Toilet position for pooing (feet up, lean forward, breathe out)

How to move

1. Go when you feel the urge, or give yourself unhurried time about 20 minutes after breakfast or a hot drink. Sit fully on the seat rather than hovering.
2. Rest your feet on a low stool so your knees are higher than your hips, with your feet apart.
3. Lean forward and rest your forearms on your thighs, keeping your back long.
4. Let your tummy relax and your waist widen, and let your bottom and pelvic floor go.
5. Breathe out slowly through pursed lips, as if blowing bubbles, to push gently. Some people find a low 'moo' sound helps. Don't hold your breath or strain.
6. If nothing happens after about 5 minutes, get up and come back later rather than sitting and straining.

Form cues

• Knees above hips.
• Lean forward, tummy soft.
• Breathe out; never hold your breath.
• Avoid: straining, pulling your tummy in, or long spells sitting on the toilet.

Practice and cautions

Every time you go, for no more than about 5 minutes at a time: NHS Lothian's pelvic health physiotherapy advice. The trials are mixed: a footstool didn't make simulated emptying easier in 41 people with constipation, and a posture device didn't reduce straining after prolapse surgery in 150 women. A posture device did reduce straining in 52 healthy volunteers, leaning forward helped half of 22 people who couldn't empty, and bowel training with a better position helped 30 care-home residents with dementia go more often.

If you often strain, feel you haven't emptied, need to press around your bottom or vagina or use a finger to help, or leak, see a GP: a pelvic health physiotherapist can help, and biofeedback therapy treats this kind of constipation. Use a stable stool, and grab rails or a toilet frame if your balance is poor. After a birth with stitches, hold a clean pad gently against them as you go. Blood in your poo, or a change in how you poo that isn't normal for you, needs a GP. This is movement education, not an assessment or treatment prescription. Stop for sharp or increasing pain, dizziness, numbness or tingling; seek individual guidance for symptoms, injury or restrictions.