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C h e c k o u t A B M P P o c k e t P a t h o l o g y a t w w w. a b m p . c o m / a b m p - p o c k e t - p a t h o l o g y - a p p . 91 4 5 To improve gut motility and relieve built-up gas in the client's pelvic floor, the therapist's thenar eminence hooks the tissues attaching to the pubic symphysis and gently scoops headward. To help relax and/or to stimulate tone in the client's pelvic floor muscles, the therapist's forearm traverses up the adductors and contacts the tissues attaching to the pubic ramus and gently rocks back and forth. To enhance this technique, the client is asked to perform slow pelvic tilts while the therapist's forearm gently resists this effort. Watch "Belly Work: Myofascial Techniques to Relieve Belly Bloat" SUMMARY Bloating and distension are highly prevalent symptoms with a marked effect on health status and quality of life. In the past few years, considerable progress has been made in understanding the pathogenesis of these symptoms, and emerging evidence indicates that targeting colonic motility, gut flora, visceral sensitivity, and dietary intake are helpful in controlling such symptoms. 2 The primary goal of digestion is to get food from one end to the other as quickly as possible with maximum absorption. Massage techniques that manually teach overworked abdominal muscles how to relax and efficiently move gases through the system will improve gut motility and strengthen peristaltic action. Though few studies exist in which bloating is a primary endpoint, I've personally found that musculoskeletal pelvic alignment coupled with breathing exercises to stimulate the parasympathetic nervous system help improve the symptoms of belly bloat among my clientele. Notes 1. Nicholas J. Talley, Philip Boyce, and Michael P. Jones, "Identification of Distinct Upper and Lower Gastrointestinal Symptom Groupings in an Urban Population," Gut 42, no. 5 (June 1998): 690–95, 2. Max Schmulson and L. Chang, "The Treatment of Functional Abdominal Bloating and Distension," Alimentary Pharmacology and Therapeutics 33, no. 10 (May 2011): 1,071–86, https://doi. org/10.1111/j.1365-2036.2011.04637.x. Erik Dalton, PhD, is the executive director of the Freedom from Pain Institute. Educated in massage, osteopathy, and Rolfing, he has maintained a practice in Oklahoma City, Oklahoma, for more than three decades. For more information, visit 2 3 When the gut is full of food or gas, the dome-shaped diaphragm should automatically relax upward, allowing the abdomen more room to expand. Pelvic floor muscles, such as the levator ani, coccygeus, and piriformis, must accommodate the bloat by expanding like a balloon, up, down, side to side, and front to back.

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