Abdominal Bloating and Core Control

Abdominal Bloating: The many tools of a Physical Therapist

This month, I thought it would be appropriate to discuss a condition that I have been seeing more in my clinic – abdominal bloating. A physical therapist has many tools at their disposal depending on the environment that they work in. As an ortho/pelvic floor therapist I have learned techniques that land in orthopedic treatment, pelvic floor treatment, and visceral treatment that make my sessions multi-disciplinary. Using information from all three, allows me to see and treat the patient in depth beyond standard care.

The Physical Therapy Evaluation

In the first few moments of meeting my patients during an evaluation, I use observation along with verbal communication to determine the best course of treatment. I have learned to screen for certain common pelvic floor and visceral conditions with most of my patients using a few simple questions.

After a detailed history, I will watch the way my patients move functionally and perform range of motion and muscular tests.  Interestingly enough, after performing a detailed muscular assessment, I see that frequently many of my patients fall into the category of poor abdominal muscular activation/endurance and decreased postural control.

Is there a connection between abdominal bloating and core control?

So, what does this have to do with abdominal bloating? I noticed that with some of these patients who experienced abdominal bloating, that they were also unable to activate their low core muscles or experienced decreased endurance and strength in their low/postural core. With some simple techniques, we cleared the bloating away and immediately saw an increase in strength and endurance in many of these cases.

Is this treatment appropriate for everyone? The answer isn’t as simple as yes or no, but I do believe that everyone can benefit from abdominal/visceral work in one way or another. Just as we take care of our muscles, we must also take care of our organs both internally and externally.

Low load and force can help restore the normal patterns of your organs and reduce abdominal symptoms with some simple mechanical work. Do these techniques work all by themselves? Probably not, but I have treated and witnessed in many cases the patients who decide to couple visceral therapy with proper nutrition and exercise tend to have better results than those who don’t.

Don’t forget, this concept of abdominal bloating reducing core control and contraction is a general statement and everyone must be treated individually. So, if you suspect that you are experiencing some abdominal restrictions, please see a therapist who specializes and treats this area of the body for a more detailed assessment and treatment tailored directly for you.

5 Steps for an Abdominal ILU Massage

For the rest of you who are looking to try something simple that can possibly increase your abdominal motility, reduce constipation, and help with bloating, give the ILU massage a try! Please only try this technique if you have been screened and cleared by your healthcare practitioner.

1. Perform all techniques gently with the palm of your hand (less pressure is more!)
2. Start with the “I” – belly button to pubic bone. Repeat 10x
3. Next, try the “L” – left lower ribs to left hip and then left hip to midline. Repeat 10x
4. Lastly, try the “U” – Upside down, right hip to right lower rib, right low rib to left low rib, left low rib to left hip. Repeat 10x
5. Finish with mini circles around the belly button. Repeat 10x.