

By Amy Stein, DPT
This week, I assisted Lila Abbate at Touro College in New York in a Bowel Course through Herman and Wallace. The BBPT pelvic floor experts--Stephanie Stamas, Corey SIlbert and Melissa Stendhal--also attended, along with over 40 others from the U.S. and Canada.
It's exciting how the world of pelvic floor PT is advancing. When I started only Holly Herman and Kathe Wallace were teaching separate classes and only one time per year. Now there are over 100 classes taught between APTA Women's Health and Herman and Wallace.
Lila discusses differentiating from bowel motility issues and pelvic floor muscle dysfunction. The biggest take-home messages are:
- none of the tests for PFMD replace palpation and findings with your expert finger
- the bowel is a slow learner and does not like change
- there's a big link between the bowel and the nervous system.
-medications can effect bowel habits and the patient may have to adjust their lifestyle
- positioning on the toilet can help with the anorectal angle
- abdominal bracing can help
-the diaphragm assists with urination and defecation
-pelvic floor muscles are passive with defecation and abdominal muscles are active
- you need to set responsible expectations




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