Oops! What to do for embarrassing issues...

The need for pelvic health for men and for women is getting more attention, including a recent blog post from the Women’s Health Foundation that talks about Accidental Bowel Leakage (ABL).  It is great to have more discussion about what is “normal” and what can be done to get or stay healthy.  Physical Therapy plays a huge role in health care as the best option for muscle and body awareness training.  

The post by the Women’s Health Foundation outlines the basics of bowel health and emphasizes that 90% of people can be helped with lifestyle changes in diet, bowel habits and retraining the pelvic floor.   But, what if some of these changes actually cause worsened problems or don’t adequately address the issue?  There is more that can be offered through a visit to a pelvic health physical therapist, think of us as all of the above PLUS unique and individual education.  A pelvic health physical therapist provides all of the above information and is trained for including a careful internal assessment of the pelvic floor to make sure that you have good control and awareness of the pelvic musculature.   We also check to make sure that you can relax the muscles.   Biofeedback may be helpful for learning a general awareness, but it does not replace a qualified internal assessment.  Your difficulty may be more complex than simple activation of the muscles and could require sensory retraining and/or desensitization as well as coordination.

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A specially trained pelvic health physical therapist also has the ability to work with retraining of functional bowel habits with specialized techniques such as the use of a rectal balloon catheter for sensory-motor reeducation and provide individually designed home exercises, toileting postures and functional activities geared specifically to regain function.


Finally, pelvic health physical therapy can also address other factors related to bowel disorders including stiffness of the spine and thorax which increase intra-abdominal pressures, mobility and pain issues of the abdomen and pelvis as well as coordinated care of urinary dysfunction (which is also closely correlated).  Education on fiber and water may not be as simple as just increasing consumption as this can cause pain and bloating in many instances.  Increasing exercise may also require intervention to help the knees, hips or back move much more efficiently to achieve these goals.  The great news is that a physical therapist can provide this care and integrate the education into treatment and work closely with the medical team for truly integrated care.


If you are a physical therapist interested in advanced bowel care, we have the course for you!

Physical Therapy Comprehensive Management of Bowel Dysfunction

September 12 – 14, 2014

Instuctors:      Susan C. Clinton PT, DScPT, COMT, MHS, OCS, WCS

Susan George PT, DPT, MS, OCS, WCS