Are You “Backed Up?” A Muscular Approach to Relieving Constipation

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Everyone has been constipated at least once in their life.   What happens when your infrequent backups become an everyday occurrence?  The normal course of action is to load up on laxatives, stool softeners or enemas. Most of these treatments, natural or not, put a tremendous amount of stress on your body. So, what if there was another option, an option that not only keeps things moving, “in the right direction”, but strengthens and activates your abdominals at the same time?

Note: This approach assumes that you have seen your physician and have ruled out any serious medical causes of constipation.

Let’s start with how food gets in and out of the body. 

Imagine for just a second that you’re hungry and your eyes gaze upon a nice home-cooked thanksgiving turkey dinner. Your mouth starts to water. The salivary glands in your mouth are triggered to start producing saliva, a compound that will aid in the digestion of the meal.

As food enters your mouth, your teeth begin mechanically breaking down the food into smaller and smaller pieces. The saliva starts to chemically break down the food particles as well. Soon, your conscious mind says, “let’s swallow this food.” You swallow it and take another bite.

While you’re thinking about your next bite of food, your nervous system is helping to move the bolus (the food package you swallowed), down the throat. A small flap of skin, called your epiglottis, makes sure your food goes down your esophagus. Movements of the smooth muscles, known as peristalsis, help move that bolus down your esophagus. When it reaches your stomach, the lower esophageal sphincter opens and dumps the food in.

Inside the stomach, parietal cells start to secrete hydrochloric acid to help increase acidity to a pH of around 2. This strong acidic environment kills most of the bacteria and starts to chemically break apart the food.  Movements of the smooth muscles in the stomach mix and churn the food.  After the food has been well mixed and has a consistency of oatmeal, it is ready to move to the small intestine.  At this stage it is known as chyme.

To move into the small intestine, chyme must pass through the pyloric sphincter.  From here it enters the duodenum, the first part of the small intestine.  The liver mixes in bile, which helps break down fats in the food. The pancreas also secretes digestive enzymes that aid in digestion.

Most of the nutrients are absorbed from the small intestine and moved into the blood stream via a system of small folds, called vili.  After the food moves through the small intestine, it enters the large intestine.  The large intestine is named for the diameter of the cavity and not for the length.  It is actually much shorter than the small intestine.  The role of the large intestine is to regulate fluid of the digested material before it is finally excreted through the anus.

If fluid is not regulated in the large intestine, or feces is is moved too quickly through the colon, one may experience diarrhea (too much fluid in the feces).  The opposite is true of constipation, not enough fluid in the feces, or slow motility. When one takes a stool softener, enema, or a laxative, water is absorbed back into the feces, thereby allowing for a smoother excretion. Unfortunately, one cannot live on these medications, so another solution must be discovered. Along with smooth muscle contractions of the GI tract (peristalsis) moving feces, striated voluntary muscle can be used to aid GI motility. To achieve the ability to voluntarily move feces, one must have control of their abdominal muscles to facilitate a right-to-left motion of feces through the colon. Below are illustrations of specific abdominal work to reinforce colon stimulation. 

To start, each exercise is to be completed 3 times, exhaling on the way up and inhaling while returning the the starting position.  As you practice and the exercises become easier, increase repetitions, but only if you can add to each exercise equally. Do these exercises daily for strong abdominals (and regular bowel movements!).

Note: Make sure to do these exercises in order for best results.

Constipation Relief Exercise #1
  1. Feces enters the cecum

-Lying on back, fix trunk with arms crossed at T8

-Work external oblique to work inguinal ligament (cross right knee over left)

-Move right knee towards left shoulder

Constipation Relief Exercise #2

2. Ascending colon

-Lying on back, bend knees toward chest and raise sacrum at S2

-Left hand on right shoulder

-Right arm across body

-Lift the trunk and rotate to left around the spine

3. Hepatic colon

Constipation Relief Exercise #3

-Lying on back, bend knees toward chest and raise sacrum at S2

-Cross arms at shoulders (right over left)

-Compress chest with left arm & rotate to left

-Move the right elbow toward toward the left knee

4. Right transverse colon

Constipation Relief Exercise #4

-Lying on your back, bend both knees towards chest

-Flex spine up to knees until reaching S2

-Place both hands on left shoulder

-Move up elbows toward left knee

5. Transverse colon

Constipation Relief Exercise #5

-Lying on your back, bend both knees towards chest

-Flex spine up to knees until reaching S2

-Both hands are on respective shoulders

-Move up elbows toward top of knees

6. Left transverse colon

Constipation Relief Exercise #6

-Lying on your back, bend both knees towards chest

-Flex spine up to knees until reaching S2

-Place both hands on right shoulder

-Move both elbows toward right knee

7. Splenic colon

Constipation Relief Exercise #7

-Lying on back, bend knees toward chest and raise sacrum at S2

-Cross arms at shoulders (left arm over right)

-Compress chest with right arm rotate to right

-Move elbows toward right knee

8. Descending colon

Constipation Relief Exercise #8

-Lying on back, bend knees toward chest and raise sacrum at S2

-Right hand on left shoulder

-Left arm across body

-Lift the trunk and rotate right around the spine

9. Sigmoid colon

Constipation Exercise #9

– Fix trunk with arms crossed at T8

-Work external oblique to work inguinal ligament (cross right knee over left)

-Lift the trunk and rotate right around the spine

So, the next time you’re dealing with a bout of constipation, instead of reaching for medications, give these simple exercises a try. For more information about this topic, please feel free to reach out to us at info@backtofunction.com or by calling 310-534-1900. At Back to Function, our goal is to get you to Feel – Recover – Perform Better!

Dr. Mike Venezia
About Dr. Mike Venezia

Dr. Mike Venezia graduated from Cleveland Chiropractic College, Summa Cum Laude in 2006. Dr. Mike has more than 13 years of clinical experience in the diagnosis and management of sports and soft tissue injuries. He is currently living in Washington and is the medical director for Addaday.