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Everyone dreads being constipated. It’s never fun to be backed-up to the point of difficult, often painful bowel movements. How we often think of constipation, and what constipation can look like may not always be the same!

Constipation is often described as having 2 or fewer bowel movements in a week. These bowel movements will often be difficult to evacuate or require effort. So anything outside of this (more frequent, and easy to get out) would be considered normal… right?

Not necessarily! Our ability to consistently evacuate the bowel may not mean that you aren’t constipated! Some individuals that are constipated evacuate the bowel several times a day. BUT HOW?! In this instance, usually we are getting out several smaller stools throughout the day, and not completely emptying the bowel. These stools may in fact be “easy” to pass, and for some people they will find that they will sit down to go pee, and some stool will come out as well, without any urge to go number 2 in the first place.

So beyond the “usual” signs of constipation, what else should we be watching out for?

  1. Large diameter stools: for adults and children we should not be thinking “whoa! I hope that doesn’t plug the toilet” or “I can’t believe it’s THAT BIG!”
  2. Cracked or dry stools: bowel movements that look cracked or dry, or like little bunches of small balls stuck together
  3. Urge to go with no results: if you have the urge to evacuate, get to the bathroom and just nothing seems to come out… this could be a sign
  4. You wipe and wipe and it never gets “clean”: this could mean that you aren’t fully evacuating the rectum
  5. It feels like there is still some in there: likely that the bowel is not being fully evacuated
  6. Belly aches and bloating: can be signs of constipation
  7. Itchy rear-end (or the wiggles) is common to see in children as well

Being constipated will put a strain on the pelvic floor, as often evacuating the bowel will require effort in the form of pushing of some sort. Sometimes we are spending significant amounts of time sitting on the toilet attempting to get stool out. Development of hemorrhoids, pelvic pain, and pelvic floor dysfunction can be a result of persistent or chronic constipation.

 

Constipation starts young for many people “I have always been like this for as long as I can remember”. With seeing many children with constipation, they have struggled with bowel movements often since starting solids, or when they began potty training. Often other issues start to arise such as bed wetting as well.

 

Helping people to re-educate the pelvic floor to improve coordination, improve evacuation, and go through bowel hygiene tips are all part of our pelvic health assessments. Some things you can start thinking about now:

 

are you getting enough water?

when you go are your feet well supported with knees above hips?

do you take enough time (but not too much!)?

when you get the urge to go, do you make time?

 

These can be some things to consider with your bowel hygiene to help you begin to get things sorted. Determining the abdominopelvic coordination and function, overall pelvic floor muscle strength and ability to relax, as well as a variety of other technical factors will be what we want to dive into with you.

Issues with constipation isn’t just a problem for children, but also men and women alike!

Book in Saskatoon                                                                       Book in Warman (Kendra, Maja)

Haylie has been practicing pelvic health and focused in prenatal and post-partum care since graduating from the U of S MPT program in 2011. Officially adding to her practice pediatric pelvic floor therapy in 2017. She has been advocating for treatment for women, ensuring appropriate and effective care throughout pregnancy and post-partum, and helping all expecting and post-partum moms ultimately brought her to open her family-friendly clinic. At Warman Physio clients are encouraged to bring their infants and children to treatment. Warman Physio has been nominated as a finalist for the 2018, 2017, & 2016 WMBEXA, is a WMBEXA award recipient of 2017 New Business Award, and a finalist in the ABEX 2018, 2017 & 2016, and Haylie was recognized as YWCA Women of Distinction for Health & Wellness in 2017, and has been nominated for the 2019 SABEX and WMBEXA Awards.

Pelvic floor dysfunction is not just a problem for women… after all, everyone has a pelvic floor!

A study by MacLennan et al, reported that 4.4% of men have self reported problems with urinary incontinence (inability to control urine) (1). If you take the population of Saskatoon, which in July of 2018 was reported at 278,500 and divide that in half you have approximately 139, 250 males (2). 4.4% of the Saskatoon population will give us 6, 127 men that have problems with leaking or controlling their bladder. Keep in mind that urinary incontinence is only one of many potential issues with the pelvic floor.

The crux of the issue is that pelvic floor health can be a big problem for both women and men.

  There has always been a stigma around men seeking help for any issue, let alone their leaking bladder, erectile dysfunction, and pelvic pain. Men need to understand that they do not need to live with these stressful and often embarrassing problems.

Pelvic Health Therapists are specifically trained to help men and women with a vast majority of their pelvic floor dysfunctions. The pelvic floor is a bowl of muscle that surrounds the external openings, in men that is the urethra (the tube you pee out of) and the rectum.

