BPPT Health Tip: Best Positioning Tips for Optimal Bowel Movements

By Sarah Paplanus, DPT, PT

Are you among the 4 million Americans who suffer from constipation? Or the 1 in 5 American adults with Irritable Bowel Syndrome? Do you occasionally experience the pain and itchy feeling associated with hemorrhoids? If so, the Squatty Potty or similar stool may be the perfect addition to your bathroom! Even if you haven’t been diagnosed with any of these conditions, it is important to note that straining or holding your breath to complete a bowel movement is never normal and is usually a sign of dysfunction. Colorectal medical conditions can vary in their cause, in their presentation and in their severity, but your pelvic floor muscles will always be affected.

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Anatomy!

 

Your colon carries waste out of your body, and where the colon meets your rectum is called your anorectal angle. This anorectal angle is an important factor in continence.

Your pelvic floor muscles work together to support the rectum, change the anorectal angle and control opening/closing. One of your pelvic floor muscles (the puborectalis) forms a sling around your rectum and works to maintain the anorectal angle. If that muscle is tight, it can essentially “choke” your rectum and contribute to straining.

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What does squatting do?

Squatting straightens the anorectal angle and helps to relax the puborectalis muscle, which helps to facilitate emptying. It also decreases the amount of pressure in the abdomen, which has been shown to decrease the time and effort needed for defecation. This all helps to reduce excessive pressure and strain on your pelvic floor muscles. In cultures where squatting is still prevalent for defecation, such as parts of Asia and Africa, it has been found that bowel movements tend to be more complete and that there is a decreased incidence of colorectal dysfunctions such as hemorrhoids, constipation and hernias.

Why is straining bad?

A principle of elementary mechanics states that “any system exposed to excessive pressures ultimately sustains injury”.These injuries can be in the form of a hemorrhoid, a hernia, a muscle strain or a chronic pelvic floor dysfunction. Straining also increases your risk of the Valsalva maneuver, which is exhaling against a closed airway. This causes a sudden increase in intra-abdominal pressure which can cause abrupt changes in blood pressure.

Toilet Posture

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Using a squatty potty, stool, or even two yoga blocks can help you assume a “squat” position. Lean forward and rest your elbows on your knees. Take deep breathes in, using your diaphragm. Place your hands on your belly and feel your breathe fill up your abdomen. Keep your mouth open and jaw relaxed!

Other Strategies to Improve Bowel Health

  • Cardiovascular exercise
  • Proper nutrition (see our previous post on fiber!)
  • Make sure you are drinking enough water
  • Relaxation training, diaphragmatic breathing

 

What to do if you are still suffering?

If the above tips are not helping defecate regularly and comfortably, you may be suffering from pelvic floor dysfunction. Pelvic floor dysfunction can occur when the muscles of the pelvic floor become too tight, weak, or both to do their job properly. Physical Therapy can help! Visit us at Beyond Basics Physical Therapy to help better your BM’s.

PH101: Running to the bathroom, again?

By Fiona McMahon, DPT

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Do you find yourself with a full map of every public restroom along your daily commute in your head? Do you find yourself competing for the aisle seat at movies so you can sneak away to the bathroom? Does it hurt to go? Do you get up multiple times a night? If you answered yes to any of these questions, this week’s Pelvic Health 101 is for you.

On Thursday, March 23 at 7pm, join Stephanie Stamas, physical therapist at Beyond Basics Physical Therapy, for all of the ins and outs of bladder health. Learn how the bladder works, common bladder disorders, and practical tips for helping your bladder symptoms. Light refreshments will be served.

Register at pelvichealth-101.eventbrite.com  today.

Location

110 East 42nd Street, Suite 1504

New York, NY

10017

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PH101: Something’s Wrong with my What?

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Image via PlayBuzz

On March 16, 2017 at 7pm we will be kicking off our spring semester of pelvic health education class, we call Pelvic Health 101 (PH101). In our first class we will be introducing you to the pelvic floor muscles, where they are, what they do, and how they relate to the health and function of your bowel, bladder, and sexual functioning. We will also be covering how things such as alignment, posture, muscle tone and nerves can affect your symptoms. This course is a great starting point to help you understand your pelvic floor and pelvic floor symptoms.

