“As a pelvic floor physical therapist, I encourage my patients to really, truly look at their poop, and then tell me all the details,” says Megan Rorabeck, DPT, board-certified women’s health clinical specialist and author of Between the Hips: A Practical Guide for Women.
Rorabeck says that different stool shapes can indicate everything from severe constipation to a lack of fiber, and provide great insight into your pelvic floor.
How to tell if your poop is normal or not
To determine if your poop is saying something about your pelvic floor, you first have to be able to identify it. The best way to do that is with The Bristol Stool Chart. “It gives us a start in the ability to identify what ‘type’ of poop we have, ranging from Type 1 (constipation) to Type 7 (diarrhea),” Rorabeck explains.
While the chart helps depict different stool shapes, Rorabeck notes that pencil-thin poop (a popular topic on Instagram) is left out. “Pencil-thin stool can be indicative of tension within your pelvic floor muscles,” she says. “If your pelvic floor muscles cannot fully relax, then there is a smaller opening for stool to pass through, which can lead to a pencil-like appearance.” According to Rorabeck, pencil-thin poop can be of hard consistency (Type 2) to soft, normal consistency (Type 4), though, it’s usually Type 4, she says.
What to do if you notice pencil-thin poop
If you go to the bathroom and notice thin poop—like, a lot thinner than usual—a weak and/or tight pelvic floor could very well be to blame.
“Here’s the thing you should know about tightness (the same goes for almost every area of the body): very often, tightness and weakness go hand-in-hand,” says Emma Bromley, a Pilates teacher, postpartum specialist, pelvic floor expert, and the founder of The Bromley Method. With that in mind, here are some ways you can release and strengthen your pelvic floor.
Release: Use a therapy ball
A therapy ball (like the Acupoint Physical Massage Therapy Ball, $15) is about the size of a tennis ball, but with very light squishiness, Bromley explains. To release a tight pelvic floor, she says to locate your tailbone and the boniest part of your sitting bone on one side, and place your therapy ball between those two points, sitting on it with your full weight.
“Roll the ball in circles and notice if there are any particularly tight spots,” she instructs, noting to make smaller circles on the tightest areas. “Breathe deeply and fully relax both your pelvic floor and your abs as you do this (imagine you are about to urinate, but not quite).”
Check in with your shoulders and your glutes—let go of any muscle tension you might be holding onto. Spend five minutes a day doing this on each side, for five to seven days in a row, Bromley says. “If you notice BM improvement, that gives us a clue that it’s being caused by pelvic floor tightness. If there is no change, see a doctor to rule out something more serious.”
Stretch: Breathe deeply
The way you breathe throughout the day can impact your pelvic floor: Rorabeck says you can stretch it with deep belly breathing.
“Instead of adopting a short, upper-chest breathing pattern, you will want to try a deep, belly-breathing pattern like what is commonly practiced in yoga,” she says. “The easiest way to learn is to begin by lying on your back with one hand on your belly and one on your chest. The goal is to have your belly hand move more than your chest hand, indicating that you are breathing deep into your belly.”
This works because of how closely related the belly and pelvic floor muscles are. “When you inhale, your diaphragm pulls down, your belly rises up so that your abdominal muscles and your pelvic floor muscles lengthen,” Rorabeck explains. “You may not feel anything in your pelvic floor at first, but that’s okay.” Continue anyways, eventually bringing the breath with you on the toilet. According to Rorabeck, it can help boost a healthier bowel movement.
Strengthen: Use a foam roller
Once your pelvic floor is sufficiently relaxed and stretched, Bromley says to introduce pelvic floor strengthening. You won’t need weights, just a foam roller and patience.
“Sit on the foam roller with the roller in between your legs, your knees bent, and your shins flat on the ground (use a pad if it’s a very firm roller),” Bromley instructs, noting to lengthen your spine, lower your shoulders, and look straight ahead. “Notice the sensation of your labia against the roller, and be mindful to keep that connection throughout so that you aren’t tempted to do a Kegel.” (News flash: Bromley says that Kegels can actually over-tighten the pelvic floor which can lead to intense pain and dysfunction.)
Instead of performing a Kegel, Bromley says to focus six inches below your belly button. “Imagine trying to lift all of your internal organs without changing the position of your spine, without squeezing your glutes, and without tensing like with a Kegel. That’s your pelvic floor lifting,” she explains. “Keep that lift and imagine you’re wearing an old Victorian corset, and someone is wrapping and tying it tightly around you. That’s your transverse abdominals.”
Once you’ve located your pelvic floor and transverse abdominals, it’s time to breathe while keeping those two connections. For this exercise, you want to avoid sending the breath into the belly. “Think instead about sending that deep inhale into the back of your ribcage,” Bromley says. “Keep breathing deeply in and out while keeping both that sensation of lift and wrap, without squeezing your glutes or allowing your shoulders to tense or round forward, and without tensing your labia or losing the connection with the roller.”
Maintain this posture in 30-second increments for three to five minutes per session, and Bromley says you’ll be well on your way to a stronger pelvic floor.
Adopt good toilet posture
Last but not least, enable a healthy BM by adopting proper pooping posture. While modern toilets may make you believe otherwise, the best, most effective way to poop is actually with your knees elevated above your hips (a stack of books or a Squatty Potty, $35, can put you in the proper stance). Sitting “normally” on a toilet can constrict the rectum, leading to thin poop.
“This relaxed, squat-like position puts slack on the muscle that wraps around the rectum, the puborectalis muscle,” Rorabeck explains. “Your poop has more room to move through the rectum, making it easier to pass.”
If you work through all of these strategies and find that the shape of your pencil-thin poop is unchanged, Rorabeck suggests seeking out pelvic floor physical therapy. To find a pelvic floor therapist near you, visit betweenthehips.com.
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