Toilet Ergonomics: Posture Matters In Places Other Than The Office

Squatty Potty

 

Written by Dr. Emily Melzer, DPT

For centuries, humans have squatted to defecate, but due to 19th century advancements of the sewer system and sanitation, the porcelain throne we sit on today was born. However, in that moment of history, society was unaware of the dysfunction they were setting us all up for.

Real Potty Talk

The dysfunctions I am alluding to are hemorrhoids, constipation and diverticulitis. Not to mention increasing our risk of syncope (fainting), deep vein thrombosis and stroke. You may wonder why simply sitting to defecate would put you at risk for these complications. As you hear quite regularly in regards to the office, there is a certain posture to help you work most efficiently, that is commonly referred to as ergonomics. Ergonomics are important in places other than the office, for instance in your bathroom. Research has sought out and proved the most efficient, effective and proper way to defecate.

And that position is, drum roll…SQUATTING.

The reason squatting is effective when defecating is due to the function of the puborectalis muscle. The puborectalis is responsible for keeping your rectum closed off, increasing the angle between the colon and rectum. Research demonstrates that the angle decreases when obtaining a full squat to defecate, easing the release of contents. This body mechanism reduces the need to strain, in turn eliminating the risk of hemorrhoids, syncope and stroke. It also better allows the release of all content, decreasing the risk of constipation.

Improve Your Toilet Ergonomics

Eliminating the toilet all together seems like a drastic, and let’s face it, unrealistic goal for the United States, but simply adding a small stool underneath our toilet, is a feasible change you can make today. One research study looked at defection while seated, seated with knees raised 60 degrees and a full active squat to 60 degrees. While the full active squat demonstrated the least angle and the quickest time for release of content, the passive squat achieved by placing a stool under the feet was a close second.

I personally have a Squatty Potty in my home, and I can provide consumer feedback of the improvement in efficiency, effectiveness and overall improved bowel health with the addition of this product into my life. I will never be without a squatty potty under the porcelain throne in my home. I may even consider purchasing the travel version (that’s right, there is an inflatable squatty potty!).

Give us a call today and we would love to help you with your mobility and strength to help in this everyday daily activity!

1. Dov S. Comparison of Straining During Defecation in Three Positions – Results and Implications for Human Health. Digestive Diseases and Sciences. 2003; 48: 1201-1205.
2. Sakakibara R, Tsunoyama K, Hosoi H, et al. Influence of Body Position on Defecation in Humans. LUTS, 2010; 2: 16-21.

WELCOME!

Welcome

We are so thankful for the support that we have received in the past 6 months! Health care providers, community members and their family and friends have come to receive our quality care.  The testimonials, verbal support and feedback have been amazing and we are so thankful for the kind words.  Word of mouth has really spread what we are doing in our clinic and for our community.  With the increased awareness of our services our clinic is definitely growing!  In the past 2 months we have added Abbie and Nikki joining our office as support staff and we couldn’t continue to provide quality service without them supporting our clinical growth.   Their hard work and contributions drive our quality of care and we are so lucky to have them on our team.  In addition to adding support staff we are very excited to bring on another health care provider Sabrina Seraj-Villaneuva starting in June.  Sabrina and Jason have known each other for the past 12 years starting back to grad school days back at USC.  They are looking forward to working together and continuing to provide quality care for all of the Therapydia patients.  Sabrina has lived in the Portland area for the past 2 years splitting her time working at OHSU and Therapeutic Associates in Clackamas.  For more information about our staff please check out our team page where you can click on everyone’s bios.  Once again thank you for all the support and we look forward to continuing the quality care we provide at Therapydia Portland.

 

Supporting local Community

Attention local community members! Keep an eye out for our new ad in the local Laurelhurst newsletters… we are excited to provide quality care to the community and we have been receiving great feedback about our services.  Check out our testimonials on our site or see what people are saying on our Google plus page!Portland Physical Therapy: Laurelhurst, Kerns

Telemedicine: Case Study

With the advancement of technology coupled with the limitations that physical therapy health care providers are encountering via insurance limitations telemedicine allows patients immediate access, near and far, to get specific health care advice, prescriptions of movement and consultations which could prevent unnecessary diagnostic tests and measures.

As our health care world continues to change I am excited to be part of the telemedicine movement.

In the past month we had a patient encounter that we felt we important to share for a couple reasons:

  • This case specifically highlights the difficulties that normal people go through when dealing with our current medical model and all the practitioners one may encounter.
  • It also highlights how when patient cases are dealt with properly someone can get more effective treatment regardless of whether someone is local or thousands of miles away.
  • With proper resources and communication people can receive physical therapy via telemedicine and it can be very effective

To protect the patient’s confidentiality names have been omitted, substituted with initials.  DW has agreed for me to post this case and she hopes that it will provide some insight to our Telemedicine process and how it has helped her.

