Meet Your Instructor 

Sheree DiBiase PT, PRPC, ICLM Sheree DiBiase is nationally recognized pelvic floor specialist with over 40 years of experience in physical therapy. Her impressive credentials include: ​Pelvic Rehabilitation Practitioner Certification (PRPC) and International Lymphedema Management Certification (ICLM) ​Founder and President of Lake City Physical Therapy with multiple locations across the Northwest ​Former professor at Loma Linda University School of Physical Therapy, where she taught kinesiology and gait training for 7 years ​Creator of the Pelvic Floor Pro App and host of the FemTech Health Podcast ​Board member of APOPS (Academy of Pelvic Organ Prolapse Support) and APP (Academy of Pelvic Health Physical Therapy) ​Sheree specializes in women's health, pelvic floor rehabilitation, oncology care, and sports medicine. Her mission is to empower and educate patients and communities on achieving optimal health and wellness throughout their lifespan.

Course Objective

Upon completion of this course, participants will be able to: Explain the musculoskeletal contributions to chronic constipation, including the role of pelvic floor muscle tension, core dysfunction, and postural alignment Describe the anatomy and function of the external and internal anal sphincters and their relationship to bowel movements Utilize the Bristol Stool Chart and bowel diary tracking to assess patient bowel function and identify patterns of dysfunction Demonstrate manual therapy techniques including bowel massage, ileocecal valve reset, and cupping for bowel stimulation Apply therapeutic exercises to improve pelvic floor mobility, sacral and coccyx movement, and sphincter function Assess and address postural alignment, foot mechanics, and hip power as they relate to pelvic floor function and bowel health Develop individualized home exercise programs incorporating pelvic floor relaxation, breathing techniques, and self-care strategies Educate patients on lifestyle modifications including hydration, fiber intake, scheduling bowel movements, and positioning techniques to optimize bowel function

