evaluation and get expert support from pelvic health therapists who care.
