One of the things I love most about being a pelvic floor physical therapist is helping women understand parts of their bodies that no one ever explained to them.

And yes…sometimes that means talking about poop.

If you’re reading this and thinking, “I can’t believe I’m reading an entire article about bowel movements,” you’re not alone. But here’s the truth:

Your pelvic floor plays a huge role in how you poop.

Most women were never taught that.

Instead, if you’re constipated, you’ve probably heard advice like:

Drink more water.
Eat more fiber.
Take a stool softener.
Try a laxative.

While those things certainly have their place, they’re only part of the picture.

As a pelvic floor physical therapist, I always tell my patients there are two pillars to treating constipation. One pillar involves looking at the stool itself—things like hydration, nutrition, and consistency. The other pillar is something many people have never heard of:

How your pelvic floor functions.

In this article, I want to help you understand why your pelvic floor matters every time you have a bowel movement—and why pushing harder may actually be making things worse.

If you’d rather hear me explain it myself, you can also watch Episode 33: Pooping & Your Pelvic Floor on YouTube.

Why Your Pelvic Floor Matters When You Poop

When I explain constipation to my patients—including the children I treat—I use a very simple analogy.

Imagine one of those toddler shape-sorting toys.

You know the ones.

There’s a box with different-shaped holes—a star, a triangle, a square—and your child tries to fit each shape into the correct opening.

One of the hardest things to watch is when they keep trying to push a triangle through the star-shaped hole.

No matter how hard they push…

It isn’t going to fit.

That’s exactly what I think about when someone tells me they’re constantly straining to have a bowel movement.

Sometimes the problem isn’t that you’re not pushing hard enough.

The problem is that the opening isn’t working the way it’s supposed to.

Understanding What Happens Before You Feel the Urge to Go

Let’s simplify what’s happening inside your body.

Think of your intestines like a long series of pipes.

At the end of those pipes is what I like to call a trap door.

This trap door opens automatically and allows stool to move into a “holding room.”

That holding room is your rectum.

As stool fills your rectum, sensors tell your brain:

“It’s time to have a bowel movement.”

Isn’t that incredible?

Your body is designed to wait until there’s enough stool before interrupting your day.

It’s an incredibly efficient system.

But here’s where your pelvic floor enters the story.

At the very end of that holding room sits part of your pelvic floor—the muscles you can control.

These muscles help control whether the outlet relaxes enough for stool to pass comfortably or whether it meets more resistance.

Understanding your body creates confidence.

The Real Reason Straining Doesn’t Always Work

Here’s where I see so many women struggle.

When it’s time to have a bowel movement, your pelvic floor shouldn’t squeeze.

It should lengthen.

I like to describe it like a trampoline.

Imagine stretching a trampoline downward.

As it stretches, the opening in the middle becomes wider.

That’s what should happen with your pelvic floor.

When it lengthens, it creates less resistance so stool can pass more comfortably.

But many people experience pelvic floor dysfunction, where the opposite happens.

Instead of lengthening…

The pelvic floor tightens.

Instead of relaxing…

It pulls upward.

Now imagine trying to push stool through an opening that’s actually getting smaller.

It’s just like trying to shove that triangle through the star-shaped hole.

No wonder it feels frustrating.

Myth: If You Push Harder, You’ll Finally Go

This is one of the biggest misconceptions I hear.

When stool doesn’t come out easily, our natural instinct is to strain harder.

Unfortunately, for some people with pelvic floor dysfunction, that can make the coordination problem worse.

Instead of opening the pathway…

Your body creates more resistance.

That’s why so many people feel like they’re fighting their own bodies every time they sit on the toilet.

Your body is not broken.

It may simply be using the wrong muscle strategy.

Cleveland Clinic explains that pelvic floor dysfunction can involve difficulty relaxing and coordinating the pelvic floor muscles during a bowel movement, which may contribute to constipation and straining.

https://my.clevelandclinic.org/health/diseases/14459-pelvic-floor-dysfunction

This is about more than symptom management.

Root-cause healing matters.

The Missing Piece: Teaching Your Pelvic Floor to Let Go

One of the first things I work on with many of my patients is helping them relearn a movement their bodies were designed to do naturally.

It’s called Balloon Breathing.

You may have heard of diaphragmatic breathing before.

Balloon breathing is my way of helping you understand what’s happening with your pelvic floor while you breathe.

Here’s how I explain it.

Imagine there’s a balloon inside your abdomen connected to a helium tank.

As you inhale:

Your belly gently expands.
Your ribs widen.
Pressure moves downward.

Now here’s the important part.

That gentle pressure should encourage your pelvic floor to drop, just like that stretched trampoline.

When you exhale:

Your diaphragm rises.
Your belly relaxes.
Your pelvic floor naturally comes back up.

This up-and-down motion is part of how your diaphragm and pelvic floor work together.

Pregnancy Can Change This Natural Pattern

One teaching point I want every mom to understand is that pregnancy and childbirth can change breathing, abdominal pressure, and pelvic floor coordination.

As your baby grows, everything inside your abdomen shifts.

Your ribs change.

Your diaphragm changes.

Your breathing changes.

Your organs have less room to move.

After delivery, many women are never taught how to reconnect with that normal breathing pattern.

That’s one reason pelvic floor coordination may become part of the constipation picture after pregnancy.

Most women were never taught this.

One Simple Exercise I Give My Patients

One strategy I often give my patients is to practice Balloon Breathing 60–80 times throughout the day.

The goal is not to force anything.

Instead, focus on noticing whether your pelvic floor gently drops as you inhale.

Once that becomes easier, I have them practice the same breathing while sitting on the toilet.

Instead of straining…

Instead of holding their breath…

Instead of pushing…

I encourage them to use their breath to help the pelvic floor lengthen naturally.

I jokingly tell my patients to “breathe your poop down.”

It usually gets a laugh.

But it also helps make the concept easy to remember.

One of my students once admitted she thought I had completely lost my mind after hearing me teach this.

The next day she came back and said she tried it herself.

She couldn’t believe how much easier—and honestly more satisfying—her bowel movement was.

That’s exactly what I want for my patients.

You should stand up after a bowel movement feeling like your body worked the way it was designed to.

Your Action Steps

If constipation has become your normal, I want you to start with these simple steps:

Practice Balloon Breathing Every Day

Practice multiple repetitions throughout the day and focus on noticing your pelvic floor gently drop with the inhale.

Stop Assuming Straining Is the Answer

If you’re constantly pushing, your pelvic floor may actually need to relax and coordinate better—not simply work harder.

Pay Attention to How You Feel After a Bowel Movement

An efficient, comfortable bowel movement can give you useful information about how well your body is coordinating.

Learn the Root Cause

If you continue to struggle with straining, incomplete emptying, or constipation, pelvic floor physical therapy can help evaluate whether pelvic floor coordination may be part of the problem.

Your Next Step

If constipation has become something you’ve simply learned to live with, I want you to know there may be another answer.

The goal isn’t temporary relief—it’s long-term function.

Healing isn’t about pushing harder.

It’s about helping your body do what it was designed to do.

If you’re ready to stop guessing and start understanding your body, fill out Your Pelvic Floor’s Next Step Form so we can identify what’s really contributing to your symptoms and determine the best path forward.

https://www.beyondthevbypauli.com/nextstep

You deserve better than fear-based advice.

You deserve to understand your body.

And when your pelvic floor functions the way it was designed to, even something as ordinary as having a bowel movement can become easier, more comfortable, and something you no longer have to think twice about.