Monthly Archives: December 2013

App of The Week

Health Tip of the Day

health tip app

Health Tip of the Day offers you easy to follow daily tips on how to be just a little bit healthier. By following one of these tips every day you will be sure to live a healthier lifestyle and feel better too!

All health tips are provided by Lisa Best, a Board Certified Clinicial Nutritionist (CCN), with a Ph.D in Holistic Nutrition.


App of The Week

Fit Mom

fit mom app

Fit Mom TV was created to help motivate moms to put stay fit and healthy for themselves and their

“Do you need to go potty?” 5 Tips to Improve Your Kiddo’s Bathroom Health


“You don’t understand! I’ve been constipated since I was a kid–it runs in my family!” 

I can’t tell you how many times I have heard that statement! We constantly reiterate on this blog that bowel dysfunction is never normal–common, yes–but not normal! And this is true for any situation, whether a person is 5 years old or 85 years old. Recently, I’ve been thinking about that same above statement and a light bulb went off,

“What if we were to change poor bathroom habits into good bathroom habits from an early age?” 

Would that help reduce the number of people who need my help when they’re older? I can’t help but think it would! So, today’s post is for you Moms and Dads! Strive to build healthy, good bathroom habits for your kids to decrease problems both now and later on!

Here are your 5 tips to do just that!

1. Encourage adequate fluid intake (mostly water!) and fiber intake

The average person should consume 5-8 8-oz cups of fluid per day–and your child is no different! Fluid is SO important for both the bladder and the bowels! For the bladder, having adequate fluid decreases the risk of urinary tract infections, encourages normal bladder urges, and allows for a normal light colored urine instead of a dark concentrated urine. As an aside, taking in too many sweet sugary drinks, caffeinated drinks, and carbonated drinks will actually irritate the bladder and could make your child go to the restroom more frequently as well as put your child at risk for problems with the bladder later on in life! (Note: Remember this if your child has difficulty with bed wetting!). For the bowels, adequate fluid allows for a soft stool that is easy to pass! If your child is not getting enough water, he or she will likely have a  more firm stool as the intestines have worked to absorb the fluid your child needs for normal bodily functions. Many a patient has been “cured” of constipation simply by drinking more fluid!

Fiber is also very important to encourage a good bowel consistency. Aim for 20-30 grams of fiber per day! Good fiber sources include fresh fruits and vegetables, whole grains, oatmeal, granola, seeds and nuts! For good recipes for your kids, check out Gina’s recipes from that are “Kid Friendly” here.


2. Encourage your child to listen to his or her normal body urges

This goes for both the bladder and the bowels as well! Quick lesson on anatomy and physiology–We have a normal reflex in our colon that helps us hold our stool to empty at an appropriate time (Yay!). Unfortunately, if a person holds stool for too long, the normal colon response to help us poop is dampened–meaning it won’t work as well! For the bladder, over suppressing bladder urges can cause a similar issue; however, your child could also develop some problems from going too often without an urge–Yes, I’m talking to you, “Just-in-case Mom.” A bladder that empties often without an appropriate urge can begin to give urges at inappropriate times. So, go when you need to go. Don’t go when you don’t!

3. Get your kids moving! 

I’m sure you’ve heard it in the news these days that kids need to get moving more! But, to take a new spin on it, encouraging your kids to move more will actually help keep their bowels more regular! Yes, it’s true, exercise is a stimulant to the bowels. So, encourage your kids to get outside and play, ride their bikes, do family walks and games– the more your kids move the better!

4. Help your child develop a bowel routine 

This one ties in perfectly with our last point. Here’s the scenario:

“8 year old Mary is not a morning person. Mom has a hard enough time getting Mary out the door in the morning, and this often means eating a bagel on the way to school. After Mary gets to school, she often needs to go #2, but is too embarrassed to go and holds it the whole day.”

Unfortunately, kids like Mary usually develop constipation from over suppressing those urges! This can be helped by building a routine for your kids in the morning (or evening) to help encourage a normal bowel movement.  We know that the colon LOVES consistency, so try to encourage your kids to spend some time on the toilet at the same time each day. We also know that the colon loves fluid (hot especially), hot food, and exercise! So, a good bowel routine would look like this:

“To help Mary’s bathroom habits, Mom started waking Mary up 30 minutes earlier. Mary starts her day with a warm bowl of oatmeal, then plays with her pet dog.  After they play, Mary heads straight to the bathroom to have a BM.”

Yes, building a routine takes some extra time–but it is well worth it to prevent constipation in your kiddos!

5. Encourage proper toilet positioning

Yes, there is a right way to sit on the toilet. For children, most toilets are too tall and this makes it difficult for them to relax the muscles around the anal canal to help them poop without pushing hard. Kids will compensate by straining, but over time this can be very detrimental to their pelvic health. To help them out, get a small stool to go in front of your toilet seat which will help encourage them to fully relax their muscles. Encourage them to lean forward and relax on their knees. This will help straighten out the rectum to encourage easy emptying.


Then, and most importantly, make sure they have time. Encourage them to read a book or magazine and give their colon 5 uninterrupted minutes to “do its thing.” If they feel like they need to push, encourage them to breathe while they push to avoid the typical valsalva maneuver we often see. Learning this will help them so much both now and in the future! For more information, read this excellent post from my colleague, Jenna Sires, called “Are you Pooping Properly?

