• Amy Wolkin PT, DPT, MBA

Twists and Turns

Life can have unexpected twists and turns. Your digestive system also does as well!


If chronic constipation is not addressed, the pelvic floor muscles, fascia, and pudendal nerve can be negatively affected. Furthermore, it can cause pressure on the bladder and urethra which can result in urinary retention or increased frequency. Pelvic floor physical therapy, however, can actually help with constipation symptoms. There are less side effects on the whole body too compared to stool softeners or enemas.


If you are ever feeling constipated, colon massage can help with symptoms. The “I Love You” “ILU” massage can help with constipation. It includes massaging the length of the ascending, transversverse, and descending colon. This increases the motility of the food being processed. By massaging the abdomen in this path, a patient can more spontaneously be able to release bowels. Furthermore, this can be a more palliative measure if someone is recovering from a complex surgery or battling more complex medical conditions.



“Permission to use copyright image from Pelvic Guru, LLC pelvicguru.com”


How to perform abdominal / colon massage:


  • Lie on back with knees bent in feet planted. .

  • Start on the right side near the pelvic bones. Apply pressure in a circulation motion up to the rib cage. “I”

  • Bring hands across from right to left side in a circular motion. “L”

  • Move the hands from the left rib cage down to the hip bone and then bring towards your belly button. “U”


“Permission to use copyright image from Pelvic Guru, LLC pelvicguru.com”

In addition to massage, patients can focus on their water and fiber intake. Aerobic exercise also helps bring in blood flow the area and facilitate movement and peristalsis. Changing toileting positions to decrease strain. For example, by propping your feet on a stool or using a squatty potty, the anorectal angle is affected, and it can be easier to have a bowel movement.


A trained physical therapist can educate a patient on how to use this colon massage technique in order to promote improved bowel health and decrease pain. Furthermore, in pelvic floor physical therapy, patients can also be trained to relax their pelvic floor for improved defecation, to coordinate abdominal contractions to assist with stool propulsion, and on incorporating breathing strategies. .A patient can then incorporate these techniques into his or her home exercise program in order to manage symptoms.




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