Hemorrhoids: A Holistic Approach with Pelvic Floor Physical Therapy
Let’s be honest for a minute, hemorrhoids are a literal pain in the ass. Trust me, I personally experienced them after the birth of my first child and dealing with the aftermath was the hardest part in my postpartum recovery. If you have experienced them you might agree! Whether due to pregnancy, childbirth, chronic constipation or other factors, these swollen blood vessels in the rectum and anus can cause pain, itching, and discomfort. While there are various treatment options available, pelvic floor physical therapy (PFPT) is an effective and holistic approach to managing hemorrhoids as it addresses the root cause contributing to their development. Pelvic floor therapy can help all genders dealing with this issue, as hemorrhoids can affect men and women alike. In this blog post, we'll explore what hemorrhoids are, their causes, symptoms, and how PFPT can help in their treatment.
Hemorrhoids, also known as piles, are swollen veins in the lowest part of your rectum and anus. They can be internal, developing inside the rectum, or external, forming under the skin around the anus. Hemorrhoids can result from increased pressure in the lower rectum, causing the veins to swell and become irritated. This pressure can be due to various factors, including:
Pregnancy: The increased pressure on the pelvic veins during pregnancy can lead to the development of hemorrhoids.
Straining during bowel movements: Chronic constipation can cause straining during bowel movements, putting pressure on the veins in the rectum and anus.
Sitting or standing for long periods: Prolonged sitting or standing can also contribute to the development of hemorrhoids by putting pressure on the veins in the pelvic area.
Poor pressure management: Again, hemorrhoids are a pressure issue. If you have poor breathing strategies, diaphragm restriction, sub-optimal posture, all of these can contribute to increasing the pressure into the pelvic cavity and possibly lead to hemorrhoids.
External anal spinchter tension: If the pelvic floor muscles or external anal spinchter muscle are too tight this can cause issues with constipation as well as pressure management, commonly leading to external hemorrhoids.
Image: The pelvic floor muscles of the male and female body. They provide support to internal organs and are responsible for spinchteric control, so play a direct role in the treatment of hemorrhoids. Image credit: Carmichael, Joseph C, and Steven Mills. "Anatomy and Embryology of the Colon, Rectum, and Anus."
The symptoms of hemorrhoids can vary depending on the type and severity but may include:
Pain or discomfort, especially during bowel movements.
Itching or irritation in the anal region.
Swelling around the anus.
Bleeding during bowel movements.
Leakage of feces or mucus.
Inability to sit or stand for prolonged periods of time without discomfort.
Pelvic floor physical therapy focuses on addressing issues related to the pelvic floor muscles, which play a crucial role in bowel and bladder function, as well as sexual health. While it may not be the first treatment option that comes to mind for hemorrhoids, PFPT can be incredibly beneficial in managing the symptoms and addressing the underlying issues contributing to their development. Here's how PFPT can help:
Posture and Body Mechanics: Poor posture and body mechanics can contribute to increased pressure on the pelvic floor muscles and veins, leading to hemorrhoids. Pelvic floor physical therapists can assess posture and body mechanics and provide guidance on proper alignment and movement patterns to reduce strain on the pelvic floor and prevent hemorrhoid recurrence.
Pelvic Floor Muscle Training: PFPT includes exercises to help with coordination of the pelvic floor muscles and improve the length-tension relationship of pelvic floor muscles and surrounding areas, which can help improve circulation in the pelvic region and reduce pressure on the veins. Coordination of these muscles can also improve bowel function and reduce the risk of constipation, which is a common contributing factor to hemorrhoids.
Manual Therapy Techniques: Pelvic floor physical therapists may use manual therapy techniques such as massage, myofascial release, trigger point therapy or Dry Needling to address tension and tightness in the pelvic floor muscles and surrounding areas. By releasing tension and improving muscle flexibility, these techniques can help reduce discomfort and pain associated with hemorrhoids as well as increase blood flow and venous return.
Education and Lifestyle Modifications: Pelvic floor physical therapists can provide education on proper bowel habits, including techniques for reducing straining during bowel movements. They may also recommend lifestyle modifications, such as dietary changes and exercise, to promote regular bowel function and reduce the risk of hemorrhoid flare-ups. Recommendations for topical tinctures and creams as well as how to clean after bowel movements can help reduce inflammation and irritation around the anus.
Biofeedback: Biofeedback is a technique used in PFPT to help patients gain awareness and control of their pelvic floor muscles. By providing visual or auditory feedback, biofeedback can help patients learn to relax and coordinate the muscles involved in bowel movements, reducing strain and pressure on the pelvic veins.
You may feel embarrassed to talk about hemorroids but they are a common condition that can often be effectively managed with the right approach. Pelvic floor physical therapy offers a holistic and personalized approach to treating hemorrhoids by addressing the underlying issues contributing to their development. Through pelvic floor muscle training, manual therapy techniques, education, and lifestyle modifications, pelvic floor physical therapists can help you reduce symptoms, improve bowel function, and prevent hemorrhoid recurrence, ultimately improving your quality of life. If you're struggling with hemorrhoids, reach out to us at Pelvic Roots or a pelvic floor physical therapist near you to explore how PFPT can help you find relief and support your overall pelvic health.
In health,
Dr. Danielle Khoury, PT, DPT