Constipation
Why would I need to come to see Healthy Pelvy: Pelvic Floor Therapy if I’m constipated?
Well, first of all - good job being proactive! A lot of people don’t talk to anyone - doctors even - about their bowel movement symptoms, so they think their normal is.. well.. normal! However, the following is what a normal bowel movement scenario should look like:
You feel the urge to go, have enough time to finish up what you’re doing, and head to the bathroom. You sit on the toilet, and maybe do one or two little pushes just to get it moving, then the rest comes out, basically on its own. No straining. No pushing. No holding your breath and forcing anything out. Afterwards, you feel “empty” and relatively satisfied. You’re not in the bathroom longer than a few minutes, and you definitely don’t have time to read a book (or scroll on your phone).
If this is not your norm - or you go many days between bowel movements and feel not great in between (cramping, discomfort, etc.) - you’re likely constipated.
The issue with being constipated is that the straining and pushing during bowel movements creates pressure down on your pelvic floor and the organs it supports, potentially creating hemorrhoids, prolapse, incontinence, tension of the pelvic floor, and a whole host of other issues.
So, when you come to us, we ask - what’s going on with your BMs? What does your poop look like (really!!)? How often to you poop? Etc. Then we try to figure out causes - are you dehydrated? Are you eating something that’s influencing your bowel movements? Are you ignoring your initial signal to have a bowel movement?
When we’ve gone through all those things (habits/behaviors), we then tackle the anatomical and physiological considerations.
Anatomy: we may do a pelvic floor assessment. We can assess a lot of the posterior pelvic floor vaginally (obviously this is not exact, but it can give us quite a good reference point). We give thorough explanation of the process, and then have informed and signed consent before performing any internal assessment of the pelvic floor. Then we also assess what’s going on externally: are you clenching your booty? How are the other muscles around your pelvic floor?
Physiology: How are you standing? Where are you balancing your body’s forces/gravity? Are you standing with your pelvis tilted under or over which can lead to weird forces downward and eventually constipation? Are you holding your breath for a lot of heavy activities (lifting groceries, weight lifting, children-lifting)? How are you walking and moving?
After these assessments, we use the findings to make a plan of exercises and stretches, body awareness changes, and activities that will help improve how your body moves and how you use your body throughout the day.
We will often see that, when these things improve, so does a person’s constipation.
Lastly, we value abdominal manual therapy quite a bit! We may work on your tummy in a lying down position frequently. This can have multiple effects: muscle/fascia improvement, nervous system regulation, GI movement, gas movement, and overall it can feel really nice!
Many a constipated patient leaves our care incredibly happy and feeling better than when they started!
