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As you know – there is no such thing as TMI for a pelvic floor physical therapist, so when it comes to hemorrhoids – I’ve heard it all!

But oftentimes you might feel like you are the only person on the planet struggling with your hemorrhoids or maybe you don’t even know that you have hemorrhoids – you just know something is not right at your anus.

Whether you are pregnant, early postpartum or just cannot seem to get rid of these pesky hemorrhoids, I’ve got you covered with some at home movement to help you start finding some relief!

What are hemorrhoids?

Before we start talking about how to address your hemorrhoids, let’s briefly review what they are.

Hemorrhoids occur when the veins in or around your anus swell. You can have two different types of hemorrhoids: internal and external. 

Internal hemorrhoids are when the swollen vein is positioned inside your rectum and they are not typically serious – in fact, you may not even be aware that you have them. However, they can become more serious if they prolapse outside of the anus, which may require more treatment. 

External hemorrhoids are when the swollen vein is on or around your anus. Because they’re located on the outside of your rectum, where you have more nerve endings, they may be more uncomfortable or painful, especially when sitting down, doing activities, or using the bathroom. They are more serious and may require eventual surgical treatment if conservative management fails.

How do you know if you have a hemorrhoid?

Both types of hemorrhoids can be painful – or at the very least, uncomfortable. 

If you’re dealing with symptoms like these, you may have hemorrhoids: 

• Pain during bowel movements
• Persistent itching in and around your anus
• Bloody stools (or bloody toilet paper when wiping after a bowel movement) 
• A small, swollen mound or lump protruding from your anus
• Rectal bleeding
• Feeling of fullness after a bowel movement

I always recommend reaching out to your OB, PCP or pelvic floor PT if you are experiencing any of these symptoms to better determine the cause of your symptoms.

And remember –  don’t panic: most bleeding from these causes is minor and harmless, but it’s a good idea to chat with your doctor anytime you notice blood during pregnancy, or at any time really!

Why do hemorrhoids occur?

Of course I wish I could tell you the exact, singular reason that hemorrhoids occur, but unfortunately, like most things in life, hemorrhoid development is complex and there are likely several contributing factors.

Here’s a list of some of the most common contributing factors to hemorrhoid development:

• Pregnancy
• Sudden weight gain
• Chronic constipation
• Pelvic floor tension
• Poor intra-abdominal pressure management
• Straining during bowel movements
• Poor bowel & bladder habits
• Childbirth

The good news is that nearly all of these risk factors for developing hemorrhoids can be managed and treated – oftentimes from the comfort of your own home!

What can you do at home to treat your hemorrhoids?

As a pelvic floor physical therapist, my goal with treating patients is to address a problem with conservative management before it requires surgery or more invasive treatment approaches.

If you are starting to notice hemorrhoid development, it’s best to implement these at-home management techniques first before jumping straight to surgical options because many times you can reduce or eliminate your symptoms without surgery!’

Here are some of my top tips for conservative management of your hemorrhoids: 

• Increase your fiber consumption to reduce constipation
• Increase your water and electrolyte consumption to reduce constipation
• Invest in a squatty potty to improve rectal positioning during bowel movements
• Release pelvic floor tension to reduce constipation and straining
• Use Tucks Medicated Cooling Pads for immediate symptom relief
• Take a sitz bath to relieve itching and soothe pain

At this point you should be starting to notice a theme with hemorrhoid development and management, and hopefully you are starting to realize that they can be prevented and treated most of the time by – improving your bowel habits, releasing your pelvic floor tension and decreasing pressure on your anal sphincter. 

Pelvic floor release exercises

Ok, so maybe you’ve taken the first few steps to treating your hemorrhoids by taking a sitz bath and buying a squatty potty – but you have NO idea where to begin with releasing your pelvic floor tension.

That’s where I step in.

As a pelvic floor physical therapist, I’ve treated thousands of women with tight pelvic floors, and these are a few of my tried and true exercises to release pelvic floor tension.

1. Child’s Pose Back Body Breathing

How to perform: 

Start in a rounded position in an extended child’s pose position. Press your palms down and away from your body to stay active and rounded in the upper back. Inhale through your nose focusing on expanding your ribcage 360 degrees. Try to direct your inhale into your lower back and anal sphincter to feel your posterior pelvic floor expand. Exhale and simply blow out the air, do not contract your core or pelvic floor. Repeat this breathwork for 1 minute really focusing on directing your inhale down into your lower back and pelvic region to release any tension in the muscles that wrap around your anal sphincter. 

2. Adductor Rock Back

How to perform:

Start in a kneeling position with one leg extended long so your toes are in line with your bent knee. Place your palms on the ground at the center of your body. Inhale as you rock back imagining someone is pulling you straight back by a string connected to your butt cheeks to keep your back and pelvis neutral. Avoid rounding your pelvis. Feel this stretch in the posterior pelvic floor as well as the inner thigh of the extended leg to release any pelvic floor tension. Exhale as you rock forward to return to start. Do not contract your pelvic floor or deep core. Repeat this for 30 seconds per side.

3. Quadruped Pelvic Circles

How to perform:

Start in a quadruped position pressing your palms through the ground to stay active and engage in your trunk and upper body. Bring your feet slightly wider than hip width to length your pelvic floor. Inhale through your nose expanding your ribcage 360 degrees as you rock back towards your heels. Keep your trunk and pelvis neutral as if someone was pulling you by a string from your butt cheeks towards the wall. Direct your inhale into your anal sphincter to feel your pelvic floor expand. Exhale as you rock forward. Do not contract your pelvic floor. Repeat for 1 minute.

4. Quadruped Rock Back – Heels Out

How to perform:

Start in a quadruped position pressing your palms through the ground to stay active and engage in your trunk and upper body. Bring your feet slightly wider than hip width to length your pelvic floor. Inhale through your nose expanding your ribcage 360 degrees as you rock back towards your heels. Keep your trunk and pelvis neutral as if someone was pulling you by a string from your butt cheeks towards the wall. Direct your inhale into your anal sphincter to feel your pelvic floor expand. Exhale as you rock forward. Do not contract your pelvic floor. Repeat for 1 minute.

5. Knee to Chest

How to perform:

Start in a supine position on your back. Bring one knee as close to your chest as possible and slightly outside of the ribcage if this feels more comfortable. Hold this position for 30 seconds as you inhale through your nose focusing on expanding your ribcage 360 degrees as well as feeling your vaginal opening and anal sphincter expand as you inhale. Exhale and simply blow the air out, relaxing your entire body. Do not contract your pelvic floor. Repeat for 30 seconds on each side.

Need more pelvic floor guidance?

I know first hand just how miserable hemorrhoids can be, and so often they are due to excessive pelvic floor tension and poor intra-abdominal pressure management – but figuring out exactly what you need to do to address these dysfunctions can be confusing and time consuming.

In my Movement Through Pregnancy and Movement Through Early Postpartum programs, I walk you through exactly how to navigate your symptoms through educational modules as well as weekly workouts to reduce your pain and improve your pelvic floor, core and full body strength. 

You do not have to live in pain just because you are pregnant. You do not have to struggle with incontinence and core weakness for the rest of your life postpartum. You can stay active, pain-free and leak-free through motherhood. Let me help you!