What have you tried to help encourage good bathroom habits for your kids? Feel free to comment below! Here’s to a healthy upcoming generation!

Written by: Jessica Powley, PT, DPT, WCS

“Is Mine Normal?”


For guys, there is often a lot more openness when it comes to their external genitalia. Unfortunately for women, we too often hear the message that that area is private, or even dirty or shameful. And so, a lot of anxiety can exist when it comes to a female’s external genitalia. With so many things in life, we all want to be normal, look normal, and not have anything funny going on with us. It’s not uncommon for a teenage girl going to her first gynecologist appointment or a woman going to get a wax to think, “Is mine normal?” In fact, we often have ladies ask us this very question when they start seeing us in Pelvic PT.

 So, when it comes to your private parts/lady parts/vagina/vajayjay/coochie/hoo-hoo/hoo-ha/flower, how well do you know yours?

Some women may look at their genitals regularly, while others would never dare to grab a mirror and look. Regardless of where you fall on the spectrum of your comfort level with looking at your own “vagina,” if it’s news to you that what is commonly referred to as the “vagina” is technically the vulva, keep reading!

So, when it comes to your private parts/lady parts/vagina/vajayjay/coochie/hoo-hoo/hoo-ha/flower, how well do you know yours? Some women may look at their genitals regularly, while others would never dare to grab a mirror and look. Regardless of where you fall on the spectrum of your comfort level with looking at your own “vagina,” if it’s news to you that what is commonly referred to as the “vagina” is technically the vulva, keep reading!

As Dr. Lindsey Doe illustrates in her YouTube video (you will never look at a hooded sweatshirt the same after watching) the vulva refers to the external female genitalia and can be thought of as the vagina’s neighborhood. So what all is in this neighborhood?

 Mons pubis – the fat pad over the pubic bone that is normally covered in hair

Labia majora – the outer folds or “lips”

  • Run from the mons pubis in the front to the perineum in the back
  • Composed of thicker skin, fat, and connective tissue
  • Normally covered in hair

Labia minora – the inner folds or “lips”

  • Run from the fourchette (frenulum of the labia) in the back and then split at the front to form both the prepuce and the frenulum of the clitoris
  • Composed of thin skin
  • Not covered in hair
  • Lots of variation in size, shape, and coloration (even in the same woman)

Clitoris – the main erectile tissue in the female (from the same embryological tissue as the penis)

  • Plays a role in sexual function only
  • Glans – the head of the clitoris (the clitoris has a body, and legs on either side, too, but they are internal); can vary in size and shape
  • Prepuce – the “hood” of tissue that covers the glans to protect it; formed by the labia minora

Frenulum – where the labia minora meet at the front, right below the clitoris

External urethral meatus – the opening to the urethra which is the tube emptying your bladder

Vestibule – the area inside the labia minora (the “porch”), between Hart’s line and the hymen

Hart’s line – separates the labia minor from the vestibule; marked by a change in coloration (this is an imaginary line)

Glands (you won’t see these) – secrete fluids important for lubrication with intimacy; may become clogged

  • Bartholin’s glands – inside the vestibule
  • Skene’s glands – on either side of the urethral opening

Hymen – the mucosal tissue that partially or entirely covers the vaginal opening at birth; may be disrupted by various means (vaginal penetration whether through sexual intercourse, masturbation, use of a tampon; surgery; trauma; vigorous sports). Remnants of the hymen will vary significantly between women. Talli Rosenbaum, physical therapist and sex therapist, has a fantastic article about the hymen here.

Introitus – the opening to the vagina; normally closed when legs are not spread

Posterior Fourchette – where the labia minora meet in the back, behind the introitus


But while a cartoon can be a great way to visualize and learn anatomy, we are not cartoons! So if you’re worried that your labia are too big or that you have funny wrinkles somewhere, remember that your vulva is just like your face – everyone shares common features, but the details are different.

If you’re still worried, check out British artist Jamie McCartney’s installation “The Great Wall of Vagina.” He has cast hundreds of vulvas, and through art has made “the sexual nonsexual.” No two look the same. Included in the collection are several male-to-female and female-to-male transgendered individuals, but chances are you couldn’t pick them out because of the vast differences among all vulvas.

 So don’t fret, your vulva is normal, just the way it is.

Note: Please know that this post is not meant to imply that ALL variations are normal. Knowing what your vulva looks like when it’s healthy can be helpful so that you can recognize any changes that may occur. Dermatological conditions and sexually transmitted infections (STIs) may change the appearance of your vulva or cause pain, itchiness, or burning in this area. If you are concerned about a potential disease process, please consult your physician. 

*For more resources on pelvic anatomy, check out this excellent post by our friend and colleague, Tracy Sher, on Pelvic Guru!


This guest post is written by Leigh Welsh, a third year Doctor of Physical Therapy student from Duke University, currently completing a 12-week rotation with Proaxis Therapy in Pelvic Health with Jessica Powley, PT, DPT, WCS. Leigh has been an excellent addition to our team, and we are confident that she will make a fantastic clinician.

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