A few weeks ago I received a Facebook message from an old college friend asking if I knew anything about a “rare” diagnosis named “idiopathic lumbosacral radiculoplexus neuropathy”.  Turns out his mother, who lives on the other side of the country, had been diagnosed with this over a year ago and was frustrated with her progressive worsening.  I told him that I had seen thousands of patients with idiopathic back pain that also had some sort of radicular symptoms down the extremities.  In layman terms idiopathic means unknown cause, lumbosacral defines the lower back and pelvic tailbone region, radiculoplexus neuropathy basically is an irritation or inflammation of the nerve bundles that exit from the spine.  It is important to note my friend’s mother, until acquiring this diagnosis was a normal active nurse and after dealing with this diagnosis she had now lost the ability to walk independently or perform many of her prior activities of daily living. I received multiple emails from the son and daughter of the patient, which gave me some insight on the patient’s medical history and timeline of diagnostic tests.  Now through these emails I had found out that over the past year DW had been to multiple doctors, multiple specialists, undergone 7 MRIs, 2 X-rays, formal physical therapy and various prescription medications to help her symptoms without any definitive plan or answers to why she had acquired this “idiopathic diagnosis” or more importantly what to do from today moving forward.

After reviewing the medical notes I set up our first Telemedicine appointment, which was just like any normal evaluation we perform here in our clinic.  Per the patient’s request DW had her daughter present on the video conference as to be an assistant just in case DW would need help with any mobility testing and/or we had technologic difficulties. Normal subjective examination was performed, objective testing, and special tests in order to determine an action plan.  In the hour appointment we spoke of DW’s diagnosis, and I came up with a physical therapy assessment of her orthopedic limitations and her functional impairments.  In addition I gave her some mobility exercises to start on that day that she could perform independently and some exercises that her daughter would assist with.

It is important to note here that in just this first appointment DW and her daughter mentioned that they received more from me in the initial evaluation that they had in the past 6 months. How does this happen?! How can one person see that many doctors, specialists and participate in formal physical therapy without some sort of education, evaluation and proper action plan to address this patient’s needs and goals.

Our next appointment was 1 week later however I told DW and her daughter that we were always available via phone, email, or Facebook messenger if they needed to contact us prior to our next appointment.

The next appointment we learned and witnessed some pretty amazing things. She had gained more mobility in her leg than she had in previous months.  She also mentioned feeling more sensation in her leg something that had been absent for quite some time.  Her mobility was starting to return but her strength and endurance for maintaining these new positions was very poor.  At this appointment she was given a progression from her day one exercises and we planned on meeting in another week.  The next goal would be to stand and be able to shift her weight from one leg to the other.

Next appointment was two weeks later and once again more good news. DW was bearing more weight through her legs with less assistance with her arms on the assistive walker she had been using to stand.  Even better news was that DW felt her muscles in her legs working, something she hadn’t felt in months.  Her ability to transfer from chair to wheelchair, wheelchair to bed, bed to sitting and sitting to standing all improved.  Her strength and endurance were slowly improving but more importantly DW had new hope.  She was seeing progress herself.

Now DW and her daughter were given more exercises to perform daily and DW was instructed that returning to a local physical therapist was the next recommended intervention.  Going to a local physical therapist that understood DW’s needs, goals and progression was crucial to her continued recovery.  In order to assure DW’s transition our office called local physical therapists near to DW, explained to the therapists what we had accomplished in just a few visits & recommended our physical therapy assessment and plan of action and collaborated with DW what she would have to do moving forward from here on out.

I’m happy to say that DW had her first physical therapy appointment this week and I received some good feedback from her regarding her first visit.  I plan to follow up with a video conference in the beginning of next year to see how far she has come with her functional mobility and if she is closer to her goal of being able to walk again…

Tips to stay healthy during the holiday season…

Be active, happy and healthy

As the weather is changing and the end of the year quickly approaches there are many of us that are experiencing the holiday work parties, the friendsgiving gatherings, and the eventual holiday hustle to travel, eat, drink and be merry.

With all these increases in tasks and relative decreases in time to complete the parties, shopping and last minute meetings stress is bound to increase.  Statistically the last quarter of the year is when hospitals see a large increase in admissions.  This has been attributed to heart attacks, strokes, and car accidents mostly stress related.  Managing stress through proper planning can prevent these health issues and potential accidents.

Thankfully we only have a few weeks left of 2014 to get through this stressful quarter however here are some gems from the Center of Disease Control and Prevention to use while we close out this year.

Wash your hands to avoid getting a cold of flu

If you haven’t done so already, consider getting a flu shot

Balance your day with work, home, play and rest

Plan properly for those holiday travels

If you are more musically inclined here is The CDC Holiday song on the 12 ways to Health.

Another component to be mindful of is Vitamin D intake.  Living in Oregon most physicians recommend taking Vitamin D supplement due to the lack of Sunshine that the population receives.  In the past 10 years technologic advances have pushed people to spend more time indoors on computers, watching television or spending time on our tablets.  During the winter as temperatures drop and holiday season demands increase people spend less time outside, therefore Vitamin D intake is sparse. This leads to increased reports of depression possibly due to seasonal affect disorder and/or people who may not have friends or family to celebrate the holidays.  This article highlights some good information regarding Vitamin D, SAD and depression.

Lessons to be learned, plan ahead this holiday season, aim to properly balance work, home, play and rest, and get outside and enjoy being active!