The muscles are the same as any others in the human body and therefore they are treated similarly.  In a good number of cases urinary incontinence is related to the lack of strength, coordination, and increased tension/tightness of the pelvic floor muscles that close the urethra. Then when the bladder is full, or someone has the urge to pee they cannot stop themselves. By simply teaching someone to relax, strengthen and coordinate their pelvic muscles, urinary incontinence problems can often be resolved.

If the pelvic muscles are too tense it may cause pain in the perineum, abdomen, low back or inner thigh. Relaxation exercises and manual therapy skills can be applied to achieve relief. Strengthening pelvic floor muscles and addressing other contributing factors can often lead to the resolution of erectile dysfunction and healthier sex lives (4). Men need to understand that the tools and resources are out there to help them with their pelvic floor dysfunction, part of which may be pelvic health physiotherapy assessment and treatments.

In short, I am asking that men take it upon themselves to seek out help for their pelvic floor dysfunction and in return understand that they will be treated with privacy, respect, and compassion. Waiting and suffering in silence doesn’t need to be the case; we are here to help you, help yourself. I have had the privilege of treating many men and women struggling with dysfunction, and the experience has been rewarding for myself and the people who have trusted me to help them.

Book a pelvic health assessment with Scott

Book an orthopedic assessment with Scott

Scott Golding is a Pelvic Health Physiotherapist that has a special interest in male pelvic health and rehabilitation. He is passionate about advocating and supporting men in their pelvic health journey. He has completed the U of S Level 1 and Pelvic Health Solutions courses for pelvic health Level 2, and 3 in addition to orthopedic and integration of pain science courses. He has been working with both women and men for pelvic health and orthopedic issues since graduating in 2016.

 

He is driven to provide excellent care in a safe and comfortable environment for his patients. Scott believes that pelvic floor health needs to be a fundamental aspect of a healthy life, as many individuals struggle in silence. 

 

“My future goals include becoming a strong support and resource for men as it relates to pelvic, and general health. I want to help decrease and remove the stigma associated with male pelvic health and provide exceptional resources for men who need or are seeking help.”
  1. https://www.ncbi.nlm.nih.gov/pubmed/11192101
  2. http://worldpopulationreview.com/world-cities/saskatoon-population/
  3. https://www.google.ca/search?q=happiness&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjdo52egMPiAhVPHDQIHTU0BBkQ_AUIDigB&biw=1218&bih=573#imgrc=A0NGFCYX4gqASM:
  4. https://bjgp.org/content/bjgp/54/508/819.full.pdf

At Warman Physio we have been working hard behind the scenes to get a secondary location going for all the clients that are unable to get out to Warman. We are pleased to announce that as of June 3, 2019 we will be located in Saskatoon!

To top it off, we are not only opening a second location, but we also have two NEW staff members to introduce to you!

Maja Stroh PT

First, our physiotherapist Maja Stroh!

  • Prolapse
  • Incontinence
  • Back pain
  • Sports Rehabilitation
  • General orthopedics

Maja is passionate about pelvic health and is always on the search to ensure that all angles are considered for every client. Her attention to detail and comprehensive exams ensure that you are obtaining the whole picture when you come in for any injury or issue.

 

We are also pleased to announce our RMT Signe Bone to the team in Saskatoon!

Signe has been working as a massage therapist for a number of years, and has always had a desire and drive to understand the human body from a very young age. She has been working in Saskatoon as an RMT as well as continuing her education in Prenatal Massage through Axiom Collage, and has begun her Visceral Manipulation through Barral Institute and Craniosacral Therapy through Upledger Institute. The areas of practice that Signe is most drawn to includes:

  • Prenatal & postpartum massage
  • General Injuries (whiplash, TOS, piriformis syndrome, etc)
  • Abdominal Health thorugh Visceral Manipulation
  • Critical Alignment Therapy
  • Cranial Sacral Therapy: CS1

Her love for learning and solving problems helps her provide the best care and treatment she can through working with her clients to better understand them as a person, not just as a body.

The schedule for physiotherapy assessment and treatment can be found HERE and to get on the list for booking for massage can be found HERE.

 

Spread the word and make sure you share this fantastic news with your friends! As per our vision – the Saskatoon location will be infant and child friendly, providing compassionate, comprehensive, and personable care to each and every client.

 

Location of the Saskatoon clinic is: 2543 Dudley St, Saskatoon

As with many issues, often we aren’t sure if what we are experiencing is normal and expected, if it will just go away, or if we need to have it looked at. For many women who are pregnant and postpartum, this is made even more difficult as we are often told that symptoms we are experiencing are normal because “you’ve had kids” and that “this is just how it is now” which can delay effective treatment of these issues! Here you can see a case study on Prolapse, which outlines some of the issues that someone may experience.

