Does your bladder control your life?
Author: Samantha Edwards, Physiotherapist
I want to talk a little bit about the most common symptom I have been seeing in clinic and that is bladder incontinence. Incontinence is the involuntary loss of bladder control. Many people are taught to believe that bladder leakage, especially after having children, is “normal”. While bladder leakage tends to affect people as they get older, it can occur at any age. Seeing a pelvic floor physiotherapist is a great place to start if you are having any signs of incontinence.
I have been back to work as a pelvic floor physiotherapist for a month now and bladder incontinence is affecting about 80% of my current caseload. The majority of these people came in to my office believing that their leakage was “normal”. However, just because a symptom is common, does not make it normal. There are a couple different types of incontinence. To be honest, I could probably write a separate blog post for each type as there is a lot of depth and detail that needs to be covered when it comes to incontinence, but for the sake of this blog I will briefly touch on each.
The first type of bladder incontinence I will talk about is called urge incontinence. Urge incontinence is when you get the urge to void (pee) and you have the matter of minutes to make it to a toilet before losing control of your bladder. As you can imagine, this can be very stressful and embarrassing for people. These people also tend to pee a lot through out the day. You should be peeing no more than 8 times in a 24-hour time span. I have had many clients in the past few weeks reporting that they pee at least once an hour; this is not normal!
The second type of incontinence I’ll speak to is stress incontinence. This is when you leak with a cough, sneeze, or activity such as running or jumping. There are also a few “lucky” people who have mixed incontinence, which consists of both urge and stress. A lot of people assume that if they are leaking it is because they are weak and they need to be doing kegels to strengthen their pelvic floor. However, kegels are not always the answer, in fact, kegels can sometimes make symptoms worse.
Ways to help with urge incontinence
Bladder retraining is a large component of urge incontinence. Not only do you need to retrain your bladder, but you also need to retrain your mind. Bladder retraining looks a little like this: once you feel the urge to go, practice some deep breathing, count backwards by 3’s from 100, anything to distract your mind. Once the urge becomes more tolerable, slowly and calmly walk to the bathroom, if the urge picks back up, start over again, until you can calmly make it to the toilet.
Another helpful strategy is breathing. Breath work is very important in helping with the coordination of your pelvic floor. Pelvic floor physiotherapists want to ensure that you are able to contract and relax your pelvic floor fully, often times this can be achieved through breathing. An example of this breath work is: as you breathe in imagine your pelvic floor relaxing/opening up, as you breathe out imagine your pelvic floor slightly lifting and returning to a closed position. Incorporate this breath work in to your everyday life so it becomes second nature. You will also want to use this breathing technique when you are trying to settle your urge to void.
Ways to help with stress incontinence
The breath work tips described above are still relevant here. The other key components to dealing with stress incontinence come down to muscle tone, control, and coordination. A few tips I give clients if they are experiencing stress incontinence are:
Tip 1. "Pick up a blueberry" right before you feel a sneeze (or cough) coming on. Imagine picking up a blueberry with your urethra and vaginal opening, pick it up and then try to pull it up inside you. This action is called a kegel and it can help brace your pelvic floor for the impact of a cough, sneeze, or jump. However, it is also very important that you “let the blueberry go” afterwards so you are fully relaxing your pelvic floor in order to release some of the tension that may be causing your leakage in the first place.
Tip 2. Try not to cross your legs or curl forward when you sneeze. This increases abdominal pressure and makes it more likely for you to leak! Try sitting/standing tall instead which will help to take pressure off the abdomen/bladder.
Tip 3. Avoid tight clothing around your abdominal area- the less pressure on your abdominal area leads to less pressure in your pelvic floor, which in turn leads to less pressure on your bladder.
Please keep in mind that these are general tips, and this is a general overview/understanding of incontinence. A pelvic floor physiotherapist would tailor these tips/education to your needs based on the findings of your assessment. If you are experiencing any of these symptoms and are not able to gain control of your bladder on your own, please reach out to a pelvic floor physiotherapist for help!
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