As we wrap up IBS Awareness Month, one theme continues to surface in both research and real-life client work: when nutrition and lifestyle changes don’t fully resolve digestive symptoms, there may be a missing piece.
For many, that missing link is the pelvic floor.
This is why I’m excited to introduce today’s guest contributor, Dr. Brooke Kalisiak, a physical therapist I deeply respect and collaborate with. Brooke specializes in pelvic floor therapy, an area that is often overlooked, yet incredibly impactful, especially for those navigating IBS and hormonal shifts.
In this guest post, Brooke breaks down how pelvic floor function works, what symptoms to watch for, and why this approach can be a game-changer when other strategies fall short.
Separately, Brooke and I are also teaming up for a free live webinar on April 28th from 7:00–8:30 PM focused on a related but distinct topic: Navigating the menopause transition with strength and confidence. I’ll be sharing strategies to support muscle and metabolic health through aging, while Brooke will walk through common pelvic floor changes during menopause and what you can do about them. It’s free! And if you can’t join live, you’ll receive access to the recording when you sign up.
5 Ways Pelvic Physical Therapy Can Help with Irritable Bowel Syndrome (IBS)
If you’re dealing with IBS, you know how disruptive it can be to your daily life. From abdominal discomfort to constipation, diarrhea, or both, it can feel like your body is unpredictable and difficult to manage.
IBS affects an estimated 10–20% of the population, and while the exact cause isn’t fully understood, it’s widely accepted to be multifactorial: meaning there isn’t just one root cause.
What many people don’t realize is that pelvic physical therapy can play a meaningful role in helping manage IBS symptoms.
Here are five ways it can help:
1. Improving Bowel Habits and Daily Routines
Your bowel habits matter more than you might think.
In pelvic physical therapy, we look at:
Timing and consistency of bowel movements
Toilet positioning and defecation mechanics
Coordination between diet, hydration, and routine
These factors are especially important for individuals with IBS, whether symptoms lean more toward constipation, diarrhea, or a mix of both.
Pelvic PT often works best alongside nutrition support. If you’re already working with a dietitian, pelvic PT helps your body better respond to those dietary strategies, creating a more complete, effective plan.
2. Calming the Gut-Brain Connection
Your digestive system has its own complex nervous system, often referred to as the “second brain.”
Research has shown that IBS is closely tied to this gut-brain connection. In fact, one study describes IBS as a combination of an “irritable bowel and irritable brain” (Qin et al., 2014).
Stress and emotional regulation can directly influence:
Gut motility
Sensitivity
Secretion and permeability
This is why IBS symptoms often flare during periods of stress.
Pelvic physical therapy incorporates strategies to help regulate the nervous system, including:
Breathing techniques
Relaxation and mindfulness strategies
Gentle, intentional movement
These approaches help shift your body into a more parasympathetic (rest-and-digest) state, which supports better digestive function.
3. Using Movement to Support Bowel Function
When symptoms flare, it’s common to move less—but reduced movement can actually worsen bowel function. A 2019 review of exercise interventions suggests that physical activity may play a role in improving IBS symptoms, although more high-quality research is needed. Additionally, a review by Schumann et al., 2016 found that yoga-based interventions were associated with improvements in:
IBS symptom severity
Anxiety
Overall quality of life
In pelvic PT, we focus not just on general exercise, but also on restoring mobility in areas like the hips and spine. These regions directly influence the muscles and structures involved in bowel function.
4. Addressing Myofascial and Abdominal Restrictions
IBS isn’t just about the gut, it often involves the surrounding muscles and connective tissues.
When symptoms persist, we frequently see tension and restriction in:
The abdominal wall
The diaphragm
The hips and low back
There is a bidirectional relationship here: visceral dysfunction can contribute to musculoskeletal restrictions, and those restrictions can, in turn, worsen symptoms.
Pelvic physical therapy uses hands-on techniques and targeted movement strategies to improve mobility and reduce sensitivity in these areas, helping the body function more efficiently as a whole.
5. Treating Pelvic Floor Dysfunction
This is one of the most overlooked contributors to IBS symptoms.
Your pelvic floor muscles play a critical role in bowel function. They must be able to:
Relax to allow for a bowel movement
Contract to maintain continence
Research has shown a relationship between pelvic floor dysfunction and IBS symptoms, including altered anorectal function (Prott et al., 2010).
Common patterns we see include:
Overactive pelvic floor muscles → difficulty relaxing, contributing to constipation
Weakness or poor coordination → urgency or leakage
Dyssynergic defecation → muscles contract when they should relax
These issues are highly treatable with the right guidance, and pelvic physical therapy provides targeted strategies to restore proper coordination and function.
What Is Pelvic Physical Therapy?
Pelvic physical therapy is a specialized form of care focused on the muscles, nerves, and connective tissues that support the bladder, bowel, and pelvic organs. It takes a whole-body approach: addressing how breathing, posture, movement patterns, and daily habits all influence your symptoms. Treatment is individualized and designed to address the root cause of dysfunction, not just manage symptoms.
You Don’t Have to Navigate IBS Alone
IBS can feel frustrating and isolating—but there are more options than many people realize.
The most effective approach is often a team-based one, including:
A dietitian
A GI provider
A pelvic physical therapist
If you’ve been focusing primarily on diet or medication and still feel stuck, your pelvic floor and movement patterns may be an important missing piece.
About the Author
Dr. Brooke Kalisiak is a pelvic physical therapist and the owner of Legacy Physical Therapy, a specialty practice serving the St. Louis area. With over 15 years of experience, she helps women and men restore function and confidence in their bladder, bowel, and pelvic health through a whole-body, root-cause approach.
At Legacy Physical Therapy, care is provided one-on-one and tailored to each individual, with a focus on helping patients return to the activities they love—without relying solely on medications or surgery.
Menu for the Week of April 27-May 1
Monday
Lemon Herb Pasta Salad with Marinated Chickpeas: It sounds fancy, but it’s surprisingly simple. Bright, herby, and packed with chickpeas, this plant-based pasta salad is perfect for make-ahead lunches.
Tuesday
Chicken Fajita Foil Packet Dinner: Not just for camping…foil packet meals make weeknight cooking easy and cleanup even easier. All the bold fajita flavors, none of the mess.
Wednesday
Spring Farro Salad: Farro is a favorite for a reason, nutty, satisfying, and great for leftovers. This fresh spring version works just as well for meal prep as it does for dinner.
Thursday
Pan Seared Black Cod with Spring Vegetables: I splurged on frozen black cod this week…hoping for that rich, buttery texture similar to sea bass or halibut. Paired with spring veggies, it feels simple but elevated.
Friday
Strawberry Ricotta Toast: Inspired by a recent visit to Fiddlehead Fern Cafe, this toast is simple but SO GOOD…creamy ricotta, sweet strawberries, and just the right balance. It won’t be the same, but it’s still worth trying at home.
XO - Jen