Pelvic rehab also addresses colorectal problems wheather they are pain disorders of voiding dysfunctions muscle coordination and health play a role. Below are commonly addressed problems.
Anorectal Pain and Levator Ani Syndrome
The role of physical therapy is to provide evaluation and treatment of the muscles with biofeedback, soft tissue/muscle stretching and muscle stimulation for pain relief. Education and training about pelvic floor muscle function with emphasis on relaxation, correcting postures and body mechanics that may help decrease the pain and improve function.
Constipation and Incomplete Emptying
Physical therapy will focus on education on the role of the pelvic floor muscle functions when emptying the bowels. Treatment sessions focus on teaching coordination, relaxation then strengthening of muscles. The also include instruction in proper toileting postures and behavioral activities that can affect this condition. Biofeedback helps you in seeing how your muscles are functioning. The role of the pelvic floor muscles to support and maintain the anal-recal angle is key in good bowel continence.
Fecal incontinence can be particularly frustrating and lead to social isolation. PT will focus on the education and training proper habits (diet, toilet positioning and use of muscles for control of bowel movements or gas). Individualized pelvic floor exercise instruction based on the assessment of your muscles is provided. Treatment can include biofeedback, a progressvie exercise program and/or pelvic muscle electrical stimulation to retrain the muscles for essential control and support of the internal organs.
Irritable Bowel Syndrome
IBS is a disturbance of colon function characterised by abdominal discomfort, bloating, and abnormal bowel movements. It can have constipation dominance or diarrhea dominance or alternate between the two. "Irritable" means that the nerve endings in the lining of the bowel are unusually active. The bowel is more or less responsive to what might be normal events such as passing gas or having a bowel movement. Managing IBS is multifaceted. Proper rest, diet, and exercise can help reduce stress and positively influence IBS. Physical therapy will help you learn massage and relaxation techniques and provide you with diet and activity quidance. Your physician may also be able to recommend medication that can help.
Sacroiliac, tailbone, hip and low back pain
Assessment for joint mobility and stability, flexibility, myofacsial mobility, muscle strength, movement patterns and psoture are performed. Treatment with manual therapy and therapeutic exercises and a home exercise program is provided. These conditions often occur with colorectal problems.
Abdominal massage, also called bowel massage, may be taught as a self-treatment. This circular massage technique can be a useful tool to reduce and eliminate gas and ease constipation. This is very helpful with bowel motility and mobility.
Treatment of constipation
- increase fiber and fluids in your diet
- increase physical activity
- learning muscle coordination
- learning proper toileting techniques and toileting modifications
- designing and sticking to a toileting schedule
Basic Toileting Tips
- Lean forward enough for your elbows to rest on your knees
- Support your feet on the floor or use a low stool if your feet don't touch the floor
- Push out your belly as if you have swallowed a beach ball- you should feel a widening of your waist
- Open and relax your pelvic floor muscles, rather than tightening around the anus