What to Expect of the Course

MODULE 1: Understanding Constipation & The MSK Connection Content sections: Constipation Statistics & The Core Three: Fluid (8-10 glasses), Fiber (26g), Fitness Musculoskeletal Stiffness Prevents Peristalsis & Bowel Movement External vs. Internal Sphincter Relationship (3-Ring Structure) Sphincter Power Requirements: 30-60 Second Hold Capacity Autonomic Nervous System: Deep Breathing for Rest & Digest Core Fitness Exercises: Lunges, Squats, Trunk Rotation, Pelvic Tilts Anal Sphincter Contractions in Elongated Positions Hemorrhoids vs. Fissures Management MODULE 2: Tracking Your Bowel Health Content sections: Bristol Stool Chart Types 1-7 (Optimal: Types 3-4) Multifactorial Causes: MSK Tightness, Medications, Nervous System How to Use a Bowel Diary: Date, Time, Food, Urgency, Pain, Stool Type The 10% Rule: Ignoring Signals Causes Fecal Matter to Dry & Back Up Creating Consistent Bowel Movement Routines (AM or PM Scheduling) Signal Recognition & Trigger Development Deep Breathing & Rest-Digest Activation (5-5-7 Pattern) Contract-Relax Progressive Muscle Relaxation Technique MODULE 3: How Your Sphincters Work Together Content sections: Three-Ring External Sphincter Structure & Function External Sphincter (Voluntary) Resets Internal Sphincter (Involuntary) Outer Rings: Pain & Temperature Sensitive; Inner Ring: Stretch Sensitive Puborectalis Muscle: The Gatekeeper That Must Relax The Donald Duck Position: Anterior Tilt Opens the Angle Proper Toilet Positioning: Anterior Tilt + Knees In = Gap Posterior Floor Massaging Rectal Pouch & Pulling Cheeks Apart Before Sitting Scheduling BMs & Creating Consistent Signals (Gastro Reflex, Massage, Breathing) Trunk Mobility Exercises: Back Extension, Forward Fold, Rotation, Side Bending MODULE 4: Sphincter Mobility & Gapping Techniques Content sections: Daily Bowel Movements Should Look Log-Like (Bristol Type 3-4) Urogenital Triangle (Front Floor) vs. Posterior Anal Triangle (Rear Floor) Each Sphincter Ring's Fascial Connections: Perineal Body, Sacrum, Pubic Bone Adductor Tightness Creates Sphincter Tension Through Fascial Lines Pelvic Rocking Motion Creates Ring Mobility Rectal Pouch Location & Signaling Mechanism Coccyx (Tailbone) Must Move Out of Way During Bowel Movements No Bearing Down Rule: Rest & Digest Position Required MODULE 5: Sacral & Coccyx Movement for Better Bowel Function Content sections: Coccyx Tilted Forward Blocks Rectal Pouch Emptying Donald Duck Butt (Anterior Tilt) Moves Coccyx Out of the Way Diaphragmatic Breathing While Seated or Standing (5-5-7 Pattern) Seated Pelvic Tilts: Practicing Anterior/Posterior Rocking Gapping Exercises: Side Lunges, Sumo Squats, Child's Pose Hip Flexor Stretches with Trunk Rotation & Side Bending Wide-Leg Hamstring Stretch for Anal Sphincter Work (5 Quick, 10 Hold) Trunk Motion Stimulates Bowel Activity MODULE 6: - Abdominal & Pelvic Massage Techniques Section 6A: The "I Love You" Bowel Massage Always Start in Left Lower Quadrant to Clear Exit Path First Circular Scooping Pattern with Skin Drag (Not Deep Poking) Clear Descending Colon, Then Transverse, Then Ascending Touch Stimulates Smooth Muscle & Soothes Brain into Rest & Digest Combine with Deep Breathing for Best Results Section 6B: Ileocecal Valve Reset Valve Between Small & Large Intestines (Rhythmic 4-Count Beat) Location: Halfway Between Hip Bone & Belly Button, 2 Fingers Down Gentle Finger Pressure Following 4-Count Down & Up Pattern 60-90 Seconds for Complete Reset Do in Relaxed Position with Legs Elevated Section 6C: Cupping for Bowel Stimulation Silicone Cups Create Suction to Lift & Mobilize Skin Follow Bowel Pathway: Left Lower Quadrant First 5-10 Swipes Per Area Along Colon Path Stimulates Smooth Muscle Movement Section 6D: E-Stim for Dyssynergenic Bowel NEMS (Neuromuscular) Mode Stimulates Smooth Muscle Four-Pad Crisscross Setup on Abdomen 20-30 Minute Sessions to Reset Neurological Input Contraindications: Pacemakers, Inner Stim Units MODULE 7: BONUS - Postural Foundations for Bowel Health Section 7A: Foot Alignment & Arch Strength Feet-Out Position = Tighter Posterior Pelvic Floor Hip-Knee-Second Toe Alignment for Optimal Floor Function Towel Scrunch Exercise: 2-3 Minutes Per Foot for Arch Strength Arch Lifts: 30 Reps Keeping Toes Flat Wall Calf Stretches with Trunk Rotation Straight Leg Calf Raises: 20 Reps Daily (Gastroc Muscle) Bent Knee Raises for Soleus Muscle Section 7B: Hip Power & Pelvic Stability Weak Hip Abductors = Overworked Pelvic Floor = Tight Anal Sphincter Tapping Sidewall Muscles to Wake Them Up (8-10 Count) Hip Rotations: In & Out to Control Posterior Floor Side-Lying Exercises: Leg Lifts, Clams, Rotations Hip Scour Motion for Joint Mobility & Lubrication Single Leg Heel Raises: Building Power for Stability Stretches: Crossover, Piriformis, Pigeon Position MODULE 8: Your Complete Pelvic Floor Relaxation Routine Content sections: Jaw Tension = Floor Tension (Same Tissue from Oral Pharynx to Anal Sphincter) Diaphragmatic Breathing: Inhale 5, Hold 5, Exhale 7 Knee-to-Chest Stretches & Wide-Leg Butterfly for Posterior Floor Eye Tracking Exercises for Neural Regulation & Rest-Digest Hamstring & Sciatic Nerve Stretches with Foot Pumps Piriformis & Crossover Stretches for Buttocks Release Low Trunk Rotation with Feet Apart for Hip Mobilization Pelvic Tilts with Leg Extension: Anterior & Posterior Rocking What Must Move for BMs: Posterior Floor, Lumbosacral Area, Hips

Course Curriculum

9 Chapters · 13 Lessons

  1. 1

    Understanding Constipation & The MSK Connection

    1. Video Free preview
  2. 2

    Tracking Your Bowel Health

    1. (Included in full purchase)

      Video

  3. 3

    How Your Sphincters Work Together

    1. (Included in full purchase)

      Video

  4. 4

    Sphincter Mobility & Gapping Techniques

    1. (Included in full purchase)

      Video

  5. 5

    Sacral & Coccyx Movement for Better Bowel Function

    1. (Included in full purchase)

      Video

  6. 6

    Bowel Abdomino-Pelvic Techniques

    1. (Included in full purchase)

      The "I Love You" Bowel Massage

    2. (Included in full purchase)

      Ileocecal Valve Reset

    3. (Included in full purchase)

      Cupping for Bowel Stimulation

    4. (Included in full purchase)

      E-Stim for Dyssynergenic Bowel

  7. 7

    Postural Alignment Hip Power and Mobility

    1. (Included in full purchase)

      Foot Alignment & Arch Strength

    2. (Included in full purchase)

      Hip Power & Pelvic Stability

  8. 8

    Your Complete Pelvic Floor Relaxation Routine

    1. (Included in full purchase)

      Video

  9. 9

    Course Evaluation

    1. (Included in full purchase)

      Course Evaluation Form

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