Please join us at our office at:

110 East 42nd Street, Suite 1504

New York, NY 10017
Register at: pelvichealth-101.eventbrite.com

Here is our line up of this and future classes:

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Spring Pelvic Health 101 is Coming

Fiona McMahon, DPT, PT

Pelvic Health 101 is back with some old favorites like, “Something’s wrong with my what?” and “Why is pooping so difficult?” We have also added a new course on pediatric pelvic floor issues.

If you have questions, we have answers. Join us for lectures and question and answer opportunities with expert pelvic health physical therapists, childbirth educators, and nutritionists. Please reserve your spot early at pelvichealth-101.eventbrite.com. Remember spots fill up quickly. As always, light refreshments will be served.

pelvic-health-101-spring-2017

Yeast the Inflammation Beast

 

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Fiona McMahon DPT, PT

You are what you eat. Trash in equals trash out. You can’t exercise yourself away from an unhealthy diet. These adages are often on my mind as I make my food choices because of the myriad of health professionals who have taken time to come to our practice to tell us how we can improve our own and our patients’ health by taking more time to look at what we are consuming in our diet. Lately many of these clinicians have been focusing on candida overgrowth and diet, which can contribute to pain and inflammation conditions.

What we eat can directly affect the bacterial and fungal make up of the gut, AKA the gut microbiome.The gut requires a certain level of good bacteria to help us digest what we eat. Over time a poor gut microbiome can affect how efficiently the gut works. The function of the gut goes beyond just digesting food, but also is vitally important for the production of neurotransmitters, which help to spread messages within the brain and throughout  the whole body.  The microbiome also plays an important role in our hormones, and immune system. When the microbiome of the gut is not balanced, it is called dysbiosis.

One of the most common culprits in gut microbiota dysbiosis is candida, (Yeast!). Candida is a naturally occurring inhabitant of the body and when it’s at appropriate levels, it doesn’t tend to be noticed, but anyone who has experienced a yeast infection knows that if this little guy is allowed to go unchecked, it can do a lot to make you miserable. Besides plaguing women with itching, burning vulvas, yeast overgrowth may cause many other ailments.

Science has pointed to the role candida can play in contributing to chronic and inflammatory conditions. In one study by Kumamoto in 2011, candida overgrowth was associated with delayed healing of inflammatory lesions and were associated with pro-inflammatory cytokines (chemicals) and increased incidence of inflammatory bowel disease like ulcerative colitis and Crohn’s  disease.

Yeast overgrowth can also affect the bladder along with over colonization of saccharomyces (another form of fungus). In fact yeast and saccharomyces was found to be higher in women during a flare of interstitial cystitis than when their symptoms were low.

Yeast is not the only organism that can get out of balance and affect our bodies in harmful ways. There are many other players that can get out of balance. Some signs of an altered gut microbiome is a history of allergies, eczema, or repeated fungal infection.

 

What to do?

It all seems pretty dire, right. How do you control who is colonizing your gut, when you barely have enough time to make it to the gym after work? There are a few simple steps you can start with.

Avoid antibiotics, unless your doctor thinks you need them.

 

 

PillsThe medical community has become a lot more aware of the dangers of over prescribing antibiotics from their perspective, but it is important to keep in mind that a powerful antibiotic can wipe out good bacteria and bad bacteria in one fell swoop. If the good guys in your gut are reduced, the bad bacteria have a better chance of taking over. Take antibiotics only when recommended. Keep in mind antibiotics will not help treat viruses like the flu, they can only treat bacterial infections.

Modify your diet

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Increase your consumption of good fats (omega 3’s) to help reduce inflammation.

Food high in omega 3’s include flax and hemp seed/oils, fish (the fishier the fish, usually means more omega 3’s, for example herring is higher in omega 3 than a milder fish like snapper). Also reduce your consumption of processed foods which can increase inflammation levels and eliminate simple sugars and fried foods. If this is only minimally successful, try a gluten and dairy free diet.  

If simple changes are not helping consider seeing a professional

doctorFind a naturopath, functional or integrated MD, or nutritionist who can investigate more fully whether or not you have SIBO (Small intestinal bacterial overgrowth), candida overgrowth, or other gut microbiome disorder. Or perhaps you are lacking certain ingredients, vitamins or mineral.  These professionals can tailor a diet and medication regimen to help return your gut microbiome to tip top shape.

