In this blog I will introduce to you how Massage Therapists are approaching constipation.

Treatment for constipation.

In the context of a massage using general and specific Swedish and Non Swedish techniques treat specific impairments such as

• Increased resting muscle tone
• Stress
• Trigger points

Abdomen : ( direction of techniques in bold are specific to the large intestine are always done in a clockwise direction )

Position in supine with knees bent or elevated onto pillows:

• General and specific massage to the abdomen diaphragm, abdominals and the psoas if indicated.
• Vibrations over the four corners ( iliocecal region, hepatic flexure, splenic flexure, sigmoid region )
• Fascial release: gently applied, “stretch” the haustra, diaphragm
• NMT: vibrations over 4 corners ( iliocecal region, hepatic flexure, splenic flexure, sigmoid region ), Be sure to work clockwise.

Self care

• Hydrotherapy
• Diaphragmatic breathing
• Aerobic exercise
• Increase hip flexion while defecating ( elevated feet on books or stool while sitting on the toilet )
• Referrals

Some common Trigger Points and Referred Pain

Abdominal muscle trigger points can cause “pseudo “visceral pain

Adductor longus : General pain inside the pelvis, possible shooting pain in the pelvis

External Obliques – Refers pain into the abdomen , possible source of chronic diarrhea

Lower Abdominals : Source of abdominal discomfort

Pyramidalis : Feeling of abdominal fullness

Somatovisceral Pain

Myofascial TrP’s can induce visceral disturbances and dysfunction.

For instance Lower Rectus Abdominus TrP’s can induce diarrhea.

Viscerosomatic Pain

A reciprocal influence of visceral structures on somatic regions including muscles can be equally important. Example being the reflex spasm of the abdominal wall in response to the inflammation of acute appendicitis.

Contraindications

• Deep head over the abdomen on clients with cardiovascular concerns
• Recent abdominal surgery
• This treatment can significantly increase motility ( CI’d if client has diarrhea)
• Crohn disease
• Ulceration colitis

Pelvic floor dysfunction as a cause or result of constipation:

Pelvic floor dysfunction is caused by a weakness of the muscles in the pelvis surrounding the anus and rectum. However, because this group of muscles is voluntarily controlled to some extent, biofeedback training is somewhat successful in retraining the muscles to function normally and improving the ability to have a bowel movement.

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