When other usual methods, such as including more fiber in your diet or the use of laxatives, enemas, and stool softeners, for constipation fail to work, physical therapy can provide effective treatment for some people. Treatment protocols such as abdominal massage, biofeedback, and exercise can help you manage constipation by regulating your bowel movements and increasing intestinal motility, which involves contraction of the muscles in the gastrointestinal tract.

Abdominal Massage

If your doctor refers your to a physical therapist, he or she may perform manual massage to help relieve your constipation. Unlike other treatments for constipation, abdominal massage has no known side effects--no gas, bloating, distension, or stomach cramps and pain.

Some physical therapists use a tennis ball, moving it in circular motions along the location of the colon to decrease abdominal spasticity – uncontrolled tightening of muscles. Later in your treatment, your physical therapist may instruct you in self abdominal massage techniques you can do at home to continue to get relief from constipation.

Performed on a daily basis, abdominal massage can help regulate bowel movements; however, therapeutic massage therapy is not recommended if you've recently had radiation therapy or abdominal surgery, or if your physician suspects an abdominal obstruction or mass, or other structural abnormality in the colon (also known as the large intestine) as the cause of your constipation. Otherwise, abdominal stimulation massage may relieve constipation by decreasing abdominal spasticity and aiding in bowel peristalsis – involuntary muscle contractions that move undigested food through the digestive tract.

Biofeedback Training

If you have hard, dry stools that are difficult to pass and need to strain to move your bowels, your problem may be due to decreased neuromuscular function of the colon. In this case, a physical therapist may use biofeedback training to help restore normal bowel function.

Pelvic-floor or anal sphincter dysfunction causes the external anal sphincter to contract and tighten, causing you to strain or not empty your bowel completely. Biofeedback trains you to relax the sphincter so that it opens when you defecate. The training also may help move stool into the rectum through control of abdominal contractions.


While sometimes neurologic, metabolic, and endocrine disorders can lead to what is known as slow-transit constipation, often the cause is unknown. Therefore, a physical therapist may include moderate physical exercise and strength training as part of your treatment program. Stretching exercise also may help ease your constipation.

Exercise can help move food through the colon faster by stimulating the contraction of intestinal muscles necessary to move out stool. The more efficiently the muscles contract, the more quickly you can pass stool.

When you exercise, blood flow to the heart and muscles increases. The same happens when you eat – more blood flows to the stomach and intestines to aid in the digestion process. Therefore, it's not a good idea to exercise immediately after eating a meal. Otherwise, blood flow to the gastrointestinal tract decreases, leading to weaker peristaltic contractions. Consequently, fecal matter moves more slowly through the lower GI tract, which may cause you to become constipated. For more information, contact a practice such as Annapolis Family Physical Therapy.