Pelvic Health and Constipation; The Importance of Proper Toilet Positioning

When it comes to managing pelvic health one of the main things your physiotherapist will talk about is your bowels. Your bowels have an integral role in managing a number of conditions such as: pelvic organ prolapse (POP), urinary incontinence, pelvic pain conditions and simply constipation. 

For a number of people the simple act of going to the bathroom can sometimes be difficult and in some cases even painful. But did you know that how you sit on the toilet could make a significant difference to this? 

Proper toilet positioning, including the use of a toilet stool, plays a crucial role in relieving symptoms, improving bowel movements, and promoting better pelvic health.

Keep reading to find out more. 

Understanding Pelvic Conditions and the Impact of the Bowels

If we talk anatomy of the pelvic region, there are three organs suspended by not only the pelvic floor muscles, but also intricate layers of fascia. These are the bladder, uterus and bowel. When we look at this picture below, it looks like there is heaps of room in the pelvis. However, when we look closely on a real person the “normal” measurement between the urethra and anus is only 7.5cm. 

So, why does this matter? Why are we talking about the bowels with all these conditions? Well, lets get a little geeky and break it down depending on the condition:

• Pelvic organ prolapse occurs when the muscles and tissues supporting the pelvic organs (the bladder, uterus, or rectum) become weakened, causing one or more organs to drop down from their normal position. There are a number of different levels of pelvic organ prolapse that we will go into in another blog. A full bowel can make you strain, this will put further pressure downwards on the already low lying pelvic organs worsening your symptoms. 
• Overactive Pelvic Floor: So when we strain, we actually get more activation of the pelvic floor muscles. This activation then further kinks the rectum making it harder to evacuate stool. Overtime this can worsen pelvic pain conditions and lead to constipation. 
• Urinary Incontinence: Fun fact, the bladder has pressure receptors on the outside. When the bowel is full (like what happens with constipation) it causes the bladder receptors to go off and the involuntary muscles of the bladder to contract. This can lead to leaking and urinary urgency. 

I could keep going on how the bowels and constipation impact pelvic health, but I’m pretty sure you aren’t as geeky as me. So I’ll stop there. 

So.. how do we manage this?

How Toilet Positioning – Why a Toilet Stool Works

The position in which you sit on the toilet affects the length of your pelvic floor muscles and your ability to pass stools efficiently. Unfortunately, most of us have actually been taught to poo wrong! Wild right?!? The standard seated toilet position, where your hips are at a 90-degree angle to your torso, can actually kink the colon slightly, making it harder to have a smooth and easy bowel movement.

So we suggest using a toilet stool (check out our recommendation here), as adjusting your position can really help. How does it do this?

1. Change the angle of the hips: By raising your knees above your hips, you can mimic a squatting position, which straightens the rectum and allows stools to pass more easily.
2. Reduce straining: With better alignment, you’re less likely to strain, which reduces the pressure on your pelvic organs and can prevent your prolapse symptoms from worsening. It also helps you evacuate more stool
3. Relax the pelvic floor muscles: A more natural toilet posture helps the pelvic floor muscles to relax, making bowel movements smoother and less painful.

For individuals with pelvic organ prolapse, the goal is to avoid added stress to an already vulnerable pelvic area. Proper toilet positioning with a stool helps you protect and support your pelvic organs while promoting healthy, strain-free bowel movements.

Other Tips for Bowel and Pelvic Health

In addition to using a toilet stool, here are a few other tips that can support your pelvic health and relieve constipation:

• Stay hydrated: Drink plenty of water to keep stools soft and easy to pass.
• Eat a high-fiber diet: Fiber-rich foods promote regular bowel movements and reduce the risk of constipation. Remember “P” foods make you poo!
• Practice good toileting habits: Don’t differ your urge! When you get the urge to open your bowes it is important to listen in those first 10 minutes. Otherwise you loose your opportunity until the next lot of faecal matter moves down to restimulate your urge. Take your time and relax.
• Support: if you have a prolapse it may help to gently support your perineum with your hand while you pass a bowel motion. Others find that splinting using either the thumb or a special tool helps them to get a full empty without straining. 

Support Your Pelvic Health Today

If you’re dealing with pelvic organ prolapse, struggling with constipation or incontinence, there are solutions available that can help relieve your symptoms and improve your quality of life. At Invigorate Health and Performance, our experienced team of physiotherapists is here to provide personalised advice and treatment to support your pelvic health.

Don’t wait to find relief. Book an appointment with us today, and let’s work together to improve your pelvic function and overall wellbeing.

Call us on (02) 4880 1622 or book online to schedule your consultation today

(Published Apr 8, 2025)

Written By: Anouska Symons (Senior Physiotherapist)