Digestive and pelvic floor problems? Are your high heels (or swollen, stiff ankles) to blame?

Kat H Author

Find out how feet and shoes affect your pelvic and digestive health and how Feldenkrais can help you return to intimate, pelvic, sexual and gut health

Do you remember "Sex in the City"? Carrie and her friends: Gorgeous women who had great jobs, great clothes, great friends, and great shoes! Really, really great shoes! I wanted to be part of them: I wanted to walk through New York on high heels carrying bags of shopping. 

These days I wonder whether Carrie and her friends suffered from constipation or bloating. Maybe they weren't able to have a good giggle because they suffered from stress incontinence. Or maybe they had sexual or intimate health problems.... Why am I thinking that? Because our feet affect our pelvic floor, our pelvic floor affects our digestive health - and vice versa.

And you don't have to wear high heels to develop pelvic floor or digestive health issues that are related to your feet! Swollen ankles or feet, bunions, clenched toes, dysfunctional gait (that is walking) patterns, larger, swollen legs and much more may all underlie your problem. 


Before I talk about how our feet can affect our intimate, sexual and digestive health, let me talk a little more about the connection between digestive and pelvic floor health.

Digestive and pelvic floor, intimate health are connected. Our anus is actually an opening at the back of the pelvic floor. If the back of the pelvic floor is tight we suffer from anal tension. Result: We might end up straining to empty our bowels. We might suffer from constipation, bloating and possibly overflow diarrhoea - that’s diarrhoea that happens like an explosion when we’ve been constipated for a while. In the medium to long term these digestive issues can also lead to vaginal or anal prolapse.

See, when we are constipated and need to strain to empty our bowels we often put excessive pressure on our pelvic floor. If the pelvic floor is tight, it is a little bit like pressing against a brick wall. You can push as much as you like, you can't move! Of course, our pelvic floor and anus aren't a brick wall so you will eventually manage to empty your bowels. But straining over long periods of time can lead to a weakened pelvic floor, affect our continence, bladder health and might even cause prolapse, hernias and hemorrhoids. 

Overflow diarrhoea, on the other hand, can affect our vaginal and urinary health and lead to infections as tiny droplets of stool can cause infections.

So what can we do to prevent this? First of all, we need to find out why we have digestive and pelvic floor issue! It’s always good to check with your medical doctor to exclude any serious underlying health issues. You should also consider your diet, fluid intake, lifestyle, weight and other issues that can affect your pelvic floor and digestion. But for many of us, this doesn’t give us all or maybe any of the answers we need. That’s when Feldenkrais and somatic movement can help!

Feldenkrais is a gentle movement practice that is designed to help us find out about our habitual patterns of movement and tension and resolve them. Habitual patterns of tension, such as tension in the jaw, chest, pelvis or anus can have a profound affect on our pelvic floor and digestive health. 

Why do we develop anal tension?

Anal tension is a common reaction to stress. Now this is not just the case for humans. Dogs and other animals tuck their tails when they are stressed or frightened. My niece, who works with animals, tells me that loads of dogs, cats and other animals suffer from gas and constipation. So we are not alone! The only thing is, animals don't wear high heels. And neither might you.... Emotional stress and high heels are one but definitely not the only cause for anal tension. The overall health of our feet, the way we walk, whether we have swollen ankles, bunions, larger legs or other movement restrictions can all be at the root of our problem. And Feldenkrais can help with all of these. 

So let me explain how anal tension can be caused by our feet and footwear: 

Our feet are actually connected to our pelvic floor through nerves and fascia. But that’s not all. Tension in our feet, the shoes we wear, swelling or restrictions in our feet and ankles, how we stand and how we move, our gait, all affect the health of our pelvic floor.

a. Pronation and Supination of our feet = aka standing with more weight on the inner or outer edge of the foot

Putting more weight on the inner edge of the foot, “over-pronation” causes a collapsed arch. The leg tends to turn in which can cause tugging on the muscles that attach to the sitbones and tailbone and cause pain or discomfort. Our pelvic floor attaches to the sitbones and the tailbone, the coccyx.

Putting more weight on the outer edge of the feet, “over-supination” can cause excessive outward rotation of the leg and can strain the ligaments of the pelvis. It can lead to tension in the sacro-illiac joint as well as the lower back. In my clinic I also observe how it seems to be linked to difficulties in emptying bowels. It can lead to an overly lifted arch and an overly tight back of the pelvic floor.

Incidentally, standing with our feet too wide or turned out have a similar effect.

Here are a few exercises for pronation and supination: 

b. Tiptoe-ing versus heel walking

If our weight is distributed mostly onto our toes the back of our pelvic floor is likely to be tight. This can lead to straining, constipation and bloating. Now we might be on our toes because it’s a habit or emotional state. I’m definitely an overexcited “get up and go” person. I even sit with my heels up, ready to jump up, when I eat my dinner! But toe-dominance may also be caused by swollen ankles which stop us from flexing our feet fully (“dorsiflexion”), say when it is very hot or if you have congestive heart failure, lymphoedema or lipoedema. Toe-dominance may also be caused by wearing heels all the time. Now many of us don’t realize that most shoes have got heels. They are often so small that we are unaware of them. But they can still have a strong effect on our feet, pelvic floor and posture.

Now in a healthy gait – that is, walking pattern - we will apply pressure on all these points as we put our foot down and pick it up again: we roll from the outer edge to the inner edge, from the heels to the toes etc. Feldenkrais has many wonderful lessons that can support this healthy gait pattern. These lessons improve the mobility of the feet and help us to connect the actions of our feet to our pelvis, pelvic floor and rest of the body. I have found that my clients - male and female - often improve their intimate and digestive health after such a Feldenkrais lesson.

Here are some exercises for tiptoe-ing vesus heel walking:

One last thing about our feet:

c. Clenched toes

Many of us hold tension in our toes, especially when we get stressed. It's as if we are trying to grab the floor for safety! Flip flop shoes may also cause us to clench our toes and cause tension in the anus: When we clench (flex) our toes, the flexors of the toes lift the arch of the foot which is linked to an overly tight pelvic floor. Feldenkrais has wonderful lessons for the toes and feet that can help to restore ease.

Feet lessons are some of my favourite lessons. I like what I sense in my pelvic floor. You see, our feet share dermatomes, that is spinal nerves, with the sacral area and pelvic floor. No wonder that there are foot fetishists….

About me, Kat Hesse

I am a Feldenkrais practitioner, Movement Therapist, Medical Herbalist and Intimate Ecology Practitioner with specialist trainings in physical rehabilitation for pelvic floor health (fascial pelvic floor rehabilitation, Hypopressives) and digestive health. I have a certificate in psychosexual health counselling and am presently studying for an MSc in Mindfulness.

I also have personal experience of digestive and pelvic floor health issues: For most of my life I have suffered from stress-related constipation. As I went into menopause I also developed severe bloating. Now that's not all: I actually ended up with a minor anal prolapse and intimate health problems, that is severe vulvovaginal atrophy. Feldenkrais and somatic pelvic floor rehabilitation techniques helped me to resolve all of these. They also helped me to understand the connection between digestive and pelvic, intimate and sexual health. And they certainly made me look at my shoes, throw out a lot of them and look after my feet! 

If you would like to take one-to-one or group classes with me, contact me via this form.

Categories: : digestive health, womens intimate health