 

 

Sources:

Kamamoto C. Inflammation and gastrointestinal candida colonization. Cur Opin Microbiol. 2011;14(40): 386-391

Upcoming Live Webinar: The Collaborative Clinical Care Model Between Therapists and Pelvic Floor Physical Therapists Involving Clients with Sexual Pain

 

Amy Stein, PT, DPT

WHEN: Monday, February 6, from 12.30-2.30pm at www.saricooper.com/webinars/

INTENDED AUDIENCE: sex therapists, general therapists, pelvic floor physical therapists and other health and wellness providers.

HOSTED BY : Amy Stein, DPT, BCB-PMD, IF and Sari Cooper, LCSW, CST

CEs for LMSW/LCSWs, AASECT

CEs for Physical Therapy

Blog By Amy Stein, DPT

I am so pleased to offer my first cross-disciplinary webinar with Sari Cooper, LCSW, CST, a leading expert in sexual health, sexual pain,and women’s health. She is the Founder and Director of Center for Love and Sex, and is a licensed individual, couples and AASECT-Certified Sex Therapist, sex coach, writer, trainer, supervisor and media expert. She specializes in sexual disorders, sexual avoidance, couple’s communication, affairs, separation, depression, anxiety, and alternative sexual interests.

Sari was trained in the Family Systems Model, which states that if there is a change in one person in the family, than it affects the whole family system.  This directly affects couples in which one partner is suffering with pelvic pain.  Sari helps the couple and the individual work on communication skills and gives them practice exercises to address their emotional and sexual relationship. When it comes to couples sexual function, Cooper feels she almost always asks clients to work with both partners.  Using techniques such teaching couples the importance of outercourse as well as intercourse in order to sustain erotic connection while a partner is being treated for pelvic pain.

Sari recognizes the need for a multimodal approach in treating pain. She has years long experience treating men and women whose pain is musculoskeletal, systemic, hormonal, or related to another condition, in addition to psychological. She is experienced and collaborated with pelvic floor physical therapists and other medical providers to aid in the healing process.

As pelvic floor PTs, we help the musculoskeletal conditions related to sexual dysfunction and we work closely with mental health and sexual health therapists.  In women, we see and have great success with treating conditions  like vulvodynia, provoked or unprovoked vestibulodynia, vaginismus, endometriosis, pelvic neuralgias like pudendal neuralgia, and other pelvic conditions. In men, we successfully treat musculoskeletal conditions related to erectile dysfunctions, non bacterial prostatitis, and genital and pelvic pain.

In our upcoming webinar, Sari will be reviewing some of the education about the female sexual response cycle that she provides couples to help them re-discover pleasure and eroticism while the patient is working with her pelvic floor physical therapist on relieving her pain.

To learn more, sign up for Amy Stein, DPT and Sari Cooper’s LIVE LUNCHTIME  webinar on Monday, February 6, from 12.30-2.30pm at www.saricooper.com/webinars/ CEs for PTs, LMSW/LCSWs, AASECT Therapists/Counselors will be provided.

BBPT Health Tip: Adding Pelvic Floor Relaxation to Deep Breathing

Amy Stein DPT, PT and Fiona McMahon DPT, PT

 

bookhppThis blog contains information adapted from Heal Pelvic Pain by Amy Stein. If you are interested in learning more about pelvic floor exercises you can do on your own, please visit http://www.healpelvicpain.com/ , http://amzn.to/2ioSz2J, or visit us at Beyond Basics Physical Therapy in New York City to get your copy today.

 

In an earlier post we discussed the positive benefits of adding diaphragmatic breathing to your routine to reduce stress. If you missed it, check it out here .

But why not go a step further. Did you know that you can add pelvic floor drops to your breathing routine to help relax a tight and painful pelvic floor.

 

What is a pelvic floor drop?

A pelvic floor drop is the relaxation of the muscles of the pelvic floor. It is like that feeling you have when you can finally relax the muscle in between your legs after holding urine in for a long time. It’s a great feeling of relaxation and here’s how you can mimic it when you don’t have to go.

 

But How do I do it?

 

  • Step 1: Get comfortable. Sit, stand, lay down, whatever suits you, relax your body and close your eyes
  • Step 2: Breathe deep. Inhale between 3 and 5 seconds
  • Step 3: Exhale. Exhale slowly, 5-6 seconds. As you exhale imagine your breath gently placing pressure on your pelvic floor into relaxation. Don’t push or strain.

Like diaphragmatic breathing, you can use this technique throughout the day to help reduce stress and pain in the pelvic floor. Happy breathing!