Hemorrhoids

Condition Overview

Hemorrhoids are a common and often uncomfortable condition that affects many individuals at some point in their lives.

Hemorrhoids are enlarged veins located in the lower rectum or anus. These veins can become swollen and inflamed due to increased pressure or straining during bowel movements, pregnancy, heavy or repetitive lifting, and being overweight.

There are two types of hemorrhoids, internal and external. Internal hemorrhoids develop inside the rectum and are usually painless. They may cause rectal bleeding during bowel movements or they can sometimes prolapse which means they protrude through the anus. External hemorrhoids develop under the skin around the anus and can be more painful. They may cause itching, discomfort, and visible swelling. 

Symptoms Related to Hemorrhoids?

The most common symptoms include:

  1. Rectal bleeding: Bright red blood may be visible on toilet paper or in the toilet bowl after a bowel movement.

  2. Itching and irritation: The area around the anus may feel itchy, and continuous scratching can further aggravate the condition.

  3. Discomfort or pain: Pain or discomfort may occur during bowel movements or while sitting for extended periods. External hemorrhoids can be especially painful.

  4. Swelling and inflammation: Visible swelling may be observed around the anus, causing discomfort and making it difficult to maintain hygiene.

How Pelvic Floor Physical Therapy Can Help

While various medical treatment options exist, one conservative approach that has gained recognition for its effectiveness is pelvic floor physical therapy. Pelvic floor physical therapy for  hemorrhoids can include:

  • Working on pelvic floor muscle coordination and relaxation: Pelvic floor physical therapy can help train the pelvic floor muscles to both lengthen and shorten appropriately which is needed for full range of motion and proper functioning of these muscles.  In addition, if the pelvic floor muscles are tense and lacking the ability to lengthen, manual therapy and exercises can be utilized to reduce tension and improve muscle extensibility.

  • Improving Bowel Movements: Pelvic floor physical therapy can help optimize bowel movements and alleviate constipation, a common contributor to hemorrhoid development. Techniques such as education on proper toileting posture and mechanics can enhance bowel function and reduce straining.

  • Pain Management: For individuals experiencing pain or discomfort due to hemorrhoids, pelvic floor physical therapy can provide relief. Techniques like manual therapy, soft tissue mobilization, and therapeutic exercises can reduce pain, promote healing, and enhance overall comfort.

  • Education and Lifestyle Modifications: Pelvic floor physical therapists can offer guidance on adopting healthy lifestyle habits to prevent hemorrhoids. This may include advice on maintaining a balanced diet and fluid intake, managing body weight, practicing regular physical activity and avoiding prolonged sitting or standing. Oftentimes, hemorrhoids occur as a result of poor pressure management and straining. A physical therapist can help assess movement patterns and body mechanics, and provide strategies to allow for optimal breathing and decreased downward pressure on the pelvic floor. 

Hemorrhoids can significantly impact an individual's quality of life, but there are effective treatment options available. By addressing the underlying factors contributing to hemorrhoid development, such as tense pelvic floor muscles and poor bowel habits and pressure management, pelvic floor physical therapy can provide relief, manage symptoms, and help prevent future occurrences.


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Pelvic Organ Prolapse