The Importance of Posture with Toileting 

July 31, 2017

Written By: Keyla Guenther, DPT 

Do you have trouble emptying your bowel or bladder? Feel the need to go again within a matter of minutes to an hour after just having gone? Straining or pushing to empty? Worse yet, do you hover or squat over the toilet rather than sitting down? These are just some of the things that we hear when working with both male and female pelvic floor patients. Millions of people around the world suffer from pelvic floor dysfunction, yet never seek treatment. Statistics suggest that 1 in every 5 Americans suffer from some form of pelvic health dysfunction during their life. Sadly, many people never seek treatment for their dysfunction and let it significantly impact their life.  

Physical therapy is a conservative option for treatment of pelvic pain and pelvic floor dysfunction. One of the most important things we as therapists do is to educate patients regarding their condition. We discuss pertinent anatomy and pathology as well as behavioral things that can be done every day to help promote a healthier pelvic floor. Toileting postures are just one of those topics. 

The human anatomy is built to go into a squat position to eliminate both our bowel and bladder. In countries around the world, some people still practice squatting to go to the bathroom. For most of us in the United States, modern day technology has changed the way that our bodies are expected to go to the bathroom. Conventional toilets position the hips into a 90/90 position at the hip and knees. If you have a raised toilet, this angle changes even more. This raised position does not allow the muscles responsible for urination or defecation to fully relax. When we are unable to fully empty, whether it be bowel or bladder, many of us strain or push.  

Pushing down on the pelvic floor can cause various impairments, including pelvic floor weakness and dysfunction. One of the easiest things you can do to help your body eliminate is to follow proper toileting habits.  

    1. First, SIT DOWN on the toilet, do not hover. By hovering the pelvic floor cannot relax. If the pelvic floor cannot relax, it will not empty appropriately. 
    2. Second, we need to take time and relax. Let things happen naturally rather than trying to force it. By allowing the body to relax, taking deep breaths, we can allow the nervous system to relax and promote motility.
    3. Lean forward with your elbows onto your knees. This will help to increase hip flexion, similar to a squat position.
    4. If possible, you can also elevate your feet onto a stool. This further helps to achieve a squatting position to relax the pelvic floor
    5. Relax your belly, let it bulge out slightly. This helps to lengthen the pelvic floormuscles and reduce tension.  
    6. Sit there and wait. Do not push, strain or try to force it to happen. Even if you do empty some urine, sit there for a little longer to see if more needs to be emptied. It is common for people with urinary retention (incomplete emptying) to hold a little urine in the bladder even if they feel like they have emptied all of the way. By sitting for a longer period of time and letting themuscles relax, the bladder will have a chance to empty the residual urine, preventing UTIs and the feeling that you need to go again just after you feel like you have already gone.  

By taking these simple steps, you can help to promote a more healthy and happy gastrointestinal system.  

  1. See Below:  
    1. Squatty Potty toilet stool: How toilet posture affects your health 
    2. Toileting Postures Sheet

    If you have any questions or would like further information, please give us a call at PTOSI Roseville Clinic at 651-635-0578 or


Keyla Guenther, DPT