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: 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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BBPT Health Tip: Eat your Fiber

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Fiona McMahon, DPT, PT

What is fiber?

Fiber, it’s the hot ticket. It is being marketed to us like crazy. But why is fiber is so important? What fiber is best? Should you get more fiber with supplements? Let’s take a closer look into the benefits of fiber in this edition of BBPT’s Health tips.

Fiber is the part of food that we cannot digest. It is separated into two types, soluble and insoluble. Both bulk up the contents of your stomach and colon, which can help you feel more full but after that, the similarities end.

As the name implies, soluble fiber dissolves in water but insoluble does not. Insoluble fiber increases the mass of the stool and helps to get things moving, in terms of passing feces. Soluble fiber absorbs water. The truth is, most people are not getting enough fiber. Less than half of people in the United States consume the recommended amount of fiber. Let’s discuss the benefits of fiber and how to make sure you are getting enough.

So what if you don’t have issues going number 2? What else can fiber help you with?

Fiber has been shown to help with reducing the risk of the following conditions:

  • Coronary artery disease
  • Stroke
  • High blood pressure
  • Diabetes
  • Obesity

Fiber has also been shown to:

  • Improve insulin sensitivity in people who have diabetes
  • Enhance weight loss
  • Improve GI conditions like acid reflux, duodenal ulcers, diverticulitis, constipation, and hemorrhoids
  • Enhance the function of the immune system

How much to eat and where to get it?

Men under 50 years and under should consume at least 38 grams of fiber daily, Women under 50 should consume at least 25 grams of fiber daily. Women over 50 should eat at least 21 grams and men over 50 should get 30.  Those who suffer from constipation may add more to your diet.   We suggest contacting a nutritionist for proper amounts of soluble versus insoluble in these cases and anyone with a history of GI issues.  Also, please discuss with your doctor before making any drastic changes to your diet.  

Adding  fiber to your diet when you are not used to it can sometimes be a little difficult. If you add too much too quickly, you may experience gas and bloating. Start slow and work your way up.  Also, drink plenty of water.

Start by adding in whole wheat items (unless you have a gluten sensitivity), legumes, fruits, and vegetables slowly to your diet. Check out the Mayo Clinic’s full list of fiber rich foods here .

Sources

Anderson J, Baird P, Davis R, et al. Health benefits of dietary fiber. Nutr Rev. 2009. 67(4)188-205

Family Doctor.org Decermber 2010: http://familydoctor.org/familydoctor/en/prevention-wellness/food-nutrition/nutrients/fiber-how-to-increase-the-amount-in-your-diet.printerview.all.html. Accessed November 11, 2016.

Medlineplus. Soluble vs. insoluble fiber.https://medlineplus.gov/ency/article/002136.htm. Accessed November 17,2016.  

Ryanne Glasper and Melissa Stendahl Expand Their Expertise with Additional Hands on Training!

Melissa Stendahl, PT, DPT

In June, my colleague Ryanne and I had the opportunity to attend the American Physical Therapy Association’s  Gynecological Visceral Manipulation Course, taught by Gail Wetzler, PT, DPT, EDO, BI-D.

Gail is well known for her visceral (organ) mobilization skills and teaching worldwide with Jeanne-Pierre Barral of the Barral Institute. She is a leader in the physical therapy field and in education for women’s health, manual diagnostics, visceral structures and disorders, and integrative therapies for animal health. She is dedicated to techniques to help balance the body’s systems for optimal function. Gail is considered an excellent and sought-after instructor in advanced manual therapy techniques for PTs.

In class, we learned how to assess the  biomechanics and mobility of the pelvic organs (including reproductive organs, the urinary system, and the rectum). We learned  treatment techniques for these structures, and how to integrate these findings and techniques into PT treatment for injuries and disorders affecting posture, core stability, spinal mechanics, and overall movement. Having these skills helps the PT to more successfully and specifically treat pelvic conditions that affect bowel, bladder, reproductive and sexual function. It takes hard work and practice to develop the sensitivity to feel the organs and their potential restrictions, and the PTs at Beyond Basics have all taken advanced training to enhance this skill  because of its importance for our specialty in returning patients to good bowel, bladder, and sexual health and reducing pelvic pain.

We did a detailed anatomy review and excellent hands-on time with lab partners to refine these techniques for our own individual practice! Did you know: neighboring structures “talk” to each other within the body? For example: the liver  is a large organ located within the parietal peritoneum. This peritoneum is a membrane (a thin covering) that wraps around the liver and many other organs in the abdomen. It travels just next to, but does not enclose, the pelvic organs. This membrane becomes neighbors with the bladder, uterus, and rectum. If the liver  is damaged, injured or restricted, the peritoneum membrane enclosing it can tighten in response, kind of like how your arm muscles might tighten up or spasm to help protect you after a shoulder dislocation.  But since the peritoneum is also neighbors with the pelvic organs, this tight restriction at the liver can also result in tension all the way down to the bladder, uterus, or rectum, contributing to urinary or bowel dysfunction or pain! So it may be possible that assessing and treating these lines of tension can help get rid of lingering pain or incontinence, and is a great example of how structures near or even far from the original site of dysfunction can be involved.

So what is a PT really treating when they do “visceral manipulation”? Good question. PTs do not take the place of physicians who specialize in organ function and hormones, like urologists, colorectal, GI or Endocrinologists. But PTs can influence the mobility and positioning of the organs in the abdominal and pelvic cavities, so that they can move and glide as you bend over, run, poop, pee and ovulate, and to reduce inflammation from injuries, or adhesions like scar tissue from surgery. This can be a very valuable treatment option to promote better organ function for digestion, bowel, bladder, sexual and reproductive health.

Link to Gail’s site (https://wetzlerptcenter.wordpress.com/meditate-zen1.jpg

PH101 Does my diet really matter?

Fiona McMahon, DPT

Gluten free, soy free, low FODMAP. It’s amazing how many diets there are out there that really can  provide people with symptom relief. If you are suffering with chronic pain you may be confused on where to start, or what is right for you. You also may have tried out a bunch of different ways of eating, not seen results and have gotten really frustrated. If this is the case for you, I highly encourage you to come to our next pelvic health seminar on October 27th at 7pm, “Does my diet really matter”.

jessica-drummond-headshot-197x300This seminar will be hosted by a special guest speaker, nutritionist Jessica Drummond. Jessica Drummond is a former pelvic floor physical therapist who now specializes in nutrition for those suffering with pelvic floor dysfunction. This seminar was a hit last year and is a great starting point for those considering adding nutrition as part of their healing journey.

 

 

 

Register at pelvichealth-101.eventbrite.com  today.

Location

110 East 42nd Street, Suite 1504

New York, NY

10017

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