A pressure injury (PrI) compromises quality of life and can be life-threatening. The fundamental cause of PrIs is sustained deformations in weight-bearing soft tissues, e.g., during prolonged sitting on inadequate surfaces such as a toilet seat. In nursing homes and geriatric facilities, patients need assistance using the restroom, and patients being left on the toilet for tens-of-minutes is a real-world scenario, unfortunately. Nevertheless, there are no published studies regarding sustained tissue loads during toilet sitting and their effects on tissue physiology. Here, the biomechanical and microcirculatory responses of the buttock tissues to toilet sitting were investigated using finite element modeling and cutaneous hemodynamic measurements, to explore the potential etiology of PrIs occurring on the toilet. We found that prolonged sitting on toilet seats involves a potential risk for PrI development, the extent of which is affected by the seat design. Additionally, we found that specialized toilet seat cushions are able to reduce this risk, by lowering instantaneous tissue exposures to internal stresses (by up to 88%) and maintaining reduced interface pressures. Furthermore, hemodynamic variables were altered during the toilet sitting; in particular, tcPO2 was decreased by 49% ± 7% (44 ± 2[mmHg] to 22 ± 4[mmHg]) during sitting. The current study confirms that investing in expensive PrI prevention (PIP) products is likely to be ineffective for an immobilized patient who is left to sit on a bare toilet seat for long times. This argument highlights the need for a holistic-care approach, employing PIP devices that span across the entire environment where bodyweight forces apply to tissues.
Keywords: Computational modeling; Pressure injury; Sitting-acquired pressure ulcer; Toilet seat; Transcutaneous oxygen tension.
By Heather Jabornik
For some of us, our time on the toilet is a sanctuary. A special place for us to be completely alone. A time for us to relax unwind and take a deep breathe (especially if you spritzed the bowl with Poo~Pourri first).
It's easy to lose track of time and suddenly realize you've been sitting on the pot for almost an hour getting lost on the internet. You finish up your business and stand only to realize you now have the walking capabilities of a newborn deer.
Your tranquil toilet time has quickly turned and your legs have betrayed you.
So, what causes this crazy phenomenon? We spoke to a couple of doctors and got the scoop on why your legs fall asleep sometimes when you poop.
Knowing is half the battle and the first thing you should know is that this is not serious—unless of course you’re experiencing persistent numbness. Then it’s time to ring your doctor.
To explain the pooping pins and needles phenomenon so many of us know so well, Dr. Karen Bisesi, Doctor of Chiropractic at Indy Sports Chiro in Carmel, IN says:
“When you bear down to poop, you raise the pressure in your spinal column, technically called the intrathecal pressure. Sometimes that rise in pressure will cause the discs in your spine to move against the nerves where they exit the spine and cause numbness, weakness, and a generally weird feeling down the legs. Another reason not to strain too much when going #2!”
Another reason indeed! Also, try saying “intrathecal pressure” three times fast!
Dr. Lauren Vreeland, Doctor of Naturopathy at Newport Integrative Health in Costa Mesa, CA agrees.
“Sitting in the same position long enough can cause nerves or blood vessels to be compressed, leading to the ‘falling asleep’ sensation, or numbness and tingling in the legs.
Why does it happen on the toilet? The way you sit on the toilet may not be ideal, and an awkward position or bend in the legs can make nerve compression more likely.”
If only there was such a thing as Toilet Yoga! ...Oh wait.
Now that we know WHY your legs turn into wet noodles, here are some ways to prevent losing feeling in your lower extremities.
Change position
Just like you’d naturally shift positions if any other part of your body began to fall asleep, the same rule applies here.
Changing positions during #2 is your numero uno line of defense.
Go faster
You’ve heard the expression “shit or get off the pot” about decision making? Make the decision to say no to latrine lollygagging.
We’re looking at you, toilet techies. Save the scroll and spin the roll.
Healthy bowel movements should happen fairly quickly and effortlessly. Having to sit for an extended period of time or straining are both signs your digestion is not functioning optimally. Diet and exercise can go a long way in improving regularity and stool quality.
Have a feeling it’s more physical? Take Dr. Vreeland’s advice and look at your diet. There are best and worst foods for digestion.
Fair warning: booze and chocolate are on the ‘worst’ list.
Accessorize
Two words: poop cushion.
Sounds luxurious, doesn’t it? Toilet seat cushions even come in gel! It’s like you’re pooping in the future.
Alexa, add poop cushion to my shopping list
Next time you turn to the toilet for your me time, remember to keep it short and sweet. Unless you like the feeling of pins and needles.
Satish S.C. Rao, M.D., Ph.D., is a professor of medicine at the Medical College of Georgia and the director of the Digestive Health Center at Augusta University.
The bathroom is one place where it doesn’t pay to take your time.
Case in point: Ever notice that your foot or leg falls asleep when you’re trying to take care of business?
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That “pins and needles” feeling occurs simply because you’re sitting there too long—and in a non-ideal position.
Related: Are You Pooping All Wrong?
When most people sit on the toilet, they tend to hunch forward. That’s not good for pooping, since it makes it more difficult to release your waste, causing you to you strain more.
That hunched position is bad for the nerves in your pelvis, too.
It can compress the nerves, which hinders blood flow to them. Those nerves run all the way down to your feet, so that poor blood flow can lead to tingling in your lower extremities.
Sitting on the toilet in this position for 10 to 15 minutes is enough to start making many guys feel pins and needles.
Related: Why You Should Never Sit On the Toilet For Longer Than 15 Minutes
Your feet are even more likely to fall asleep if you’re a skinny guy.
That’s because body fat cushions the blood vessels in your legs, preventing them from getting compressed when you sit. But if you don’t have that cushioning, your blood vessels can get compressed, causing another problem to blood flow—and ultimately, tingling feet.
In most cases, experiencing pins and needles on the john is nothing to worry about. (If you feel persistent numbness or tingling in your hands or feet during other times, see your doctor.)
Related: Can You Die From Pooping?
You can, however, try to prevent it from happening: Buy something called an air doughnut, an inflatable device that can give your butt more cushion, improving blood flow to your feet.
Still, that’s not giving you a green light to camp out on the toilet: Spending too much time there—particularly if you’re straining to go—can lead to unpleasant conditions like hemorrhoids, bleeding, or even a tear in your lower rectum called an anal fissure.
So if you’re not accomplishing your goal after 10 to 15 minutes, leave the bathroom and try again later.
Information by Satish S.C. Rao, M.D., Ph.D.
For nearly 10 years, Christa has created health, fitness, nutrition, and wellness content that’s steeped in science but engaging enough that people actually want to read it. She’s tuned in to all the latest research that people with an athletic lifestyle need to know, and prides herself on helping her readers apply it to their everyday lives.