We show that the dynamics of high-intensity laser pulses undergoing self-focused propagation in a nonlinear medium can be understood in terms of the topological constraints imposed by the formation and evolution of spatiotemporal optical vortices (STOVs). STOVs are born from point phase defects on the sides of the pulse nucleated by spatiotemporal phase shear. These defects grow into closed loops of spatiotemporal vorticity that initially exclude the pulse propagation axis, but then reconnect to form a pair of toroidal vortex rings that wrap around it. STOVs constrain the intrapulse flow of electromagnetic energy, controlling the focusing-defocusing cycles and pulse splitting inherent to nonlinear pulse propagation. We illustrate this in two widely studied but very different regimes, relativistic self-focusing in plasma and non-relativistic self-focusing in gas, demonstrating that STOVs mediate nonlinear propagation irrespective of the detailed physics.