Advice for dealing with chronic anal fissures regarding pelvic muscle tension?
By: Dr. Brianne Grogan, PT, DPT
Chronic anal fissures are most commonly due to the following items. Please note how each item can have pelvic floor muscle tension as a contributing factor!
Common causes of fissures:
- issues with constipation and/or straining to pass large or hard stools (constipation can be caused by dietary issues - i.e. not enough fiber and/or fluid in the diet, as well as heightened emotional stress, and lack of regular physical activity.... but tight/overactive pelvic floor muscles can also contribute to straining and difficulty passing stools)
- decreased circulation to the anorectal area (this lack of blood flow can be due to chronic clenching or "holding" of the pelvic floor muscles)
- overly tight sphincter muscles around the anus (tight sphincters may be due, in part, to chronic tension in the pelvic floor and buttock muscles)
- inflammation due to irritable bowel syndrome can make the tissues around the anus more prone to tearing (inflammation and discomfort from any type of gut health issue, or even bladder pain syndrome, can cause chronic tension and holding in the pelvic floor, which can contribute to all of the above-listed concerns)
Because of the above reasons, "downtraining" the activity in the pelvic floor muscles can be very helpful in the treatment of chronic anal fissures.
Of course, the pelvic floor muscles also typically tighten up IN RESPONSE to the pain of the fissures, and so starting a program such as Overcome Pelvic Pain is a great way to interrupt that "vicious cycle" and treat both the CAUSE and the EFFECT (which in both cases can be pelvic floor muscle tension).