To Squat, Perchance to Poo
Gabrielle Marcus
I think this is one of the most important subjects I could write about. For if my algorithms and complex calculations are correct, it affects, like, half of you.
People who have problems "going #2" often blame themselves: they're too anxious, they don't eat enough fiber, they don't move enough, they don't drink enough water.
Of course all these things affect colon health---and, well, health. But all across the world people aren't having to go through this checklist each day. That's because the problem is often a basic muscle imbalance, exacerbated by sitting in chairs and the good-luck-with-that shape of Western toilets.
Now, all across the movement world (almost), the leading movers and manual therapists (the ones I like) want you to deep squat if your body allows it (keep reading). Gray Cook, Ido Portal, Katy Bowman etc etc all say this is an ergonomic position that helps maintain full function of the hips, knees, ankles and core.
This guy has it down.
But even if deep squatting didn't do any of that, it would help you go #2. And go efficiently. There are many known reasons we want to be able to do that. Further, squatting may equally help with incontinence and a number of other conditions. I can't verify all the claims in the following list, and I really don't mean to scare you---we all know Westerners have been living to ripe old ages for hundreds of years with Western toilets. But because of the pelvic floor's role in not only waste elimination but also sex, childbirth, breathing and a healthy core. it's not hard to imagine that it affects much more than we usually give it credit for: http://naturesplatform.com/health_benefits.html
If you can deep squat or safely build up to it, sitting in a deep squat several times a day is one of the most effective ways to help the pelvic floor lengthen. It's also an ergonomic position for helping the waste to move out. Here's Katy Bowman's formula for developing the deep squat (read both of these):
http://www.katysays.com/you-dont-know-squat/
http://www.katysays.com/you-still-dont-know-squat/
Sometimes a physical or manual therapist with a movement background can improve your deep squat more quickly, so you may want to get help with it.
Some people may have a condition that prevents deep squatting. Do not try this if you've had a knee or hip replacement (manual therapists, if you've seen someone who was able to squat safely with a replacement, please let me know). It's also possible that your bone shape has developed in a way that prevents the deep squat. Don't worry. Read Katy's blogs above for suggestions, try some of the unloaded versions below, and get care for any pelvic floor muscle imbalance.
Also, though I don't know of them, there might be some conditions for which sitting is a more effective bathroom position than squatting. And finally, don't substitute this for medical advice, silly.
Behold. The Squatty Potty. (it's the stool at the base.) Very inexpensive. Comes in different designs. Not exactly a deep squat, but can be very helpful.
The yoga positions "Child's Pose", Supported Child's Pose, "Happy Baby", and "Knees to the Chest" are examples of simple "unloaded" (non-weight-bearing) positions that can help relax the pelvic floor. The Squatty Potty toilet stools mimic an unloaded squat: http://www.squattypotty.com/
When we talk about "the pelvic floor," please remember that we're talking about a bunch of muscles at once, muscles that affect both going #1 and #2. Problems going #1 may also be pelvic floor disorders and benefit from the same suggestions. Take a look at these images of the pelvic floor (male and female) so you can see how many muscles are involved from front to back. (Click each image to enlarge.)
Female Pelvic Floor
Male Pelvic Floor
If squatting alone doesn't help or isn't an option for you, positional or manual pelvic floor releases may help. (Like squatting, this can also help prevent or improve many other conditions, including incontinence, cystitis, and IBS.) Most people will only need external releases (these are uninvasive and can often be done by the client); some may also benefit from internal work with a physical therapist specifically trained in that work. I list some external releases below, but please remember that muscles anywhere on the body become tight for a reason. Usually, the muscle tension is the body's way of maintaining stability. Releasing muscles without knowing why they're holding on can sometimes create pain or dysfunction. (NKT therapists are particularly good at identifying when it's safe to release muscles, but there are many good therapies out there. Most of all, maintaining good form during a well-designed workout is one of the best things you can do to help muscles lengthen and strengthen at the same time.) If you would like to go ahead and try the releases on your own, just be cautious. If a muscle isn't releasing easily, if the muscle tension keeps coming back, or if something else starts hurting, please get assessed. Here are just some examples of external pelvic floor releases:
1) Here is a simple release that aims to target the whole pelvic floor:
2) Sometimes you need to work specific areas. One way of doing that is simply placing a tennis ball under the muscles of the pelvic floor, obviously not directly on openings, and melting in to release them. There are several other methods as well. See images above to locate the muscles of the pelvic floor.
If you can deep squat and want to try it safely in the bathroom, you could get one of these: http://www.naturesplatform.com/index.html. In addition, "Anglo Indian toilet seats" can be affixed to your toilet to allow people the option of deep squatting. (I don't yet know the best place to get shipping inside the U.S. but I'm sure it's available.)
"Nature's Platform"
"Anglo Indian" toilet seat. A seat for all seasons.
If you would like to get assessed for pelvic floor dysfunction and your doctor has cleared you for more serious issues, pelvic floor physical therapy for this may be covered by your insurance. It may never occur to your doctor to refer to physical therapy for constipation, so talk to them about it. Pelvic floor physical therapists are trained to be extremely keen and sensitive to their clients and the hesitations people may have about getting care. Nevertheless, please don't hesitate to investigate your options carefully in advance, confirm proof of licensure, and ask as many questions as you want about the process,. You can search physical therapists in your area by specialty here: http://www.womenshealthapta.org/pt-locator/. (While some pelvic floor physical therapists specialize in women's issues, many work with both men and women.) Other modalities to look for include NKT Level 2, Restorative Breathing, or a Restorative Exercise therapist (these three are for external work only; anyone doing internal work should be properly licensed to do so). There are many other modalities out there. Before you schedule, ask your therapist if pelvic floor modalities (or learning how to deep squat, if that's your goal) are part of their work, and where they received their training. Do not hesitate to investigate them thoroughly. Your safety and comfort is essential when receiving this or any kind of bodywork.