Got Constipation? Could it be Poor Coordination?
Most would be surprised to know that having a bowel movement takes coordination.
Ew. Are they really talking about bowel movements?
YEP, because when they do go wrong, it makes a big impact on our daily life and mental health. And, barring other medical reasons, everybody poops, so be comforted by that little fact.
Reasons you may be constipated
Low dietary fiber intake and low fluid intake
Psychosocial aspects including mental health issues, fear of pooing in public bathrooms, fear of pain with bowel movements
No urge to defecate or ignoring the signals
Poor body coordination and posture
Aging
Lack of activity
Medications
Birthing injury or other injury to the anal sphincters
Coordination is key
Having a bowel movement takes conscious and subconscious processes to happen. We must be able to get into the proper position, relax the correct muscles, bear down, but not strain….whew. Are you already confused and overwhelmed?
Step one is relaxing those pelvic floor muscles. As seen in the diagram below, male and female’s alike have a muscle that surround the rectum and pulls it forward in order to stop the passing of bowel contents. If this muscle is uncoordinated with your bowel movement, it squeezes around the rectum and prevents the passing of stool. Without understanding how to relax those pelvic floor muscles, we can not even proceed to step 2.
Relaxation of the puborectalis muscle is important for smooth bowel movements.
To relax the pelvic floor muscles, lie on your back with legs bent and resting over a pillow or two, take a breath into the belly and gently push down as if trying to pass gas. If you can’t tell what is going on, you can try using a hand mirror to see the area relax down. If you see or feel no movement, or you see or feel them lift instead, you may have poor pelvic floor coordination or strength. If you can not do this, skip step two and three, and proceed to step four.
Step two is breathing and a small bearing down. We need to breath into our belly, using our diaphragm. Imagine smelling a rose deeply. At this point, our stomach stays extended and we breath out through pursed lips as if blowing out a candle and GENTLY push down on our pelvic floor muscles as if trying to pass gas.
The key with this is to breath out with an open mouth and not strain. If your face is turning red when performing this, you are increasing your pressure incorrectly and can cause serious issues. If you are doing this, skip step three and proceed to step four.
Step three Position is important. Have you heard of a squatty potty? You can find one here for less that $30. You can also buy a simple stool, but those can be a trip hazard as they do not sit flush to the toilet when not in use.
The importance of this stool is to help put your knees higher than your hips. This increased hip flexion (above 90 degrees) helps put the rectum at an angle for smooth flow of bowel contents. Once you have your knees high, keep your back straight and lean forward from the hips. You should look like the picture below.
Combine Steps 1-3 to have a successful and smooth bowel movement, but if you’re still having trouble, proceed to step four.
Step four When you are still “hitting a wall”, having to wipe more that once or twice, or are passing small pellets of poo, call us at Lystra Physical Therapy. We’ve taken continued hands'-on training and education courses through the American Physical Therapy Association just so that we can help people like you get back to a life they love.
Don’t wait, contact us today.