The presenting symptoms:

A 31 year old woman attends the clinic mentioning a history of intermittent pelvic floor heaviness “feeling like things are falling down” and discomfort. She has noticed that the heaviness has been worse since starting back with weight lifting at her gym 1 month ago. She has two children ages 2 years and 4 months old.  She had continued to go to the gym throughout her pregnancy (symptom free), but notes she had reduced her weights somewhat during her third trimester.

She hadn’t returned to the gym until now, as her life has been quite busy since the delivery of her second child! No pelvic floor pain, urinary or fecal incontinence is reported.  She had felt like now was a good time in her life to return to the gym and is quite devastated at this setback. Going to the gym and working out had been an

important part of her life-mentally, socially and physically and she is worried she won’t be able to do any activity at all anymore.

She went to see her family physician as was concerned about her symptoms and was referred to pelvic floor physiotherapy for prolapse. She reports no symptoms first thing in the morning, but these progressively worsen as the day goes on.  Some days are better than others with her symptoms.  Lifting weights at her gym and lifting her children aggravate her symptoms.  She notes she did just get over a bad cold and had been coughing/sneezing quite a lot during the past month. She also identifies that she has always had issues with constipation.  Both of her deliveries were vaginal with no instrumentation (forceps or vacuum) or complications. She is currently breastfeeding.

Assessment and Treatment

The client was assessed with an internal pelvic examination by a pelvic floor physical therapist. A Grade 1 cystocele was found. (A cystocele means the prolapse was from the bladder descending into the wall of the vagina and a Grade 1 prolapse means the organ descent was halfway to the vaginal opening). The pelvic floor muscles were weak with a Gr. 2 strength (a weak squeeze and no lift of the pelvic floor muscles) and tight.

The client and the therapist worked together to increase her pelvic floor strength and coordination, as well as to optimize her intraabdominal pressure management systems. Toileting positions and discussion around constipation management were discussed and the client was able to implement these at home. Optimizing postures during breastfeeding and throughout the day were discussed to reduce strain on the pelvic floor and discussed on how to successfully get them implemented at home.  Education on anatomy of the pelvic floor and the pelvic organs/their supports as well as POP was provided which will help the client to take control and understand the why behind the recommendations.

Activity modifications were implemented but keeping her active was part of the plan and exercises were progressed as appropriate.  The client returned to her gynecologist for a pessary fitting to use intermittently during heavier weight lifting at the gym. She was seen in follow up 2 weeks after the initial assessment and then 1x/month for 6 months. She was able to return to her weight lifting and was symptom free with all tasks and activities at the conclusion of therapy, although her Grade 1 prolapse remained.

Have you been struggling with prolapse symptoms? Not sure if your symptoms could be part of prolapse, please feel free to contact us and we will help chat you through what you are experiencing as best we can.

Don’t delay start your road to recovery today!

Maja Stroh is a physiotherapist that has a particular interest in pelvic health and perinatal care. She graduated from the U of S MPT program in 2009 and has been working with pelvic health populations since 2013. Maja’s interest in helping her clients and spending quality time with her family has brought her to Warman Physio where she will be providing services in the Saskatoon and Warman locations.

We have been practically bursting waiting to be able to announce our newest physiotherapist to you! Maja Stroh is joining us and is starting with clients the week of March 11, 2019, and she already has her first clients booked in! As many of our new and current clients are aware, we have been very busy at the clinic since Shannon went on maternity leave and we have found Maja, the perfect therapist to join our Warman Physio family to help you help yourself!

Maja will be working out of both our Warman and Saskatoon locations, and has a specific interest in perinatal health.

 

Biography

Maja graduated from the University of Saskatchewan with a Bachelor of Science in Biochemistry in 2007. She went on to graduate at the same university with a Masters of Physical Therapy in 2009. Maja has been working as a physical therapist since 2009 in private clinic settings, both in Saskatoon and rural areas. Maja has experience in treating orthopedic based populations, as well as pelvic health clients. Her particular interest is in treating the prenatal and post-partum pelvic floor populations.

She considers continuing education a high priority as well as strives to provide the best evidenced based practices. She has completed a variety of post graduate continuing education courses. These include courses relating to pain management, her Level III for both the Upper and Lower Quadrant Orthopedic Division courses, as well as a variety of pelvic health continuing education courses/lectures. She plans to continue to advance her knowledge with treating pelvic floor populations by continuing with further pelvic health courses.

Maja loves spending time with her two young boys. Some of her other interests include, cooking, gardening, painting and camping/hiking.

Areas of Practice Interest:

*Pre-natal & Post-partum assessment and treatment

*General Orthopedics

*Urinary Incontinence

*Pelvic Pain

*TMJ Dysfunction

*Spinal Assessment & Treatment