Managing Gastroparesis with Physical Therapy: Techniques and Tips

By Dr. Zarina Vitebsky, DPT, MSPT, PRPC, TPS, LPF, DN on 10/18/2023

Clip Art of a Pelvic Floor Patient's Gastroparesis


Explanation of Gastroparesis

Gastroparesis is a medical condition that affects the stomach muscles and causes delayed emptying of food from the stomach into the small intestine. This can lead to a variety of symptoms such as nausea, vomiting, bloating, and abdominal pain. It is often caused by damage to the vagus nerve, which controls the movement of food through the digestive tract.

Importance of Physical Therapy in Managing Gastroparesis

Physical therapy plays a crucial role in managing gastroparesis as it focuses on improving the function of the stomach muscles and promoting better digestion. It can also help alleviate symptoms such as bloating and abdominal pain by improving muscle strength and coordination in the abdominal area. Additionally, physical therapy can also address any underlying issues that may be contributing to gastroparesis, such as poor posture or muscle imbalances.

Understanding Gastroparesis

Definition and Causes of Gastroparesis

Gastroparesis is a medical condition that affects the stomach's ability to properly empty its contents into the small intestine. This can be caused by damage to the vagus nerve, which controls the movement of food through the digestive tract, or by damage to the muscles in the stomach. Other potential causes include diabetes, viral infections, and certain medications.

Symptoms and Complications

The most common symptom of gastroparesis is delayed stomach emptying, which can lead to a variety of other symptoms such as nausea, vomiting, bloating, and abdominal pain. In severe cases, gastroparesis can also cause malnutrition, dehydration, and blood sugar fluctuations in individuals with diabetes.

Diagnosis and Treatment Options

Diagnosis of gastroparesis typically involves a physical exam, medical history, and various tests such as gastric emptying studies and imaging tests. Treatment options for gastroparesis may include dietary changes, medication, and in some cases, surgery. Physical therapy can also play a crucial role in managing gastroparesis by improving stomach muscle function and promoting proper digestion.

Role of Physical Therapy in Gastroparesis

Explanation of Physical Therapy

Physical therapy is a form of treatment that focuses on improving mobility, function, and quality of life through exercises, stretches, and other techniques. It is often used to help individuals with chronic conditions, such as gastroparesis, manage their symptoms and improve their overall health.

Benefits of Physical Therapy for Gastroparesis

Physical therapy can provide numerous benefits for individuals with gastroparesis, including:

  • Improved digestion: Physical therapy techniques, such as abdominal massage and diaphragmatic breathing, can help stimulate the digestive system and improve the movement of food through the digestive tract.

  • Pain relief: Gastroparesis can cause abdominal pain and discomfort, and physical therapy can help alleviate these symptoms through targeted exercises and stretches.

  • Improved muscle strength and flexibility: Gastroparesis can lead to muscle weakness and stiffness, but physical therapy can help improve muscle strength and flexibility, making it easier to perform daily activities.

  • Reduced nausea and vomiting: Physical therapy techniques, such as postural drainage and positioning, can help reduce nausea and vomiting associated with gastroparesis.

  • Improved overall health: By addressing the physical symptoms of gastroparesis, physical therapy can help improve an individual's overall health and well-being.

Types of Physical Therapy Techniques Used

There are several types of physical therapy techniques that may be used to help manage gastroparesis, including:

  • Abdominal massage: This involves gentle massage of the abdomen to help stimulate digestion and relieve abdominal pain and discomfort.

  • Diaphragmatic breathing: This technique focuses on deep breathing exercises to help improve digestion and reduce stress and anxiety.

  • Postural drainage and positioning: These techniques involve specific body positions to help improve digestion and reduce nausea and vomiting.

  • Stretching exercises: These exercises can help improve muscle flexibility and reduce muscle stiffness and pain.

  • Strengthening exercises: These exercises target specific muscle groups to help improve muscle strength and function.

Preparing for Physical Therapy

Initial assessment by a physical therapist

Before starting physical therapy for gastroparesis, it is important to undergo an initial assessment by a physical therapist. This assessment will involve a thorough evaluation of your medical history, symptoms, and current level of physical functioning. The physical therapist may also perform tests and measurements to assess your strength, flexibility, and range of motion. This assessment will help the physical therapist develop a personalized treatment plan for your specific needs.

