When hikers think of physical therapy, our minds tend to drift toward the type of practitioners who help with the number of issues that may arise with our feet, legs, shoulders, or other joints while on trail. But there’s a branch of physical therapy focused on pelvic floor health that can also help keep us functioning well in some other critical areas.

Dr. Lauren Trosch, PT, DPT, is a pelvic floor physical therapist based in the Washington, D.C. area who spends a fair share of her own time staying active in the outdoors. In this “Pelvic Floor Health for the Trail” mini-series, we’ll be chatting with Dr. Trosch about how you can take care of your pelvic floor health for better experiences with bowel movements and urination in the backcountry. We’ll also talk about some particular tips for how women can readjust to hiking postpartum.

If you’re particularly excited to gather some beta on how to get cleaner wipes and avoid traveler’s constipation on your next backpacking trip, this first post in the series is for you!

Disclaimer: This interview is provided for informational purposes only and does not constitute professional medical advice, diagnosis, or treatment.

Interview With Dr. Lauren Trosch, PT, DPT, on Pelvic Floor Health for Good Trail Poops

We all (hopefully) know to leave no trace when it comes to “number two” on the trail, but might not give much thought to how to ensure smoother moves or gauge whether we’re constipated. But understanding these topics can lead to a cleaner and more comfortable backpacking experience.

Below, we chatted with Dr. Trosch to learn more about the connection between pelvic floor health and pooping—and what we can do to support it.

Gossamer Gear: Before we dive into all things pooping and hiking, can you tell us a little about your work and why you chose this field?

Dr. Trosch: Pelvic pain and problems with peeing, pooping, and sexual function can have a huge impact on some really important aspects of your life—like your relationships, your ability to exercise and stay healthy, and even really basic activities like sitting and standing. These issues can feel embarrassing or shameful, and so many people just suffer with them in silence rather than finding someone to talk to and get help. It’s so rewarding to help people feel more comfortable in their bodies and help them get back to doing the things they love.

Ok, let’s start with the good news. What are some things hikers and backpackers already have working in their favor when it comes to good bowel health on trail?

Exercise and hydration are great ways to stay regular, and most hikers value exercise and know the importance of having a water bottle nearby. So, you all are already off to an amazing start in your pooping journey! 

Plus, squatting down to poop outside is great for your pelvic floor and can make pooping a lot easier! Squatting allows your pelvic floor to relax, which is essential for easy bowel movements. Unfortunately, our toilets are not designed for your best pooping posture, and this is where the Squatty Potty or other bathroom stools come into play. 

When you're not on the trail, you might want to start using a stool under your feet to make pooping easier. As for the size of the stool, it should be just high enough that your knees are slightly above your hips when pooping. Having regular, easy bowel movements off the trail is a great way to prepare for success on the trail!

Now, what is traveler’s constipation and how can it impact hikers?

So many people find it’s harder to go when they’re traveling—we call this traveler’s constipation. Your bowels love a nice routine to stay regular and traveling can really mess that up! This is especially true if you’re not moving, hydrating, and getting the rest you normally would. So, if you’re traveling for a hike, you might notice you’re a little backed up on those first few days.

How can a backpacker tell if they’re experiencing this and how can they best address it if they are? Is it OK to strain a bit for the sake of keeping things moving?

So, if you know you get a little traveler’s constipation, I would encourage you to move and hydrate as much as you can when traveling. If there is something that helps your constipation—prunes, pear juice, smoothies, fiber, or Miralax, for example—make sure you pack them on your trip to keep you going, because I would rather you not just strain one out for the sake of it!

But, why not strain? Hard straining isn’t the best for your pelvic floor and can lead to some problems down the road. So, if you can work on making your poops smooth and soft and get in a good toilet posture, you should be in a better position to have a good bowel movement without straining. Ideally, your stool should be a type 4 on the Bristol stool chart.

Overall, what can backpackers do to best prepare for regular, clean movements in the great outdoors?

First, let's talk about constipation, because being constipated on the trail can be difficult and even messy. Signs of constipation can include having less than three bowel movements a week, straining hard, feeling like you’re not completely emptying, or even needing to wipe 100 times to get clean. 

So, here’s the thing, you can have a bowel movement every day, but if you feel like you’re not emptying and have to wipe a lot, you still may be constipated. If you have to wipe a lot, you’ll need to carry more toilet paper, which is not ideal for backpacking. One of the best ways to manage this is to get on a nice regular bowel routine.

Many people would love to dependably go to the bathroom at around the same time on a daily basis—ideally in the morning before the day gets started. Naturally, many people have the urge to go in the morning (though not everyone), which is great because you can poop in your own toilet before work or before you hit the trail! While many people are morning poopers, it’s okay if you aren’t one—it might mean you’ll have to use a public restroom or poop mid-hike. And that’s okay—we all poop!

But our bodies tend to like a nice routine, which can help to keep you a bit more regular. So, if you want to go more regularly in the morning (or another time of day), try to give yourself enough time to go. When you’re rushing around, you may miss your opportunity to go. 

A warm drink can also be helpful, and many people will get an urge after drinking some coffee. If that doesn’t work, eating food might also create the urge to go. Why does eating help you poop? Getting enough food in your stomach causes a reflex known as the gastrocolic reflex. This reflex causes processed food to move down the colon towards your rectum, which gives you the urge to go. Out with the old, and in with the new! So, you may notice you have the urge to go about 15 minutes after eating. 

Other ways to help keep you nice and regular include consistent exercise, decent water intake, and a good diet. Diets are tricky, and different diets work for different people. A big topic of conversation when it comes to regular pooping is fiber. The recommended doses of fiber are around 21 to 38 grams per day, depending on the person. If you can meet your fiber needs through foods, that’s great! But if you can’t, you can get fiber through Metamucil or other products that have psyllium husk. There are also a whole range of other supplemental fibers you can take, and different ones work for different people. Now, if you start adding too much fiber into your diet too fast, this may cause discomfort and gas, so you may need to increase your fiber gradually. 

Train for Your Next Backpacking Trip By Establishing a Consistent Pooping Routine

For more tips on bowel health and other pelvic floor information, you can follow Dr. Trosch on Instagram and Facebook and learn more about her work on her website.

And, if you’re feeling as inspired as we are for our next smooth move in the backcountry, make sure to grab yourself one of our favorite pooper scoopers, the Deuce Backpacking Trowel. This backpacking trowel is the best ultralight tool you need to get down to business in the backcountry. At a mere 0.45 ounces, it weighs the same as 10 small blueberries. And, as we say, both are great for pooping in the woods!

You can also check out our blog on A Thru-Hiker's Guide to Toilet Paper Substitutes in case you find yourself in need! 

Stay tuned to the Light Feet blog next month for more pelvic floor tips for the trail from Dr. Trosch.