My mom lives in a community designed for people age 55 and older. We love going to visit her because the area is packed with activities the children can do from swimming, to pickleball, to golf. There’s a fun playground on the property along with walking trails, lakes for fishing, and some sort of celebration for every holiday on the calendar.
Because the community is geared towards seniors, all of the houses are built with accessibility in mind. For the senior in the housing market, this is ideal because it means she can purchase a home at 55 that will allow her to remain at home as long as possible. There are no stairs, all of the doors have levers for handles in lieu of knobs, and all of the walking surfaces are stable and firm.
Then there are the toilets.
Oh, the toilets.
At home, I use a Squatty Potty. Sound silly? Whatever. It rocks my world.
There are mechanical reasons that it rocks my world and if you are interested in the science behind the potty, you can read up here. But it comes down to this: the more hip flexion a person uses when defecating, the straighter the anorectal canal will be. The straighter the anorectal canal is, the less force the person has to exert while toileting.
The toilets at my mom’s are the polar opposite of the Squatty Potty. Because my dad has limited mobility, she has wheelchair accessible toilets. Now, I didn’t measure mom’s toilets, but I am assuming they fall somewhere between 17″ to 19″ above the finished floor, because that’s what the Americans with Disabilities Act requires of wheelchair accessible toilets.
What I do know, and what is relevant here, is that I am 5’3″ tall, and when I sit on her toilets, my feet don’t touch the ground.
Now, ask any mom who has toilet trained a small child and she will tell you that children have a lot more troubles on the potty when their feet dangle. Quickly google “feet on the floor” and “potty training” and you are likely to read advice like this from Children’s Health Network:
Buy a floor-level type potty chair. You want your child’s feet to touch the floor when he sits on the potty. This provides leverage for pushing and a sense of security.
When I am at mom’s, I have neither leverage, nor a sense of security.
But there’s a larger issue at play here because it’s not just my dad who is using wheelchair accessible toilets. When Mom and Dad leave that house, another couple will move in and while they may start out with special needs in the mobility area, chances are they won’t.
All over the world except in places like the United States, people squat to toilet. There exist people who from the earliest age of mobility to the end of life use deep hip, knee and ankle flexion multiple times a day. They can do it because they do do it.
(If you just laughed, you might have the mind of a seven-year old.)
In Move Your DNA, biomechanist Katy Bowman writes about a conversation she had with a physical therapist worried about the contraindications to squatting in her client population. Katy explains:
‘…(S)quatting is a non-negotiable ingredient to improving issues with the gut, pelvis, hips, and knees.’ The problem, you see, is not the squat but that we haven’t squatted – for the bulk of our lives.”
Move Your DNA, page 193
Later, she writes:
Squatting to go to the bathroom is so crucial to pelvic health, some pelvic restoration protocols now include it in their therapeutic protocol for those with digestive and pelvic floor issues. May I suggest that we include it in our preventive model as well?
Move Your DNA, page 194
But Katy’s not talking about going to the gym to do your squats:
The way we’ve come to erroneously equate fitness with health has interfered with our understanding of the body’s dependency on specific loads. Maybe you got your workout in, but what about the loads you created the rest of the day?
Move Your DNA, page 39
What if, for example, you dutifully went to your exercise class where you performed a movement called a “squat,” let’s say twenty-four times, but then you spent the rest of your day sitting in a car? Or at a desk?
And then, what if, when your body needed to squat the most – while toileting – instead of engaging in that deep joint flexion, you propped yourself up on a little tower of porcelain and let your feet dangle below?
What bothers me most about the toilets at my mom’s house isn’t that they are uncomfortable for me to use. It’s that they’re being used by a population that is already losing mobility at a rapid pace. These toilets are encouraging women to further avoid positions that can help preserve their range of motion.
It’s a chicken and egg problem, though, right? People have to use the toilet, and these taller toilets are the ones that people with limited hip range of motion can use.
But if you pull away for a second and look at a higher level of abstraction, you start to see all of these ways that we accommodate our lack of mobility. And the more we accommodate this lack of mobility that we have crafted by living our modern lives, the LESS mobile we will become.
This is a long post, so I’ll stop here. Expect to see more from me in the future about the objects around us that limit our ranges of motion and minimize much-needed activity.
I’ll close with this pearl of wisdom, again from Move Your DNA, because I think it frames the issue nicely:
Imagine your body is made of clay, with each type and frequency of movement shaping the physical outcome.
Move Your DNA, pages 33-34
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Katy Bowman’s Move Your DNA is available at major booksellers and also via my Marketplace here.
Move Your DNA is also available in audiobook form at audible.com here, so you can “read” while you walk.