​Yes, you heard me. Prioritising a poo or bowel motion is important for both adults and children.
 
My view point as a pelvic health physio is that EVERYBODY should be have a SOFT, DAILY poo.
 
Here are some non-negotiables to getting to soft, daily Poos:

1. ALWAYS RESPOND to the urge to poo. So yes, there are times when it is not possible. But the danger with that, especially with kids, is that the holding results in poo sitting for too long and then poo gets hard and that can be uncomfortable. So when you get the urge to go, PRIORITSE getting to a toilet so you don’t defer more than 15 min. TIP: the bowel loves routine and is most active in the morning, so getting it into a suitable routine for you will eliminate visits to unwanted toilets.
2. Drink enough water. Its simple- water helps to keep the poo soft. The science: As poo moves through the large intestine, water is re-absorbed from the mush and sent back to the body which results in a more solid poo. So if we hold poo in for too long, more water gets reabsorbed into the body, making your poo hard. Drinking more water means you have enough for your body and your poo. TIP: If you are using products like Movicol, Pegicol, Lacson or Duphalac- these products are like magnets and draw water into the colon to keep the poo soft. So for it to be effective, you need to up your water intake!
3. Good toilet posture and breathing are essential for complete and easy defeacation. We all know the feeling of having a good poo vs a poo that’s there and doesn’t want to come out. Our bodies are made to poo easily, but we often just need to re-learn it. Squatting is the most natural position- think of babies that often poo when playing in a squat position. We replicate that on the loo by using a foot step. This is essential for EVERY BODY not just kids and women. Let’s get to a place where we normalise a foot step in every toilet. Get my poop guide here. Tip: Use a foot stool whether you are an adult or a child.
4. Nerves matter. When we are stressed or anxious about anything- Poo is no longer a priority. Getting out of danger or stress is= Enter sympathetic nervous system who responds to stress. We need to be calm and chilled for our nervous system to feel safe and prioritise poo and pee and digestion= Enter parasympathetic nervous system which is responsible for calm. So for good poos, lets pay attention to our stress and anxiety- the less we have, the better we poo and we all know that when we poo good, we feel good. TIP: Make a ‘safe cave’ in your toilet and work on a routine so that so that you can have a daily, good poo.

 
(Link to other blogs about knowing your poo, Happy poo and correct toilet position)

The most common reaction when I teach adults and kids about their pelvic floor is “oooohhhh, I never knew that”, “Why do we not learn this in school”, “ That makes sense, I wish I knew that before”
 
Since the pelvic floor muscles are situated at the bottom of your pelvis on the inside, it's difficult to visualise and  sometimes feel. The pelvic floor is made up of various muscles that form a hammock at the bottom of your pelvis. 
 
Function of the pelvic floor muscles for all bodies:

1. Form part of the deep core
2. Maintain continence- i.e. keep pee and poo in
3. Allow things to come out i.e. pee, poo, baby
4. Important for posture and postural control
5. In adults- it is important for sexual function

 
Action of the pelvic floor:
When tightened (squeezed), the muscles lift the organs and close their openings. 
When relaxed, one is able to easily and effectively empty the bladder and bowel or allow a tampon to be inserted.
 
It is important to know that it is not an island- It does not work on its own. It needs to work together with your breathing muscles, tummy muscles, hip muscles and foot muscles to name a few. So when we have problems it's not as simple as the person having a weak pelvic floor.
 
Common Problems of the pelvic floor:

1. Too Weak
2. Too tight
3. Uncoordinated

 
In my experience all will result in some sort of bladder or bowel issues.
In my opinion and clinical experience, most adults are uncoordinated and tight and most kids are tight cos they are great at holding but not letting go.

 Yes, I deal with all things Pee, Poo & Pelvic floor...basically below the belt. Almost all clients irrespective of age DREAD their first visit. They often enter my rooms (virtually or in-person) blanketed with shame, full of anxiety and looking for answers to all their tough questions.
 
My approach is always to go according to where you or your child are at, educate so that you understand what your body needs to do and give you some tools to make a change.
 
I love talking and educating, so the first visit  for women and children is simply a good ol chat.
What  do we talk about?

