Author: Dr. Maureen O’Keefe, DPT specialist in pelvic floor dysfunction, bladder, bowel and pelvic pain physical therapy
There are so many things that pelvic PT can help if you have IBS!
Here at Purple Mountain PT we help individuals overcome pelvic pain, bladder, bowel and intimacy problems. Many of our patients come to us and have a diagnosis of irritable bowel syndrome. If you would like more information about our program to help people who have IBS, you can contact us here. Here we’ll detail 8 ways that high quality pelvic PT helps IBS.
The term “Irritable Bowel Syndrome” refers to your symptoms! It doesn’t explain the underlying causes of your problem. Here’s a definition of IBS from NIDDK:
Irritable bowel syndrome (IBS) is a group of symptoms that occur together, including repeated pain in your abdomen and changes in your bowel movements, which may be diarrhea, constipation, or both. With IBS, you have these symptoms without any visible signs of damage or disease in your digestive tract.
-The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
NIDDK also states
Irritable Bowel Syndrome is a part of a wide spectrum of disorders that affect your digestive system.
We’ll dive into 8 ways that pelvic PT can help your IBS. Here we go!
1. Pelvic PT will identify if you have Pelvic Floor Dysfunction and treat this.
When a person has IBS, they often experience either chronic constipation or episodes of constipation mixed with diarrhea. In both cases (constipation and diarrhea), the pelvic floor muscles are experiencing non-optimal activity that can strain them and contribute to ongoing difficulty with bowel control, whether it is inability to empty your bowels (constipation) or fecal smearing (diarrhea leading to constipation issues). Pelvic PT will address underlying problems with the group of pelvic floor muscles that help you to urinate and have bowel movements. Coordinating these muscles so they allow you to urinate and defecate without straining and without pain can be tricky. When someone has experienced ongoing pain or cramping from IBS symptoms, it is common that their pelvic floor muscles have become discoordinated. If this happens, when they use the toilet, whether for urinating or bowel movements, they are often not having an easy experience. In fact, our patients who have IBS commonly have high tone pelvic floor, resulting in inability for these muscles to relax and open up the passageway when defecating. We can help resolve this issue, thereby, reducing your strain through the area. If you are interested in learning more about our physical therapy for IBS, call us at 616-516-4334 to get your questions answered or contact us here. If you are wondering what pelvic PT can treat, we have written an article about that topic here.
2. Pelvic PT will improve your control and coordination of your anal sphincter and reduce anal fissures, if you have them.
The anal sphincter must be able to tighten to keep gas and stool inside and be able to dilate and open to allow you to defecate. We find the anal sphincter is not functioning well for our patients who have IBS. When they try to defecate they often have to push the stool through a narrow or tightened anal sphincter. When this is going on repetitively, you may experience pain to pass a bowel movement, anal fissures or hemorrhoids. Pelvic PT helps your IBS by resolving underlying anal sphincter discoordination. If you are interested in learning more about our physical therapy for IBS or anal fissures, call us at 616-516-4334 to get your questions answered or contact us here.
3. Pelvic PT will provide visceral manipulation and get your organs to move, slide and glide optimally.
Our doctors of physical therapy have advanced training in visceral manipulation. We offer visceral manipulation to all of our patients because it is a gentle and therapeutic way to improve your organs’ ability to move around in your abdomen. The “viscera” is a fancy term for all of your organs. Your organs should be able to move and glide without difficulty; when you have IBS, endometriosis adhesions, scar tissue, hernias, diastasis recti abdominis or any other problems with the abdominal wall (such as rib cage flare), your bowels and organs cannot operate in the ideal environment that enhances their function. For example, when you bend over, your organs need to be able to slide around to allow you to bend over; if you have scar tissue, IBS or endometriosis adhesions, often we find that our patient’s organs don’t move readily. Individuals who have IBS often have restrictions in visceral mobility. We perform gentle and therapeutic visceral mobilization that our patients tell us relieves pain and frees up tension in the abdomen; they also report more regularity with their bowel movements and calming of their IBS. To learn more about our pelvic PT program, contact us here.