Setting realistic goals

During the initial assessment, the physical therapist will work with you to set realistic goals for your physical therapy. These goals should be specific, measurable, achievable, relevant, and time-bound. This means that they should be clear and specific, able to be tracked and measured, within your capabilities, relevant to your condition, and have a specific timeline for achievement. Setting realistic goals will help you stay motivated and focused during your physical therapy sessions.

Understanding the treatment plan

Once the initial assessment is complete and goals have been set, the physical therapist will develop a treatment plan tailored to your individual needs. This plan may include a combination of exercises, manual therapy, and education on lifestyle modifications. It is important to fully understand your treatment plan and ask any questions you may have. This will ensure that you are able to follow the plan effectively and get the most out of your physical therapy sessions.

Physical Therapy Techniques for Gastroparesis

Breathing Exercises

Breathing exercises can help improve digestion and reduce symptoms of gastroparesis. These exercises focus on diaphragmatic breathing, which involves deep, slow breaths that expand the stomach and diaphragm. This can help stimulate the digestive system and improve motility. Breathing exercises can also help reduce stress and anxiety, which can worsen symptoms of gastroparesis.

Postural Training

Postural training involves learning how to sit, stand, and move in ways that can improve digestion and reduce symptoms of gastroparesis. This may include avoiding slouching or hunching over, as these positions can put pressure on the stomach and slow down digestion. A physical therapist can teach proper postural techniques and provide exercises to strengthen core muscles and improve posture.

Abdominal Massage

Abdominal massage can help stimulate the digestive system and improve motility in individuals with gastroparesis. This technique involves gentle, circular motions on the abdomen to help move food through the digestive tract. A physical therapist can teach individuals how to perform self-massage or may perform the massage themselves during therapy sessions.

Relaxation Techniques

Stress and anxiety can worsen symptoms of gastroparesis, so learning relaxation techniques can be beneficial for managing the condition. These techniques may include deep breathing, progressive muscle relaxation, or guided imagery. A physical therapist can teach these techniques and help individuals incorporate them into their daily routine to reduce stress and improve digestion.

Strengthening Exercises

Strengthening exercises can help improve overall muscle strength and function, including the muscles involved in digestion. This can help improve motility and reduce symptoms of gastroparesis. A physical therapist can create an individualized exercise program that targets specific muscle groups and gradually increases in intensity.

Stretching Exercises

Tight muscles in the abdomen and pelvic area can contribute to symptoms of gastroparesis. Stretching exercises can help alleviate tension and improve flexibility in these muscles, which can improve digestion and reduce discomfort. A physical therapist can teach specific stretches and provide guidance on how to safely perform them.

Incorporating Physical Therapy into Daily Life

Importance of consistency in physical therapy

Consistency is key when it comes to physical therapy for gastroparesis. This condition requires ongoing treatment and management, and skipping sessions or exercises can hinder progress. It is important to stick to a regular schedule and attend all physical therapy appointments to see the best results.

Tips for incorporating physical therapy into daily routine

Incorporating physical therapy into your daily routine can help make it a habit and ensure that you are consistently working towards managing your gastroparesis. Some tips for doing so include setting a specific time each day for your exercises, finding a comfortable and quiet space to do them, and incorporating them into other daily activities such as watching TV or listening to music.

Tracking progress and making adjustments

It is important to track your progress in physical therapy for gastroparesis to see how your body is responding to the treatment. This can help you and your physical therapist make any necessary adjustments to your exercises or treatment plan. Keeping a journal or using a tracking app can be helpful in monitoring your progress.

Collaboration with healthcare team

Physical therapy for gastroparesis should be done in collaboration with your healthcare team. This includes your physical therapist, as well as your primary care physician and any other specialists involved in your treatment. They can work together to create a comprehensive treatment plan that addresses all aspects of your condition and ensures the best possible outcomes.

If you are experiencing pelvic floor dysfunctions associated with the issues above, please reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at

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