1. Firstly, your story or your child’s story is important. I want to know all the details - It allows me to start problem solving.
2. Secondly - Education. This is the KEY to success. Understanding how your body should work vs how it's currently working helps you to know why we need to make changes. And more importantly how those changes are going to help you in your journey.

 
Physical checks: It is important for me to assess how yours or your child’s body moves and the strategies you use so that we can see what needs to change. So, on the first visit I will also always check the following:

• Posture
• Breathing
• Tummy
• Balance and strength of tummy, hips, legs and arms

 
I don’t always do a pelvic floor muscle check on the first visit.  Pelvic floor muscle assessments can be internal or external for adults (based on consent) and always external for kids. I like to build rapport and trust with you before we dive into this part of the assessment. This way it is done with mutual respect, consent and preparation. SO DON’T LET THIS BE THE REASON FOR YOU NOT MAKING THE APPOINTMENT.
 
Exercises: 
I will give you 2-3 homework tasks to start your journey. These can be exercises or bladder / bowel detective work. 
 
Planning and follow-up:
By the end of the session, I will be able to explain my findings and how they relate to your problem. I like to make a follow-up within 7-10 days so that we can consolidate the information, add to your program with more depth and plan the way forward.
 
Things to note for the first visit for Adults & Children:

• The initial evaluation is very important and so I prefer that we don’t rush it. This appointment will be between 60 to 75 minutes long. 
• The questions that I ask are of a sensitive nature with regard to bladder, bowel, toileting and sexual function (adults). These questions can be uncomfortable, so it is really important to complete the pre- visit intake questionnaire. This will be sent to you before the appointment so that you have time to think and respond to the questions.
• I make every effort to meet you and your child where you are at- so I really do my best to have ‘Go-with-the flow’ approach.
• My aim is to make you feel at ease so that we can problem solve, plan and tackle the problem together.   

As a physiotherapist, I always had a nonchalant attitude towards my pelvic floor strength and function. Having had one lecture on the topic during my undergraduate training, I had decided that
1) I will never have this problem because I'm a physio and I now know better and
2) this only happens to old ladies. 

I learnt very quickly, before the age of 30, that neither of these sentiments were  true. After the birth of my second child, I realised that I wasn’t 'strong' anymore but I was in denial because I am a physiotherapist and this thing shouldn’t be happening to me. I struggled with stress incontinence which was most embarrassing . I kept telling myself I know better  and really tried to do 'Kegel' exercises. I honestly believed that I was activating perfectly and with time this problem will eventually get better. But in the back of my mind. I was concerned that being leaky was going to be something that I should just accept.

Fast forward one year later: there were no improvements!!!By chance,  I bumped into a pelvic floor physiotherapist at a course. My anxieties and frustration at the lack of progress forced me to tell her my story. For the first time she made me realise that I not only wasn’t activating my pelvic floor or core properly but I also couldn’t feel my pelvic floor! PANIC!!                                                                
​
I immediately got help from a pelvic floor physiotherapist. I was devastated when she showed me how uncoordinated I was and how I  couldn’t activate my pelvic floor even though I thought I was fantastic with my kegels. She taught me how to get in touch with my core and pelvic floor and how to do things correctly. A lightbulb moment!! In just a few sessions I was on my way to POWERing my pelvic floor.  
                                                             
Fast forward 10 years as I headed towards 40: I was still 'exercising' my pelvic floor or rather connecting to it.  I felt much stronger than I was pre-mummyhood. I no longer struggled with stress incontinence unless I jumped for too long on the trampoline- an activity I could happily live without. 

Another 5 years into my journey brings me to Today: And, there is change again. I'm entering peri-menopause and goodness I suddenly have issues with stress incontinence again. I am definitely also more aware of my muscles feeling softer, joint aches and a change in things down below. These changes are common for women in this phase as oestrogen levels drop and muscles are now longer as firm as they used to be. I will often get ladies saying they never had pee and poo issues until menopause.
So this time, I am not burying my head in the sand - time to be proactive. I am more conscious of how I move my body, how I breathe - especially with exercise and how I am supporting my pelvic organs during exercise. Yes, I still connect to my pelvic floor but it is as I do my exercises rather than in isolation. Again, I am re-learning to be in tune with my body and connect through my breath. 

So in the end- I am still on my pelvic floor journey. And if I must be honest, I think I am better at having power over it now rather than just being able to power it!