Pelvic Health Blog

Splinting to help empty the bladder or bowel

5/25/2022

by Katelyn Sheehan, PT

Splinting

Have you ever experienced any of these symptoms?

Constipation
Fecal incontinence
Heaviness in the Vagina
Feeling like you haven’t emptied your bladder all the way
Having drops of urine come out as you stand up from the toilet

If you answered yes, then splinting may be a useful tool for you. Splinting is a technique often used by patients with pelvic organ prolapse to help them fully empty their bowels or bladder. Splinting is primarily suggested for helping with constipation, but certain splinting techniques can also help with urinary symptoms. Typically, splinting is performed by inserting a clean finger into the vagina to help hold, or splint, the pelvic organs and stabilize them in a more optimal position while using the bathroom. This can help hold the bowels or bladder in a more upright position to allow for full emptying when you go to the bathroom. You may also find that splinting externally can also help; this involves applying some gentle upward pressure to the perineum (see pictures and video below).

Internal splinting for the bladder/urethra

Begin by sitting on the toilet. Then use a clean finger with or without some toilet paper around it. Insert the tip of your finger into the vagina and gently apply some pressure forward, away from your spine.

External view (from below)

Internal view (from above)

INTERNAL splinting for the bowels

Begin by sitting on the toilet. Then use a clean finger with or without some toilet paper around it. Insert the tip of your finger into the vagina and gently apply some pressure backward, toward your spine.

External view (from below)

Internal view (from above)

EXTERNAL splinting for bowels

Begin by sitting on the toilet. Then use a clean finger with or without some toilet paper around it. Next gently apply some pressure with your finger to the perineum upward, toward your head.

How to help your abdominal muscles immediately after delivery

5/12/2022

by Bryn Zolty, PT

As a pelvic physical therapist there are many things I would have liked to have done differently immediately after giving birth to my daughter. If I had to pick one exercise to have started immediately after delivery, it would be this one.

During pregnancy, your abdominal wall lengthens. The muscles have been working because even though they were stretched, the baby kept them on tension. Remember feeling like your abdominal wall was so tight? How could it stretch any more?! Picture a long string from the bottom of your sternum to your pelvis over your pregnant belly. Now the baby is delivered and suddenly the tension on the long rope is gone. The abdominal muscles are now hanging down, feeling loose, almost like they aren’t even yours. So many women are told to start working on their abdominal muscles lying flat. But, when you lie flat, picture the string again as your muscles. It is loose, and we cannot contract our muscles in their full length. We need to flip over, so the muscles can be all the way long. We also need to get the ribs moving. Rib motion will help the abdominal muscles, the diaphragm, and other core muscles working sooner!

You can try it in a few positions - pick the one most comfortable for you. Remember that you should be facing down, since we want the belly to be able to fall down:

Stand at the kitchen counter with your elbows resting on the counter. Position your back in a comfortable position.
Sit in a chair with wide legs and rest your elbows in front on a high table.
Flip onto hands and knees, a mini version of cat/cow.

Start with your belly relaxed, hanging down, no tension in the muscles. Inhale and feel your ribs expand wide, but gently. Then start your exhale with a gentle “shhhh” sound, like you are calming your baby to sleep. The “shhhhh” sound should start to create some tightening in your abdominal muscles. The loudness of the “shhh” may affect the amount of tightening you feel.

Once you feel the abdominal muscles tightening, gently help them draw in. Can you feel the tension start lower, above the pubic bone, and then the middle and upper abdomen tightens? As you start to reach the end of your exhale, can you feel the ribs tightening in as well?

Now inhale. Feel the ribs move wide and back, opening like an umbrella. Now, we use the muscles in reverse by slowly lowering the abdominal muscles back down. Slow down. We need to use our muscles to control this without dropping them. They are still strengthening even though they are getting longer.

Repeat these steps. This is a gentle exercise, so you can do it throughout the day. Be mindful of how you feel to judge how much you should do this. I would recommend at least 3 times a day for 10 reps minimum. This can be done if you had a vaginal delivery or a c-section. It is just breathing and gentle tension as you are just following your breath. Pick the position that best suits how you feel.

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