Using your tummy muscles and pelvic floor muscles to empty your bowels is usually instinctive. Your tummy muscles have to contact while your pelvic floor muscles need to relax in order for the defecation to happen. However, sometimes people develop problems with these muscles and have to relearn proper emptying technique. If you:
- have weakness in your muscles (pelvic floor and tummy) https://mnaphysiotherapy.com/what-exactly-is-the-pelvic-floor/
- have pelvic organ prolapse https://mnaphysiotherapy.com/pelvic-organ-prolapse-and-how-physiotherapy-can-help/
- have decreased sensation in your pelvis,
- ignore and defer the urge to go to the toilet,
you may find yourself straining to empty your bowel.
Signs of straining
Straining to empty your bowels is mostly due to lack of pelvic floor relaxation and poor coordination between your pelvic floor muscles and tummy muscles. Notice what happens to your body when you are having a bowel movement:
- Is your jaw clenched?
- What is the angle of your hips?
- Are your feet touching the ground?
- Is your spine straight?
- Is your belly soft or tense?
- Is your anus back passage) relaxed or tight?
Common signs of straining to empty your bowels can include:
- holding your breath or taking in a big gulp of air and holding it
- keeping you jaw tense
- haemorrhoids
- feeling of incomplete bowel emptying and have to go multiple times a day
Bowel emptying technique
Here are the 5 steps to emptying your bowel better:
1. Lean forward and rest your forearm on your thighs.
2. Support your feet on the floor or use small foot stool if you can’t reach the floor- no tiptoeing!
3. Make sure your knees are higher than your hips (again, foot stool is very helpful to achieve that) and your spine is straight.
4. Stick your belly out as if you have swallowed a balloon and feel your waistline widening. Make your belly wall hard using your tummy muscles while continuing to breathe. Doing this makes it easier to open your back passage.
5. Open and relax you back passage.
Relaxation and emptying tips
Breathe in deeply through your nose (as if smelling the flowers) and out slowly through your mouth(as if blowing out candles). If you are not sure how to relax your pelvic floor muscles, visualize your anus (small circular muscle). Feel the circle widening and opening as you breathe in and feel the circle gently closing as you breathe out. The digestive tract starts at the mouth and ends at the anal opening, so be sure to relax both ( jaw, mouth, back passage). To empty better, give a grunt as you breathe out (or try using sounds such as Mooooo…! Watch the video here https://www.youtube.com/watch?v=QDk93cvZAuk). You can read more about breathing for a happy pelvic floor here https://mnaphysiotherapy.com/360-breathing-technique-breath-for-healthyhappy-pelvic-floor/
If you struggle with constipation, make sure to read my blog on how to manage it Can abdominal massage help constipation? – mnaphysiotherapy.com
Reference:
2007 Herman & Wallace | Pelvic Rehabilitation Institute