Anismus
Condition Overview
Anismus is a disorder in which the pelvic floor muscles remain tightened during defecation when should be relaxed and lengthened. This can occur in men, women, and children and can cause significant pain with bowel movements.
Common Causes:
A third of people experience the onset of anismus in childhood and can span throughout adulthood. A third of people experiencing anismus have an onset in adulthood that begins after childbirth or a pelvic injury. And the last third develop it for no apparent reason. It does seem to be a learned behavior; therefore, it can be unlearned - which is where pelvic health therapists come in! There seems to be a correlation to those who have chronic constipation stemming from another reason and straining too hard which stresses the pelvic floor and can cause over tightening of these muscles instead of relaxation/lengthening.
Symptoms:
Having a BM less than 3x/week
Pain with bowel movements
Inability to initiate defecation
Incomplete bowel evacuation
Bloated abdomen
A need to repeatedly change posture during defecation to improve emptying
Overuse of laxatives and enemas
Fecal leakage
What can physical therapy do for me?
Because this is a functional disorder, there is great ability to reduce these symptoms with pelvic health physical therapy. In therapy, we will discuss your bowel, bladder, and sexual health. We will discuss the onset of symptoms, exercise routine, water intake, general dietary habits, etc. With this information, we are taking note of habits and patterns that may be associated with the constipation or incomplete emptying you are experiencing.
With your consent we may perform an external and internal rectal or vaginal pelvic floor muscle assessment to determine muscle function, strength, endurance, and coordination.
From our findings we will set-up a treatment plan depending on your pelvic floor characteristics! We may suggest implementing daily activities to improve your bowel routine, improve water and fiber intake, and reduce stress. We may also perform manual treatment including but not limited to dry needling, myofascial release, connective tissue mobilization, and cupping. We may also perform biofeedback training which is shown to greatly reduce anismus, constipation, and defecation disorders.
With each session we will progress as able and learn new activities to include in your daily routine to manage and prevent worsening symptoms!