Women’s Health Rehab: Piles

2.6 mins read | Physical Therapy Rehab

Women’s Health Rehab: Piles

Written by Anamika Bheda, Maria Dalal

Graphics by Nimisha More

Visual Media by Param Sampat

Audio by Aparna Premraj

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Peek into

What are Hemorrhoids
Symptoms of Piles
Causes
How can Exercises help?
The Dysfunction of the Pelvic floor

Too Bored to watch the entire video? We have got you covered! Listen to the full Interview on the go –

What are hemorrhoids? Nothing but the veins at the lower part of the rectum and anus that act as cushioning and are the cost of our erect posture! When these vein walls are stretched thin or irritated, they become painful, swollen, and bulging.

Over 4.4% of the general population have piles, and the peak incidence is between 45 to 65 years of age. [1] Men are more likely to seek treatment than women.

The symptoms of Piles can range from mildly irritating to debilitating. They can present as

Moist swelling at the anus
Pain
Itching
Rectal bleeding
Difficulty passing stool

If the causes are not addressed, it can also lead to fecal and flatus incontinence.

The causes of this common but complex condition are multifold.

Constipation, straining, and bearing down during bowel movements
Straining during heavy lifts
Pregnancy: added weight of baby and uterus irritates the veins
Obesity

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How can Exercise help?

To address symptoms:

1. Pain – Cryotherapy

2. Difficulty Passing Stools – Pelvic floor Relaxation. Breath Coordination, Core Strengthening and TA bracing

3. Fecal flatus incontinence – Recal toning, Sacral Nerve Electrical Stimulation

4. To address the etiology

5. Lifestyle Modifications

Also Read: Meniscus Repair Rehabilitation: Aggressive or Non-Aggressive Route

The dysfunction of the pelvic floor (the layer of muscles that support our abdominal organs like a sling), can arise from 3 means:

Pelvic floor weakness– Decrease in strength and endurance of the muscles due to trauma, childbirth, chronic neurological injury. Addressed with Kegels, Toning exercises, and Biofeedback from electrical stimulation. Best way to give cues for Kegels: lift the muscles you use when urinating.
Pelvic floor tightness– A tight pelvic floor does not have the ideal length-tension relationship and is also a weak pelvic floor. Can we perform heel raises on 4-inch heels? Just like that, if the PF is tight or under constant tension, it cannot function ideally, and cannot benefit from Kegels.
Pelvic floor incoordination -Inhalation, thoracic diaphragm coming down, abdomen pushing out, relax your pelvic floor ( allow the abdominal cavity to fully expand ). Exhalation thoracic diaphragm going up, contract pelvic floor for good contraction.
General strength training and aerobics– Regular exercise has been directly linked with gut mobility and digestion, and a healthy balanced fiber-rich diet can help in constipation.
Additional tips: Pay attention to posture! Posterior pelvic tilt and hip external rotation ‘tuck’ the pelvis in can provide comfort but is not beneficial when training pelvic floor function.

Kegels without PF relaxation is incomplete training- like heel raises on stilettos.