Los Altos, CA
Millions of women – and men! – in the U.S. suffer daily from bladder problems that hold them back. It may be a small (or not so small) leak of urine when you cough, sneeze, laugh, jump, or lift something heavy. Or maybe it’s the need to go so frequently that you avoid going to certain places where a restroom won’t be conveniently available or you won’t know where it is. It may even mean losing precious sleep due to your bladder waking you up repeatedly during the night. For some people, there is even discomfort or pain when the bladder is filling up. In any of these situations, life is no fun with a “weak bladder.”
But is it really true that you simply have a weak or small bladder? I hear this quite often – usually from women, lamenting their “small bladder” that they share with their mother, aunt, or even best friend. The truth is that the vast majority of people’s bladders are actually quite similar in size and capacity. What can be different from one person to the next, is how well it functions to do its job – being able to fill and store urine and hold it even under pressure without leaking! There are many reasons for this difference, including, of course, pelvic floor and abdominal muscle health, as well as overall health and physical condition. But what you may not know is that what can really vary a lot from one person to the next and lead to such different bladder problems or behaviors are also bathroom habits!
“What do you mean?” I hear you say. “Doesn’t everyone just go to the bathroom the same way?” Not by a long shot! And new evidence suggests that the following restroom practices are likely to lead to trouble down the road. Here they are, and what to do instead to avoid bladder problems:
- Convenience Voiding – Also aptly named, going “just in case.” You know about this one. This is when you use a restroom just because you see that it’s there, or at a certain time or place, “just in case” you will not have the opportunity to do so in the next hour/ stop/ meeting, etc. While it’s okay to do this once in a while when you really know that you won’t have access to a toilet for quite some time, going at each and every opportunity can make your bladder more sensitive, and train it not to be able to do its job, which is to fill and store urine.
- Delayed Voiding – This is just the opposite of the last one, and it means waiting too long to empty your bladder once you need to. People do this for many reasons – often because they are working, visiting with someone, driving long distances, or simply because they do are not comfortable with the restroom that is available. Doing this too often for long periods of time can not only increase the risk of urinary tract infections (UTIs), it can be more likely that you will have a leak if you sneeze or laugh, if your pelvic floor muscles are not up to the task.
- Strained Voiding – This is what I affectionately call “power peeing,” or pushing out your urine. People with this bladder problem usually do this either because they are having difficulty emptying their bladder fully, or they think they are not emptying it because they often have to urinate again so soon (a whole other topic for another time), or simply because they are in a hurry to finish in the restroom and get back to whatever they were doing. Either way, this is not a healthy practice. It can lead to weakened pelvic muscles, and pelvic pain or can worsen pelvic organ prolapse. So when you need to urinate, make sure to simply relax your pelvic muscles and let your bladder empty itself at its own pace. If you feel that there is a problem and it’s not doing so normally, that’s a sign to ask for help from your pelvic health physical therapist or another medical professional.
- “Hovering” over the toilet – This one is for women, and mainly occurs in public restrooms. As many as 24% of women report not sitting all the way down on the toilet when urinating in a public restroom. This is a problem for healthy urination since your pelvic floor muscles have a very hard time relaxing when you are in a partial squat hovering over the toilet. When you urinate with your pelvic muscles still contracting like this, you are more likely to have to strain, and will not be able to empty your bladder as fully as when you sit down and relax. Understandably, some public toilets are not well maintained and may be unsanitary or unsafe to sit on. But thankfully, this is the minority of cases in modern America. If you still have doubts or are squeamish to sit on a seat where a stranger’s bottom has just sat, then put down the paper seat cover provided – or line the seat with toilet paper – and then please, sit all the way down and let the relaxation of your pelvic muscles tell your bladder that it’s now time to empty!
If you have any concerns about your bladder function or questions that have not been adequately answered for you so far, just reach out to us for a courtesy phone consultation by calling (650) 947-8500. We’re here to get you back to you running your life, not your bladder problems!
Kim Gladfelter, MPT, OCS, FAAOMPT Kim Gladfelter is a physical therapist, Pilates instructor, educator, author, and co-founder of PhysioFit Physical Therapy & Wellness. She is known as a keen, well-rounded expert of healing through movement and women’s health specialist in the Silicon Valley area. Kim has helped men and women of all ages to stay active and feel their best. She also writes about managing pain in her health columns, blogs and the local Los Altos Town Crier newspaper as well as reaches out to the local community, support groups, schools, libraries, and sports centers to advise and educate on body awareness and therapeutic exercise.
ABOUT THE AUTHOR
Women's Health Physical Therapy Specialist at PhysioFit Physical Therapy & Wellness