PF: Eval and Treatment of External Anal Sphincter (Lab) | 8:43
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9 Comments
Is your thumb externally, or inserted partially into the sphincter? Is the compression of the lower section using your thumb nail uncomfortable? I use my pad vs. nail for most pelvic floor muscle work?
Your thumb is external. If the muscle is stuck open you might go internally but that is not your intention. The nailbed is not uncomfortable, as I’ve never had anyone complain about it and I keep the index finger in vaginally while I’m assessing the EAS so that is why I use the nailbed. I explain more in the Holistic Treatment of the Postpartum Body course or the Pelvic Floor Course.
I tried releasing the EAS twice this past week. I am anxious to hear how the clients do this week afterward. I also educated them about releasing their own EAS before BMs. Both of them have an anal fissure. I am hoping that I did it correctly!
When releasing the top half of EAS with index and thumb pressing, would we be worried about stretching the perineal body if someone already has a larger genital hiatus?
When releasing the top half of EAS with index and thumb pressing, would we be worried about stretching the perineal body if someone already has a larger genital hiatus?
You are not stretching the tissues with this technique. You are compressing the “knot” or thickened tissues between your fingers. Thumb pushes up as much as finger pushed down. Don’t move the tissues down as you do so. There should be no concern for genital hiatus with the technique when done correctly. Does this make sense?
When you say the lower EAS is palpated with the “nail bed”, is that essentially the very tip of the thumb vs. the upper EAS with the thumb pad near the DIP? (EAS muscle between these areas on the thumb and the index finger internally)… so gotta keep those thumb nails short then! Also when you say “tailbone” you are talking about the coccyx, but not the base of sacral and coccyx juncture for the bone mobilization hand?
To palpate the lower half of the EAS you use the bed of the thumb nail not the tip of your thumb to assess the muscle. The upper half you can use the pad of your thumb to assess. Yes the tailbone is the coccyx, and it doesn’t matter if you are on the coccyx or the junction of coccyx and sacrum, as long as you are connected to the tailbone that is the important part.
Is your thumb externally, or inserted partially into the sphincter? Is the compression of the lower section using your thumb nail uncomfortable? I use my pad vs. nail for most pelvic floor muscle work?
Your thumb is external. If the muscle is stuck open you might go internally but that is not your intention. The nailbed is not uncomfortable, as I’ve never had anyone complain about it and I keep the index finger in vaginally while I’m assessing the EAS so that is why I use the nailbed. I explain more in the Holistic Treatment of the Postpartum Body course or the Pelvic Floor Course.
I tried releasing the EAS twice this past week. I am anxious to hear how the clients do this week afterward. I also educated them about releasing their own EAS before BMs. Both of them have an anal fissure. I am hoping that I did it correctly!
When releasing the top half of EAS with index and thumb pressing, would we be worried about stretching the perineal body if someone already has a larger genital hiatus?
When releasing the top half of EAS with index and thumb pressing, would we be worried about stretching the perineal body if someone already has a larger genital hiatus?
Thanks for your help.
You are not stretching the tissues with this technique. You are compressing the “knot” or thickened tissues between your fingers. Thumb pushes up as much as finger pushed down. Don’t move the tissues down as you do so. There should be no concern for genital hiatus with the technique when done correctly. Does this make sense?
Yes, thank you!
When you say the lower EAS is palpated with the “nail bed”, is that essentially the very tip of the thumb vs. the upper EAS with the thumb pad near the DIP? (EAS muscle between these areas on the thumb and the index finger internally)… so gotta keep those thumb nails short then! Also when you say “tailbone” you are talking about the coccyx, but not the base of sacral and coccyx juncture for the bone mobilization hand?
To palpate the lower half of the EAS you use the bed of the thumb nail not the tip of your thumb to assess the muscle. The upper half you can use the pad of your thumb to assess. Yes the tailbone is the coccyx, and it doesn’t matter if you are on the coccyx or the junction of coccyx and sacrum, as long as you are connected to the tailbone that is the important part.