4. Pelvic PT will treat all abdominal scars
When a person has IBS, it is important that any abdominal scars from any surgeries, including c-section, endometriosis excision surgery, laparoscopy, pelvic reconstructive surgery, hernia repair or any other surgery (gall bladder removal, for example) be mobile. If you have had any abdominal or pelvic surgeries (hernia, cesarean, gall bladder removed, appendix removed, D&C, hysterectomy, etc), our licensed physical therapists will assess and treat every scar in your abdomen. Scar tissue that you see on the skin actually penetrates deeply into the abdomen and can cause restrictions in digestion. When we eat we need our food to be able to pass through the intestines in a smooth, unrestricted way. If you have any scar tissue impairing this movement, pelvic PT helps your IBS. We have written an article about chronic c-section scar pain here. To learn more about our pelvic PT to help IBS and abdominal scars, call us at 616-516-4334 or contact us here.
5. Pelvic PT helps IBS pain generators, such as abdominal trigger points
Pelvic PT will assess your entire abdominal wall to determine if you have ongoing cramping or trigger points in any of your abdominal muscles. We find that our patients who have IBS usually experience intermittent intestinal cramping, bloating and pain. Even when digestive pain has passed, we observe that their abdominal wall has substantial muscle guarding and trigger points. These trigger points can be painful and a reason why it might hurt to bend, stand up straight or workout. If you have IBS, we must treat and resolve all abdominal muscle dysfunction to help your IBS improve. Without resolving these, you will remain in pain. We have written an article about how pelvic PT helps pelvic pain, if you are interested in reading that, click here. Often after a PT appointment, our patients visibly notice that their bloating is improved and their IBS pain is relieved. Sometimes during an appointment they are finally able to empty their bowels. To learn more about our PT, reach out to us here or call us at 616-516-4334.
6. Pelvic PT helps IBS by teaching you how to optimally breathe. Diaphragmatic breathing helps your bowels and pelvic floor muscles!
You might not realize it, but diaphragmatic breathing is essential to our digestion and ability to defecate properly. Most of our patients who have IBS do not have effective diaphragmatic breathing ability.
Instead, we notice shallow breathing patterns. Shallow breathing patterns do not “massage” the abdomen and promote the ability of the intestines to digest food. Also, shallow breathing patterns do not coordinate properly with the pelvic floor muscles and, therefore, contribute to pelvic floor muscle stiffness and pelvic floor dysfunction. When the diaphragm is working properly, with each breath you take there will be beneficial intra-abdominal pressure created. This flow of breath and pressure helps encourage digestion. We need diaphragmatic breathing for digestion and defecation to occur optimally. Call us at 616-516-4334 to learn more or contact us here.
Diaphragmatic breathing also helps to balance the autonomic nervous system so that we are not in fight or flight all the time.
Our PT helps people who have IBS to bring balance in your the two parts of your autonomic nervous system: the sympathetic and parasympathetic nervous system, is important for people who have IBS. According to the research on IBS:
The main mechanism underlying irritable bowel syndrome is currently believed to be a dysfunction of the brain-gut axis. Autonomic nervous system dysfunction can contribute to development of irritable bowel syndrome symptoms by disturbing visceral sensations.
Mazur, M., Furgała, A., Jabłoński, K., Mach, T., & Thor, P. (2012). Autonomic nervous system activity in constipation-predominant irritable bowel syndrome patients. Medical science monitor : international medical journal of experimental and clinical research, 18(8), CR493–CR499.
We know that people who have IBS have an overactive nervous system that would benefit from calming that elevated activation of the sympathetic nervous system (fight or flight) and improving the reductions in parasympathetic nervous system activation (rest and digest).
At Purple Mountain PT, our licensed PTs provide various therapeutic methods to help your IBS and bring balance into your autonomic nervous system.
One method, in particular, that we use is called heart rate variability (HRV) training. HRV training has been shown to calm your nervous system by generating increased parasympathetic nervous system activity through increasing the Vagus nerve firing, which will help your to rest and digest, which can ease IBS, constipation and diarrhea. Vagus Nerve activation is crucial to digestion and gut happiness. If you are in fight or flight dominance all the time, then your rest and digest isn’t optimized. Fight or flight can show up as diarrhea (which is why you may have loose stools when you are nervous) or constipation (which is why you may get backed up when you are stressed). Yes, you can swing between constipation and diarrhea (IBS symptoms!) when you are stressed out. If you are interested in learning more about how our pelvic PT helps IBS and calms your nervous system, you can contact us here.
