How Hemorrhoids Are Related to Pelvic Floor Tightness
When most people think about hemorrhoids, they picture swollen, uncomfortable veins around the rectum caused by straining during bowel movements. While that’s true, there’s another important, and often overlooked, piece of the puzzle: pelvic floor muscle tightness.
Yes, tight pelvic floor muscles can directly contribute to hemorrhoids. Let’s break down how these two issues are connected and why addressing pelvic floor function matters just as much as managing diet and hydration.
1. The Pelvic Floor: Your Body’s Support System
The pelvic floor is a group of muscles that support your bladder, uterus/prostate, and bowels. These muscles help control urination, bowel movements, and sexual function.
A healthy pelvic floor is balanced, not too weak, not too tight, but responsive. But many people (especially those who sit a lot, have chronic stress, or improperly lift heavy) develop hypertonic or overly tight pelvic floor muscles.
2. How Tight Pelvic Floor Muscles Affect Bowel Movements
When the pelvic floor is too tight, it doesn’t relax well during a bowel movement. And relaxation is critical.
To poop easily, the pelvic floor must:
Drop and lengthen
Allow the anal canal to open
Coordinate with abdominal pressure
If the muscles stay tight, the anal opening can’t widen fully. This makes stool harder to pass, even if you’re not technically “constipated.” The body then compensates by pushing harder.
3. Straining → Hemorrhoids
Straining increases pressure on the rectal veins. Over time, this pressure causes:
Veins to swell
Bulging tissue to protrude
Bleeding
Itching or burning
Difficulty cleaning
While constipation and diet are common culprits, pelvic floor dysfunction is often the hidden reason people strain in the first place.
4. Why Hemorrhoids Keep Coming Back
Here’s the catch:
You can treat hemorrhoids with creams, fiber, hydration, or even surgery, but if your pelvic floor remains tight and dysfunctional, you’re likely to continue straining.
That’s why so many people say:
“I keep getting hemorrhoids even though I eat plenty of fiber.”
Fiber helps the stool.
Pelvic floor work helps the opening the stool has to pass through.
Both matter.
5. Signs Pelvic Floor Tightness Might Be Involved
Pelvic floor tension might be contributing to your hemorrhoids if you notice:
Difficulty initiating a bowel movement
Feeling like you can’t fully relax “down there”
Needing to push or strain even with soft stool
Tailbone or deep pelvic pain
A feeling of incomplete emptying
Chronic constipation despite fiber/water
6. How to Improve Hemorrhoids by Addressing the Pelvic Floor
Here are some strategies pelvic floor physical therapists commonly use:
Diaphragmatic breathing: Deep, belly breathing helps relax the pelvic floor and reduce tension.
Blow-as-you-go technique: Exhale gently while you bear down, this decreases pressure on hemorrhoidal tissue.
Correct toileting posture: Using a squatty-potty or footstool helps the rectum align properly.
Pelvic floor relaxation exercises: Reverse Kegels, hip-opening stretches, and guided relaxation help the pelvic floor lengthen.
Avoiding chronic holding: Many people unknowingly “clench” their pelvic floor throughout the day. Awareness + relaxation can make a huge difference.
The Bottom Line
Hemorrhoids are not just a bowel issue, they’re a pelvic floor issue too.
A tight pelvic floor makes it harder to relax during bowel movements, leading to straining, which increases pressure on the rectal veins and contributes to hemorrhoids. Addressing pelvic floor tension can reduce symptoms, prevent recurrence, and make bowel movements easier and more comfortable.
If hemorrhoids keep returning or you feel like you’re straining even when your stool is soft, a pelvic floor physical therapist can be a game-changer.
Looking to optimize your well being with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at receptionmadison@pelvichealthnj.com.