Tummy massage for constipation (abdominal massage)

How to move

1. Lie on your back with your knees bent and a pillow under your head, or sit back in a comfortable chair. You can massage over thin clothes, or on bare skin with a little oil.
2. With one hand on top of the other, stroke the lower part of your tummy upwards, working from your right side to your left.
3. Circle your whole tummy slowly clockwise, around your belly button.
4. Stroke from your right groin up to the level of your belly button, across to the left, and down to your left groin: up, across and down.
5. Follow the same up, across and down path with your fingertips or knuckles, in small clockwise circles.
6. Finish by resting your warm hands on your tummy, with gentle pressure, for about 20 seconds, breathing slowly.

Form cues

• Clockwise: up your right side, across the top, down your left.
• Start gently: it should never hurt.
• Keep breathing slowly and let your tummy go soft.
• Avoid: pressing hard, or massaging over a hernia, a scar or a stoma.

Practice and cautions

Each step 3 to 4 times, when you're most likely to need the toilet, such as after food and drink, or the night before: the dose in NHS Lothian's pelvic health physiotherapy booklet. An NHS continence service in Leeds describes 10 to 20 minutes. Trials ran for 4 to 8 weeks: two used daily massage, and one used 10 minutes 3 times a week for 4 weeks. Our starting point is about 10 minutes once a day; give it about 4 weeks before you judge it.

Don't use tummy massage if you're pregnant, have any hernia in your tummy, have had recent tummy surgery or have recent scars, have cancer, a growth in your tummy or a past bowel blockage caused by cancer, have Crohn's disease or ulcerative colitis, have irritable bowel syndrome (IBS) with a 'spastic colon', or have an unstable spinal injury: NHS Lothian's list. Stop if it hurts. It adds to fibre, fluids and any laxatives you've been advised to take, and doesn't replace them: in trials it didn't reduce laxative use, and you shouldn't stop a prescribed medicine yourself. Call 999 (911 in the US) for severe tummy pain with vomiting or a swollen tummy, or if you can't poo or fart at all. 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.