As a pelvic health physiotherapist, I love to talk about the pelvic floor and bladder interaction as it relates to incontinence (refer to my previous posts, “Paediatric Incontinence” and “Pain Down There”). Research has shown that approximately 1 in 5 adults over the age of 20 report some type of lower urinary tract symptom (LUTS)2. A healthy bladder is a main contributor to overall health and LUTS has been linked to decreased quality of life and depression1. That being said, bladder “health” is much more than remaining continent with a cough or sneeze.
Some anatomy background:
Imagine your pelvic floor muscles as a trampoline that attaches from your pubic bone to your tailbone. Sitting on the pelvic floor lays your bladder, uterus and bowels. As your bladder fills up with urine from your kidneys, the pelvic floor naturally tightens up to close the bladder sphincter from releasing its contents. When the bladder is at its full capacity (average is 300-400mL in healthy adults1), a signal is then sent to your brain to release the urine. Once you are in a safe and convenient place, your pelvic floor relaxes to release the bladder sphincter, essentially relieving the urine.
(Pictures taken from Lukacz, E. et al.2)
Sounds pretty simple, right? Unfortunately, these 5 bladder myths may contribute to your less than “smooth” urine flow.
I should go to the bathroom as often as I can
Many people think the more they go to the bathroom, the less they will have accidents or discomfort. In fact, the normal amount to release your bladder is 8 times/day – that means once every 2-3 hours. Going too often may train your brain to send signals to release your bladder prematurely, meaning, next time your bladder fills up just a little you’ll be running to the bathroom with your legs crossed.
I’m drinking less water so I don’t need to go as often
Unless you’re getting up more than once in a night to use the bathroom, limiting your water intake will not improve your bladder habits. Instead, it may actually increase your urine concentration, leading to bladder irritation. Focus on improving your bladder habits and strengthening your pelvic floor while ensuring you are staying fully hydrated.
I do my kegels over the toilet to strengthen my pelvic floor
Abort. Mission. Immediately.
When you are voiding (urine, feces, gas, whatever it is), you should be fully relaxed and comfortable. Stopping-and-starting your urine flow will train your brain to continuously tighten your pelvic floor during voiding, which is the opposite of what your body is trying to do and may add to further bladder irritation.
I’ve always had poor bladder habits as a child
This may be true, but it doesn’t mean you have to accept it as an adult. There are many external behavioral factors that influence our bladder habits, including what we eat and drink, how much sleep we get, smoking and alcohol, etc. It is important to know exactly what is triggering and irritating your bladder.
My personal favourite: It is normal to pee yourself after having children
This may be common but it most definitely is NOT normal. Our pelvic floor experiences a lot of trauma with childbirth and soon after we may notice some urinary incontinence with certain activities. This could be a result of your pelvic floor muscles being too weak or tight and unfortunately, kegels are not always the answer. The sooner you get it checked out, the sooner you can return to your pre-baby state.
Now that you’ve learned a little bit more about having a “healthy” bladder, come see a pelvic health physiotherapist to learn more about what you can do for your own pelvic health!
1- Lukacz, E. et a. A healthy bladder: a consensus statement. International Journal of Clinical Practice. October 2011; 65(10): 1026–1036
2 – Maserejian, et al. Incidence of Lower Urinary Tract Symptoms in a Population-Based Study of Men and Women. Urology. 2013 Sep; 82(3): 560–564.
Sandra Ghaly – Pelvic Floor & Paediatric Physiotherapist
Sandra graduated from Dalhousie University with a Masters degree in Physiotherapy after completing her Bachelor of Kinesiology degree with honours from McMaster University. She has worked with a variety of clientele but has developed a true passion in working with both the paediatric and women’s health populations. Sandra has extensive experience assessing and treating a variety of paediatric conditions and most recently has become certified as a pelvic health physiotherapist. She also has additional training in acupuncture and kinesiotaping. Sandra finds great value in guiding each individual through a tailored rehabilitation program to optimize their function and quality of life.