Ph101 Why is pooping so difficult?

toiletFiona McMahon, DPT

The number of Americans who deal with constipation issues is massive (4 million!)! It seems like every time I mention that I’m a pelvic floor physical therapist, another friend of a friend pulls me aside with bowel movement concerns. Why is it that so many people have issues? And more importantly – what can we do about it? This is the topic of our next Pelvic Health 101 seminar  on  March 30th at 7pm. 

Not only will constipation be discussed but other bowel conditions, such as irritable bowel syndrome, fecal incontinence, bloating and hemorrhoids will be addressed. The lecture will also go in depth on the role of fiber, water intake, toilet posture and pelvic floor muscles in having a successful bowel movement. You will even go home with easy techniques that you can implement immediately to help you get that smooth move! Don’t miss out on this FREE event – it’s a MUST for anyone who struggles on the porcelain throne. Seats are going fast!  Light snacks and refreshments will be served.

Register at pelvichealth-101.eventbrite.com  today.

Location

110 East 42nd Street, Suite 1504

New York, NY

10017

Check out or upcoming courses!

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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.

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The use of Breath in the Pilates Method

Denise Small PT, DPT

The following series of Pilates blog posts will focus on the principles that define the Pilates method.  Joseph Pilates developed his methodology using eight basic movement principles: whole body movement, breathing, balanced muscle development, concentration, control, centering, precision, and rhythm.  Today’s blog will focus on the principle of Breathing.

pilatesBreathing is a natural phenomenon that is performed thousands of times a day. Our daily intake of oxygen and expulsion of carbon dioxide is needed to cleanse our blood, and maintain the functioning of our body systems.  That being said, there are different ways to manipulate one’s breath to help facilitate certain physiological functions. For example, there have been many BBPT blog posts about diaphragmatic breathing, where one breathes into their abdomen to get a stretch of both the diaphragm and the pelvic floor muscles. Well, Pilates had his own approach to breathing, which was a variation on Diaphragmatic breathing.  Pilates approach to breathing was aimed at getting maximal air intake and release to give the body, what he called, “an internal shower” to rid the body of “toxins”. Pilates focused specifically on lateral expansion of the diaphragm, whereas traditional diaphragmatic breathing focuses on the vertical expansion of the diaphragm. In order to achieve this, Pilates encouraged maintaining the engaged tone of the abdomen, while breathing into the front, sides, and back of the ribcage. See the image below for further explanation.

 

Pilates- Ribcage/ Chest breathing versus Belly/Diaphragmatic breathing

This is an overly simplified view of the actual mechanics. However, both versions are very important. With the ability to differentiate between ribcage and diaphragmatic breathing you can offer your diaphragm a 3-dimensional stretch and the ability to work on abdominal contraction as well as endurance. If you have any questions you can ask them in the comments section. Or come visit me at Beyond Basics for a Pilates Private session!

Yeast the Inflammation Beast

 

candida-albicans

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