Let’s be honest: no one wants to talk about pelvic floor issues. But if you’re dealing with symptoms like pressure in your pelvis, difficulty with bowel movements, or a sense of fullness “down there,” it’s time we bring one word into the spotlight—rectocele.
A rectocele might not be something you hear about every day, but it’s more common than you think—especially for women who’ve gone through childbirth, hormonal changes, or pelvic floor trauma. Unfortunately, most people wait way too long to do something about it. That hesitation? It can lead to bigger issues down the line.
At Simply Physio, we see this often: women living with discomfort, uncertainty, and embarrassment for months—or even years—without knowing there’s help available that doesn’t involve surgery. So let’s clear up the confusion, break down the symptoms, and talk about what you can do starting today.
What Is a Rectocele, Really?
A rectocele is a type of pelvic organ prolapse—specifically, it’s when the wall between your rectum and vagina weakens, causing the rectum to bulge into the vaginal canal. It’s often described as a “herniation” or “bulge,” and it’s typically caused by strain or damage to the pelvic floor muscles and connective tissues.
Sounds intense? It can be—but it’s also treatable. The key is catching it early and understanding what’s really going on in your body.
Understanding the Pelvic Floor: Why It Matters
Think of your pelvic floor like a hammock of muscles and connective tissue that supports your bladder, uterus, and rectum. When these structures are healthy and strong, everything stays in place. But when the tissue weakens—due to age, trauma, childbirth, or other stressors—that support system can start to give way.
In the case of a rectocele, it’s the back wall of the vaginal canal that gives out. That creates a pocket where stool can collect, leading to symptoms like:
- Difficulty with complete bowel movements
- Needing to press on the vaginal wall to poop
- Sensation of pelvic pressure or fullness
- Vaginal bulging or heaviness
- Low back discomfort
- Sexual dysfunction or discomfort during intercourse
A lot of these symptoms overlap with other pelvic conditions, so it’s easy to chalk them up to “just getting older” or “having kids.” But your body is trying to tell you something—and it’s not just in your head.
What Causes a Rectocele?
Let’s unpack what’s going on behind the scenes. A rectocele doesn’t just happen—it’s usually the result of chronic strain or trauma. Here are the most common contributors we see at Simply Physio:
1. Childbirth
Vaginal deliveries—especially if they were prolonged, involved forceps, or caused tearing—are a top cause of pelvic floor weakening. The more births, the higher the risk.
2. Chronic Constipation
Straining on the toilet day after day puts serious pressure on the rectovaginal wall. Over time, that pressure can weaken the tissue and create a bulge.
3. Heavy Lifting
Whether it’s at the gym or picking up toddlers, repeatedly lifting heavy loads without proper core support can strain the pelvic floor.
4. Obesity
Excess weight increases intra-abdominal pressure, which contributes to prolapse—including rectocele.
5. Aging and Menopause
As estrogen levels drop, tissues lose elasticity and become thinner. That makes it easier for organs to shift out of place.
6. Pelvic Surgery or Trauma
Hysterectomies, perineal tears, or other surgical interventions can weaken pelvic structures and contribute to rectocele development.
How Do You Know If You Have a Rectocele?
This is where things get tricky—because symptoms can be vague or come on gradually. But if you’ve noticed any of the following, it’s time to pay attention:
- You feel a bulge in the vagina when wiping or showering
- Bowel movements don’t feel complete, even after straining
- You need to press between the vagina and rectum to poop comfortably (a move called “splinting”)
- You feel a constant heaviness or dragging sensation in the pelvis
- Sex feels uncomfortable or different than before
If any of this sounds familiar, you’re not alone—and it’s not “just part of being a woman.” These are signs your pelvic floor is struggling and needs attention.
Diagnosis: Getting Clear Answers Without the Guesswork
At Simply Physio, we understand that pelvic floor issues are personal, sensitive, and sometimes hard to talk about. That’s why our evaluations are done with care, empathy, and full confidentiality.
Here’s what a proper rectocele diagnosis involves:
- Detailed Health History – We’ll ask about childbirth, bowel habits, hormone changes, and previous surgeries.
- Pelvic Floor Assessment – A skilled pelvic floor physical therapist will gently assess the strength and coordination of your pelvic muscles.
- Visual and Manual Exam – This helps us determine the grade of the rectocele and whether other types of prolapse are present (like cystocele or uterine prolapse).
- Functional Tests – You might be asked to bear down or simulate a bowel movement to evaluate how the pelvic structures respond under pressure.
In some cases, we may refer you for imaging or collaborate with your OB/GYN or urogynecologist if needed. But here’s the good news: most cases of rectocele can be improved significantly without surgery.
How We Treat Rectocele at Simply Physio
Treatment starts with understanding your goals. Some women just want to reduce symptoms. Others want to avoid surgery or return to an active lifestyle without discomfort. Whatever your goals are—we’ve got your back.
1. Pelvic Floor Physical Therapy
This is our bread and butter. And it works.
We focus on retraining the muscles of the pelvic floor to better support your organs. This includes:
- Strengthening weak muscles
- Releasing overactive or tight muscles
- Training your core and diaphragm to work in sync
- Improving bowel mechanics to reduce straining
We’ll teach you techniques like proper defecation posture, coordinated breathing, and splinting methods that make a huge difference in your day-to-day life.
2. Biofeedback
This tool helps you see how your muscles are functioning in real time so you can improve control and coordination. It’s especially helpful for people who don’t know how to “find” or activate the pelvic floor correctly.
3. Lifestyle and Bowel Habit Coaching
We’ll guide you on fiber intake, hydration, posture, and bathroom routines to prevent constipation and reduce rectocele strain triggers.
4. Pessary Use
For some clients, a pessary (a soft device inserted into the vagina) can help support the rectum and alleviate pressure. We collaborate with medical providers if this is a good fit.
5. Collaboration with Specialists
If surgical intervention becomes necessary, we’ll make sure you’re supported before and after—helping with prehab and rehab to ensure the best recovery possible.
Preventing Rectocele or Keeping It From Getting Worse
Once you’ve got the symptoms under control, it’s all about maintenance and prevention. Here’s how we help clients protect their progress:
- Continue pelvic floor and core exercises as part of your regular wellness routine
- Avoid chronic straining—whether that’s on the toilet or in the gym
- Lift properly, using your legs and breath coordination to reduce intra-abdominal pressure
- Stay hydrated and eat fiber to keep bowel movements smooth
- Get support early—don’t wait until symptoms escalate
Remember, this isn’t just about managing a problem. It’s about getting your life back without discomfort, uncertainty, or shame.
You Don’t Have to Just “Live With It”
If you’ve been told your only options are surgery or “just dealing with it,” we’re here to tell you that’s not the whole picture. A rectocele isn’t just a structural issue—it’s a signal that your body needs better support and strategy. And we can help you find that.
At Simply Physio, we create personalized, one-on-one care plans for women navigating pelvic floor challenges—without judgment, pressure, or overwhelm. Schedule your consultation today, and let’s get you feeling stronger, more confident, and finally in control of your body again.
