Day 1 – Getting Your Bladder On Board
You’re getting ready to head out of the house to run some errands, and figure, “I’d better pee before I head out just in case”. Does this sound familiar? If so, you may want to read on to learn about the daily habits and behaviours that we adopt that can adversely affect our pelvic health.
The bladder and pelvic floor muscles work in harmony to control how we hold and manage urine. The bladder is relaxed much of the time in order to collect urine. While the bladder is relaxed, the pelvic floor muscles are engaged to support the weight of the bladder and to prevent leakage. Once the bladder is full, stretch receptors signal to the brain that it is time to empty, and the bladder begins to contract (imagine a balloon full of air being squeezed). Like a well-timed tango, both partners play their part to make the system work well. But if one of them is off a bit, this can lead to bladder leakage, urgency, pelvic organ prolapse, or other pelvic floor dysfunction.
While bladder leakage is an easy-to-spot signal that our system is not working optimally, there are subtler day-to-day habits that might also be problematic for our pelvic floor and bladder system. Doing “just-in-case” peeing is one such habit. Emptying the bladder at times when we do not have a feeling of bladder fullness circumvents the natural brain-bladder-pelvic floor reflexive system. Drinking too little or too much is another way we might be undermining the system. Getting up a few times a night to pee can affect not only the pelvic floor and bladder system, but also our sleep quality and overall energy levels during the day.
Here are some easy habits you can adopt to optimize your bladder system and safeguard the wellness of your pelvic floor:
1. Avoid doing “Just in case” peeing
Wait for your bladder to feel somewhat full (but not uncomfortably full) before emptying. If you know you will not have access to a washroom for 3-4 hours, you may need to go before your activity or outing, but a healthy bladder and pelvic floor system can usually hold for 3 hours comfortably. Ask yourself, “Do I really have to go, or am I doing a preventative pee?”
2. Ditch the soda…or at least cut back
What we drink matters. If most of your hydration comes in the form of carbonated sodas, coffee, caffeinated tea or citrus juice, you may be irritating the lining of your bladder. Over time, this can lead to feelings of urgent needs to void, even when the bladder isn’t very full. While water is the ideal liquid for optimal bladder functioning, it’s more important to be aware of how our body feels overall and whether we are integrating non-irritating liquids (water, non-dairy and dairy milk, herbal tea) into our day. Most of us have heard that 8-10 glasses of water a day is a good goal for adults to aim for, but if that sounds like a daunting task, try incorporating 1-2 more glasses of water or water-based non-caffeinated beverages into your day. Water underpins many natural biological processes and makes up most of our body – giving our body adequate hydration can increase energy levels, improve body system functions, and even curb hunger.
3. Don’t rush it
Sure, we’re all busy, and peeing isn’t exactly an important item on our daily “to do” list, but if we’re rushing to empty, we may be bothering our pelvic floor muscles more than we realize. A moderately full bladder should empty easily without any straining or pushing on our part. If you find that you push to empty your bladder, STOP IT RIGHT NOW. Imagine a balloon filled with air. Once it’s mostly full and we let go of it, the air rushes out naturally because of the elasticity in the sides of the balloon walls. Similarly, the bladder should empty naturally as well. Pushing to empty the bladder can weaken the pelvic floor muscles over time and even cause the internal organs to descend downwards (pelvic organ prolapse). A healthy bladder will empty well and feel empty after voiding. If you find that you still retain a bit of urine, feel like you need to go soon after emptying, or have any pain or discomfort while peeing, please talk to your doctor and/or see a pelvic physiotherapist – there are things that can be done to address these issues!
4. Get your zzzzs
Sleep is quite possibly as important to optimal health and good nutrition and adequate exercise. Not only is sleep a time for our minds to relax and process the events of the day, it’s also a time for the body to heal, cells to regenerate, muscles to relax, and rhythms to reset. If you find that you are getting up at night to empty your bladder, it’s time to ask yourself why this might be. A healthy bladder should not wake us up in the night. This is assuming, however, that we didn’t guzzle a few glasses of water (or vino) before bed, aren’t taking specific medications that affect bladder habits, aren’t pregnant, or have a pre-existing medical condition that affects the urinary system. Are you waking up because of a noise, a nightmare, a crying baby, or a mysterious thump in the attic? If your first instinct is to go pee, ask yourself if this is because your bladder really feels in need of emptying, or if you’ve made a habit of emptying a night. Night time voiding isn’t necessarily a bad thing, per se, but if it becomes a regular habit, it can disrupt our sleep quality, circumvent that brain-bladder-pelvic floor system we talked about above, and eventually weaken our pelvic floor muscles.
5. Don’t Be a Camel
Camels are cute, furry, and great at surviving in harsh climates with minimal liquids. But in the context of optimal bladder and pelvic health, they might not be the ideal animal to emulate. I refer to my patients who hold their bladder all day long as “camels”. Just as it’s not ideal to go every time we leave the house, see a public washroom, head out to work, or get home from an outing, the opposite is also not great. Holding the bladder contents in all day long can lead to tight pelvic floor muscles (think of carrying a really heavy dumbbell around in your arm all day long). If it’s a matter of not drinking enough, see tip #2 above. In the context of optimizing our systems, emptying every 2-3 hours allows the bladder and pelvic floor muscles to share the load, with neither having to work overly hard.
The Bottom Line:
At the end of the day, it’s more important to listen to your body and become aware of your habits and how they might be optimized. Try gradually incorporating some of the tips above into your regular routine. If you think your bladder system might need a “tune-up”, please bring it up with your family doctor or primary healthcare provider. And as always, pelvic physiotherapy is here to help.