Join us in wishing a fond farewell to Lauren as she heads off to Dental Hygiene School at Concorde. Thank you for your many contributions to the CTS team! 

Here at Comprehensive Therapy Services, we get a lot of questions about bowel movements. What is normal? What is not normal? Unfortunately, a lot of people wait until it becomes an issue before they seek help. Luckily, we have some answers for you. Below is a quick rundown of some popular Number Two discussion points. So, without further ado... Let's talk about poop!

  1. A wise person once said, "If you don't poop in the library, you shouldn't read in the bathroom."
    Sitting on the toilet for a long period of time puts the pelvic floor muscles and vascular system on prolonged stretch. This may increase the incidence of hemorrhoids, weaken pelvic floor muscles, and even overstretch sensitive nerves in the pelvis. How long is too long? Ten minutes should be the maximum amount of time spent on the golden throne. Keep the Kindle on the coffee table.

  2. Are you regular?
    Regular bowel movements are one indication that everything is going smoothly. Regular, normal bowel movements can occur 3 times a week or up to 3 times a day. Most often, the reflex to have a bowel movement is synced with circadian rhythm. This is why most people have a bowel movement right upon waking. Making sure you maintain a consistent morning ritual of eating breakfast, drinking a warm liquid, and making time to relax on the toilet is vital to having regular bowel movements and increases this natural reflex.

  3. Repeat after me: When you feel the "Call to Stool," you must answer the "Call to Stool."
    Delaying the urge to have a bowel movement may cause the rectum to begin to accommodate to this increased volume of stool. When the stool stays in the body longer, the more opportunity there is for the large intestine to extract liquid. This makes the stool increasingly firm, making the stool more difficult to pass, and ultimately may contribute to constipation.

  4. Is it a floater or a sinker?
    Floating stool may indicate a diet with adequate fiber. In an ideal diet, one consumes 25-35 grams/day. Among others, you can get fiber from beans, fruits, and vegetables. Fiber works to bulk the stool, allowing for improved motility. You may have to add to your diet with soluble or insoluble supplements. If you do add a supplement to your diet, make sure to accompany it with plenty of water.

  5. You should never have to bear down with bowel movements.
    Bearing down is an indication that something in the digestive system is unhappy. For females, it is especially important to avoid bearing down in order to avoid stretching of the ligaments holding the pelvic organs, causing pelvic organ prolapse. Bearing down with bowel movements may be an indication of pelvic floor muscle overactivity, poor diet, or inadequate/poor timing of bowel movements. If you find yourself sweating on the toilet, try bringing a stool under your feet to allow your knees to be higher than your hips. This allows the pelvic floor muscles to be in a more relaxed position. It also improves the angle of the rectum, allowing for feces to have a smoother exit route. Remember: a stool for better stool.

If you're concerned you are not having normal or satisfying bowel movements, contact a physical therapist at Comprehensive Therapy Services. There are LOTS of interventions physical therapy can offer to solve your bowel conundrums. We know our... stuff!
Anne Shea, PT, DPT
Knee pain affects one in four adults. Often people with low back or pelvic pain have difficulty moving correctly because their knees hurt. Let's talk about risk factors and four easy ways to decrease your knee pain!

Risk factors include inactivity, carrying too much bodyweight, poor posture, insufficiently healed injuries, and poor nutrition.

Here's what you can do NOW!

1. Stay active:
Joints thrive on movement. Motion is lotion to aching joints. Some movement is always better than no movement. For knees, low intensity is best. Swim, walk, bike.

2. Stretch:
Several muscles cross your knee joint. When one muscle pulls abnormally on the joint, it can change the way your bones move around each other and increase pain.

Try these 3 stretches, twice a day, 5 days a week.

Active Calf Stretch

Stand on the edge of a step. Slowly lower your heels and hold for 20 seconds, then slowly raise heels as high as you can. Repeat 5 times.

Quadriceps Stretch on Chair

This one is easy to do at the office! Place your knee on a chair, keep chest upright, lean forward and feel the front of your thigh stretch (A). Hold 20 seconds. Repeat 5 times. For an even deeper stretch, stand further from chair and bend your stance leg allowing your knee to bend more (B).

Active Hamstring Kicks

Hold onto something steady. Swing your leg forward keeping toes up and feel stretch in the back of your thigh (A), then let your leg swing behind you as far as you can (B), feeling a stretch in the front of your thigh. Kick forward and back 10 times, two sets.

3. Strengthen:

Strong muscles help hold your knee bones in place while you move, this decreases painful wear and tear. The muscles found to help most are the muscles on the front of your thigh, hip muscles, and core.

Straight Leg Raise

Lie on your back with non-affected leg bent. Activate your core and squeeze the front of your thigh. Slowly lift your leg two feet and lower. Repeat 10 times, two sets. Add ankle weights if this is too easy.


Lie on your side with knees bent (A), keep your pelvis level, activate your gluteal muscles, then lift your knee (B). Slowly lower. Repeat 10 times, two sets.

Side Plank

Start on your elbows and knee. Add a pad if the pressure hurts your knee. Lift hips and hold 30 sec-5 min, whatever you are able to do.

4. Good Form:

Sit to stand correctly every time. First, let's see what's not good. On the picture below, can you see knees moving towards each other during a run? Think of sitting in a chair as a squat. Try to avoid letting your knees fold into each other.

Now check out the great form below. This lady has it right! Her knees and feet are both hip width apart. No painful angles on her knees!

Use good form each time you sit and stand, and try to move slowly. It's a great way to sneak strengthening into your day!

These simple strategies will help ease most knee pain. If you still are having trouble, come see a physical therapist at CTS for individualized exercise prescription and manual therapy to get you moving faster!
Crystal Hazelton, PT, OCS