7. Your pelvic PT will help you learn how to coordinate your breathwork with your pelvic floor so you can defecate effectively and minimize straining caused by IBS
Once you have learned how to diaphragmatically breathe, your pelvic PT will help you learn the proper mechanics of passing a bowel movement. We will teach you the optimal posture during a BM. We help you learn how to breathe, drop your pelvic floor and open your anal sphincter to allow stool to easily pass. People who experience IBS and chronic constipation are at risk for pelvic organ prolapse. We have written about our pelvic PT treatment for prolapse here. Suffice to say, that if you have IBS we will help you reduce strain with BMs so that your are not causing excess intra-abdominal pressure and strain through your pelvic organ support system.
Many of our patients have constipation, yet they are not always recognizing that they are constipated. It is possible to be having a bowel movement daily and still be constipated because you are not completely emptying. We wrote a blog that goes into detail about what constipation feels like; you may be interested to read this if you aren’t sure if you are constipated.
8. Pelvic PTs help IBS by teaching you what exercise is best for your IBS and that can help encourage digestion
Our treatment is customized to each person’s body. By learning where you have stiffness, tightness, restrictions, weakness or muscle imbalances, we can help teach you which exercises are best for IBS, so that your body can ease pain and improve digestion.
Our patients who have IBS commonly have reductions in flexibility in their spine, hips and thighs. We assess and treat every person to determine where they have fascia restrictions, joint stiffness or muscle tension.
Clearly, your intestines are housed in your abdomen, so we provide you certain exercises that are designed to facilitate motion and ease in the abdomen. Beyond this, we also include exercises that are customized to the findings we note in your body. It is common that our patients have low back pain and tight hips and we know that we need to resolve these to help IBS.
Our patients often tell us “I just didn’t know which exercises to do. There are so many to choose from, I didn’t know which would help me the most.” We take the guesswork out of it for you. Because we customize your program for your body, you will have a focused and effective regime to help your IBS. If you are interested in learning more about how we can customize an exercise program that helps your IBS, back pain or pelvic pain, contact us here.
9. Pelvic PT will help your constipation
If you have wondered if pelvic floor tension can cause constipation, the answer is yes. Our licensed pelvic PTs will help you understand if this is part of your IBS problem. By providing holistic and therapeutic tender loving care to your abdomen, spine, hips, pelvic floor, scars, viscera, breathing, rib cage, we can help improve your constipation and IBS. We also help you learn what exercises are best for your IBS so you can ease bloating, abdominal pain, diarrhea and constipation. If you are not sure if you have constipation, you may be interested to read our article here about what constipation feels like. If you have questions about our therapy, please reach out to us here at 616-516-4334 or contact us here.
IBS is a symptom. Pelvic PT helps IBS by resolving the many things that are contributing to your problem.
Purple Mountain Physical Therapy is a specialty pelvic health clinic located in Grand Rapids, MI. Our licensed physical therapists have post-doctoral training specific to gut health, digestion, IBS, constipation, rectocele, endometriosis, anal fissures, hemorrhoids, pelvic floor dysfunction, chronic constipation and other pelvic and abdominal issues.
We offer effective and compassionate care for IBS, pelvic floor dysfunction and bladder, bowel or intimacy related problems.
Many of our patients come to us frustrated due to chronic pain, whether it is abdominal, hip pain, back pain or pelvic pain (such as pubic, SI joint or deep inside). We have advanced training and experience helping individuals overcome chronic pain, IBS, prolapse, chronic constipation and more. There is not a formula to overcome chronic pain. Instead, we provide individualized and comprehensive care that is customized to each person’s findings. Our patients tell us finding our treatment has been the most important thing they’ve done to help their pain! We are honored to help you. You can request an appointment or call us at 616-516-4334.
If you are interested in reading more of our blogs, here are some that may be of interest.
Our pediatric pelvic PT also treat kids who have bladder and bowel problems. Here is an article about kids who have chronic constipation.
If you are wondering when you may benefit from pelvic PT, this article gives you some details.
For some information about our physical therapy for endometriosis, read here.
We also treat all bladder problems, including interstitial cystitis, overactive bladder, post-prostatectomy bladder control issues, stress incontinence, pregnancy and postpartum related care and more. To learn more about our bladder PT, read here.
Peace,
