Keeping your bladder happy, healthy, and functioning!

By Dr. Brooke Meinema PT, DPT, FAFS

November is bladder health month, which means it’s time to talk about our bladder habits! It is estimated that 1 in 3 women suffer from some form of incontinence. While this is clearly a very common issue, it should by no means be considered normal. There are things that can be done to address bladder control and bladder health.

What is urinary incontinence?

Urinary incontinence is the loss of urine beyond our control. There can be a number of different causes for this:

• Stress incontinence: when we lose urine due to increases in pressure.
  • Examples of this may include coughing, sneezing, jumping, etc
• Urge incontinence: the loss of urine due to thoughts of needing to use the bathroom or the sudden urge to go.
  • Examples of this could be when we are trying to undo the button on our pants, pulling in to the driveway and having a sudden urge to pee, leaking while waiting in line to use the bathroom, etc
• Mixed incontinence: leaking due to the combination of both stress and urge incontinence
• Overflow incontinence: leaking just after urinating due to the bladder not fully emptying
• Neurogenic incontinence (not pictured): a miscommunication between the bladder and our system leading to leaks

  

What can I do if I have incontinence?

Knowing the different kinds of incontinence and their specific triggers can help us create a plan to address the leaking. We also should know a little bit about the bladder and what we can do to keep it happy and healthy.

• Stay hydrated! I know it can seem counterintuitive to put MORE fluid into your bladder if you are having problems with leaking, but hear me out. One reason for staying                  hydrated is the dry plant analogy: if you water a plant that is really dry, the water pours right out of the bottom and doesn’t absorb into the soil/roots; the same principle applies to our bladder. The tissue in the bladder has a hard time absorbing the fluid to hydrate itself if it is too dry to begin with causing an increase in chances of leaking. Also, the less hydration we have, the more concentrated our urine becomes. The darker yellow urine is more concentrated and acidic, which can agitate the bladder and cause it to want to force the fluid out, making us need to use the bathroom more often. Staying hydrated is less irritating on the tissue in the bladder making it able to hold urine longer without as much problem.
• Consuming irritating foods and drinks. Things such as acidic foods, caffeine, carbonated drinks, alcohol, citrus, and many others (I know, most of the fun things we like to eat and drink), can lead to irritation in the lining of the bladder effectively making it harder for it to hold in urine. Reducing intake of some of these can help our bladders function optimally.
• Understanding pressure management. This applies mostly for stress and mixed incontinence, but is also an important note for those suffering with other issues such as prolapse. Increases in abdominal pressure can lead to an increase in downward pressure, making it harder for our body to support our bladder, leading to leaks. (See previous blog addressing breathing and pressure management for further information on this topic).
• Prevent constipation. Chronic constipation and straining with bowel movements can lead to strain and dysfunction of the pelvic floor. This can increase issues with incontinence.
• Keep your pelvic floor muscles strong and coordinated. The pelvic floor muscles are a support system for your bladder. If these muscles get weak, you may experience leaks. A pelvic floor physical therapist can help with this.
• Stop “just in case” peeing! Training your bladder to void “just in case” teaches it to create the urge to go at the slightest increase in fluid. If you are going for a long car ride, going to bed, or after intercourse, then peeing “just in case” is more than ok, but if you are just going out of fear or for the sake of going, that can lead to further dysfunction.
• Reduce tension. Too tight of muscles in your pelvic floor can lead to further leaking. I know this seems backwards, but if the muscles are constantly tense, they aren’t able to take on more work. Take this analogy for an example: imagine you are carrying a heavy box around all of the time, and some puts more weight on it. What happens? You drop the box because your arms give out from the weight because they are already tired and couldn’t take more stress. The same the can happen to your pelvic floor: if the muscles are constantly tense and tight, the added weight and pressure from fluid entering your bladder can make the muscles give and, whoosh, the dam is broken. In this instance, you wouldn’t want to do kegels and try to squeeze harder, those muscles need a break!

What can I expect from physical therapy?

A pelvic floor physical therapist is a great resource to help you determine what your body needs to stop struggling with incontinence. We can develop a program specific for your needs. This may include working to increase strength as needed, improving coordination with breathing and pressure management, and also assessing for pelvic floor tension and dysfunction.

For a free 10-minute consultation, visit us at https://imovedaily.com/womens-health/ and fill out the form to contact a Women’s Health Physical Therapist and schedule your consultation.