Finding Relief: Pelvic Floor Therapy for Rectocele

Experiencing a rectocele can be both physically uncomfortable and emotionally challenging, often affecting daily activities like bowel movements and intimate moments. However, there’s hope—pelvic floor physical therapy offers a conservative approach to managing and improving rectocele symptoms. In fact, pelvic floor physical therapy can help with all types of pelvic organ prolapse. Through targeted exercises, lifestyle modifications, and personalized care, physical therapy can restore strength to the pelvic floor, alleviate discomfort, and enhance your quality of life. Let’s explore how this specialized therapy can be a vital part of your recovery and well-being.

First, what is a rectocele? A rectocele is a condition where the rectum pushes into the back wall of the vaginal canal due to a weakening of the tissues, ligaments, or pelvic floor muscles. Similar to a cystocele and uterine prolapse, the weakening can result from chronic constipation, aging, childbirth, or increased pressure on the pelvic floor, such as heavy repetitive lifting with improper body mechanics. It's important to note that lifting is still encouraged—just ensure your form is appropriate for your body.

The severity of symptoms can vary, with some individuals experiencing mild discomfort while others face more significant challenges. Common symptoms of a rectocele include:

A noticeable bulge or feeling of fullness in the vagina

Difficulty with bowel movements, including the sensation of incomplete evacuation

Discomfort or pain during sexual intercourse

A feeling of pressure or heaviness in the pelvic area

If you refer to the blogs on **Overcoming Frustrations** and **Prevention of Uterine Prolapse**, you'll find valuable strategies for managing a prolapse diagnosis and preventing its progression. In each blog, you'll discover how pelvic floor physical therapy is an effective treatment for managing symptoms. So, how can physical therapy help? 

Strengthening Pelvic Floor Muscles

Individualized Programs: No two people are alike, so your exercise program should be tailored to your specific needs based on a thorough assessment. Common target areas include the glutes, hips, hamstrings, and core, which help support your pelvis and improve posture.

Kegels: Depending on your assessment, pelvic floor muscle contractions can enhance the strength of these muscles, providing better support to the vaginal walls.

Improving Pelvic Floor Coordination

Relaxation: While strengthening is important, it's equally crucial to know how to relax your pelvic floor muscles. Proper relaxation can relieve unnecessary tension that may affect your bowel movements.

Biofeedback: This technique uses a device to detect muscle activity in the pelvic floor, providing visual feedback so you can see how you contract and relax your muscles. It’s especially beneficial for addressing bowel dysfunction by showing how your muscles work during defecation.

Addressing Bowel Function

Dietary and Lifestyle Guidance: Identifying and avoiding dietary triggers that cause constipation can help manage rectocele, bladder, and uterine prolapse. Hydration and exercise plans can also promote stool motility.

Toilet Retraining: It may sound funny, but your posture on the toilet can significantly impact bowel movements. Working with a physical therapist can help you find the best position for you.

Body Mechanics and Postural Education

Posture: Finding the optimal posture for you is key—there’s no “perfect” posture, but our bodies thrive on movement. We work with what feels good and build from there.

Body Mechanics: Just like posture, your squat form may differ from someone else’s. We assess any deficits to optimize your exercise routine and reduce pressure on the pelvic floor.

Breath Control: Proper breath control is crucial. Reducing pressure through breathing techniques can significantly alleviate pelvic floor strain and reduce symptoms.

Pain Management and Symptom Relief

Manual Therapy: Hands-on techniques may be necessary to alleviate muscle tension in the pelvic floor or surrounding muscles associated with rectocele.

Pessaries: While many physical therapists aren't trained to fit pessaries, they can help you find a provider or decide when it’s time to try one.

Education

Patient Education: My favorite part! Understanding prevention, management strategies, and the role of physical therapy is vital in improving your symptoms. The old saying “Knowledge is Power” empowers you to take control of your health instead of letting the rectocele control you.

Long-Term Relationship and Management: Routine check-ups, lifestyle adjustments, and ongoing exercises can prevent prolapse progression and help you stay in control of your health.

Pelvic floor physical therapy offers a holistic approach to managing rectocele, focusing on strengthening, coordination, education, and lifestyle changes to improve your quality of life and reduce symptoms. 

🚨If you have any health concerns or pre-existing conditions, consult with a health professional such as a pelvic floor physical therapist before attempting a new exercise and/or manual treatment.  This blog is for educational purposes only and is not intended to treat or diagnose any medical condition.🚨

Dr. Susan Miller PT, DPT, is a licensed pelvic floor physical therapist and the owner of Lotus Core Physical Therapy in Colorado. She welcomes both in-person and telehealth appointments for Colorado residents, as well as coaching calls for clients residing out of state.  

Book at www.lotuscorept.com