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Changing How You Go

Amber Roche, Physical Therapist, Southwest Health

Do you feel like you always have that urge to urinate? Do you also struggle with having regular bowel movements and feeling constipated? Do you sometimes think your urinary leakage is worse when you struggle with bowel movements? 

Urinary incontinence can be caused by many factors, with one of the main contributors being constipation. It’s considered constipation when someone passes less than three bowel movements per week or has difficulty with bowel movements.

Constipation is often discussed frequently with patients because the enlarged colon, which is the result of constipation, places more pressure on the bladder, making incontinence and urgency, or feeling like you have to go NOW, worse.

There are several ways to help constipation. There’s one quick way to address constipation, adjust how you sit!

Unfortunately, American toilets are not designed to help people have easy bowel movements. Instead, they actually cause the puborectalis muscle to tense. This muscle slings around the rectum, and its job is to keep stool in, but it also needs to be able to relax to let stool out.

So what can be done to relax that muscle, helping with easier bowel movements? Sitting with propped feet on a footstool brings knees slightly above the hips, placing the puborectalis muscle in a lengthened position and allowing for less tension on the rectum.

Sitting with a straight back, elbows resting on knees, continuing to breathe evenly, and avoiding holding your breath will help relax the body. A quick reminder to not sit longer than 10-15 minutes and not strain to push.

This adjustment can be made to address urinary incontinence and constipation. If you are struggling with either of these issues, it doesn’t have to be like this! There are specialists ready to help you!

One Pelvic Health Physical Therapist that you can seek advice from is Southwest Health’s, Dr. Amber Roche. Amber became interested in pelvic health from having pelvic floor dysfunction following having her daughter and being exposed to pelvic health on her first clinical. She saw how beneficial pelvic PT can be and how grateful people were to have someone listen to what they were experiencing and not feel alone in their struggle.


Amber completed a clinical in pelvic health and continuing education courses in pelvic health evaluation and treatment. She is very passionate about pelvic health and would love to help people feel better again! To talk with Amber or any Physical Therapist at Southwest Health about possible pelvic floor therapy or other concerns, call the Rehab Services line at (608) 342-4748.