Bladder Health!
Bladder health is one of the most common conversations I have with the community, clients, friends, and family members! Which is a good thing because bladder health is up there in my list of favorite conversations to have. Why?? Because bladder health is life changing. If you have an “upset” bladder that likes to pee a lot or leaks… that can be VERY isolating and VERY frustrating. The good news is the bladder is super trainable and so are the pelvic floor muscles that support it.
Let’s dive into it.
What is the bladder and how does it work?
The bladder is actually a muscle and like any muscle - it is responsive to input and stretch. As the bladder is filling, it starts to stretch and this stretch is the way the bladder communicates with the central nervous system and the brain. The bladder should tell the brain how full it is and the brain should be in control of telling the bladder when it is appropriate to pee. Once the brain decides it is appropriate to pee, it will send a message to contract the bladder and relax the pelvic floor muscles . Check out this video for a visual on how the bladder works.
Bladder Health
On average we should be be peeing 5-8 times in a 24 hour period.
During the hours we are awake we should be peeing in intervals of around 2-4hours.
During the hours we are asleep, it is considered typical to pee 0-1 times.
We should definitely make sure we SIT on the toilet in order to assist the pelvic floor muscles in their ability to relax.
Think of the pelvic floor muscles as a door. If the door is jammed, and there is a line of people needing to get through the door - it is going to be more difficult than if the door is easy to open and remains open. If the pelvic floor is having a hard time relaxing, it is going to be more difficult for the urine to pass through the urethra and we may find ourselves straining.
You should be peeing for around an 8 Mississippi count.
Making sure we are avoiding constipation.
There is only so much room and if the bladder doesn’t have the space to expand, we may have to empty more frequently.
DO NOT pee JUST IN CASE.
Why? The bladder is very trainable - you could liken it to a toddler. If you give a toddler a lollipop every time they throw a tantrum… the toddler is going to be even more upset if you don’t give them a lollipop. It’s the same idea for the bladder. If you empty your bladder every time you feel an urge to pee - it is going to start to believe that being only partly full is urgent and it will send incorrect urgent messages to the brain. Check out this video for a visual.
Drink water! It is currently recommended to drink around 1/2 your body weight in ounces and 2/3 of this should be in the form of water. The rest can be from your food intake. I always feel this is a good starting point and then we can adjust as needed. If you feel you are drinking water like a fish and still thirsty - I would consider adding electrolytes.
Consider your bladder irritants.
Theories suggest that certain liquids and foods can make the urine more acidic and increase urgency by irritating the bladder. If you start to recognize that you have a trigger with a certain drink or food consider drinking water to help dilute the effects of specific irritants or consider minimizing your intake of the irritant.
Unwanted Symptoms
Oftentimes, when our bladder health is off, it can cause unwanted symptoms.
These are the common symptoms I see:
Not feeling completely empty.
With frequent peeing the bladder, urethra and pelvic floor muscles can become irritated and send incorrect messages - so now peeing never feels satisfying and you are often looking for a bathroom.
Straining to pee.
If there isn’t actually a lot there because of how frequently you pee- it can be difficult to force what little you have out of your bladder.
Spraying during or dribbling after you think you are done.
Leakage with activity or coughing, laughing, sneezing.
When the system is off, the ability of it to maintain continence can decrease.
Pain with peeing.
What to do?
There is actually A LOT we can do to help address these symptoms. Each individual has their own experiences, habits and strategies - addressing and reviewing these is SO SO important. I use different approaches for each person when looking at integration of new strategies and habits (future blog post for sure!). I also believe treating the pelvic floor is important as it is an integral part of the system when it comes to bladder health. The pelvic floor usually falls into one of these three categories underactive, overactive and/or uncoordinated. Our treatment approach may change depending on our evaluation of this muscle group.
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Cheers to a happy bladder!
In health,
Dr. Emma Lengerich
PT, DPT, OCS, CMTPT, Birth Doula
