Peeing all the time? Take back control of your bladder!

“I think I have a small bladder” 

“As soon as I drink anything I feel like I have to pee”

“I pee just in case before going anywhere”

I hear this all the time from my patients. If this sounds like you (or someone you know) and you want to take back control of your bladder, URINE for a treat! 

So what’s normal when it comes to peeing?

🤏 There’s no such thing as a small bladder. A healthy adult bladder has the capacity to hold 16 oz of fluid and is designed to s-t-r-e-t-c-h as it fills. This stretch also communicates to the brain giving us: a mild urgency signal when filling has reached 4-6 oz, a moderate signal at 7-10 oz, and a strong signal at 11+ oz.

🥤 7-10 oz of urine per bathroom trip is ideal. This helps to maintain optimal bladder stretch/flexibility AND because this amount helps train the pelvic floor to maintain adequate strength and endurance to hold that amount of urine while doing other activities.

🕑 2-4 hours between bathroom trips is ideal. When the brain, bladder and pelvic floor are working well as a team we have time to plan appropriately for bathroom breaks when they are actually needed as opposed to going just in case (more on this below).

What can disrupt the brain - bladder - pelvic floor team?

🚽 Peeing just in case. This learned behavior may have been: modeled or encouraged by friends & family growing up, a product of taking more bathroom "breaks" while working more from home or a habit you started to try to decrease the urge. BUT when you frequently pee just in case or at the slightest urge to urinate, the bladder looses its ability to s-t-r-e-t-c-h and starts to signal to the brain that it’s full prematurely. This also deconditions your pelvic floor because it gets used to holding less weight (liquid in your bladder) over time, making you need to go even more. See my 30s Explainer.

🪑 Weak or tight pelvic floor muscles. Sitting too much, a lack of regular activity, weak hip muscles, and pregnancy/postpartum changes can all wreak havoc on the pelvic floor muscles. When the pelvic floor doesn’t have the right amount of strength it can't hold the extra weight of a filling bladder. When the pelvic floor is too tight (stuck in a contracted position) it can’t respond appropriately either. Both of these situations will result in leaks, frequent sensations of urgency, or incomplete emptying. 

How do I get back to normal?

🧠 Train your brain, bladder & pelvic floor. Keep a bladder diary (this is what I use with my patients) for 2-3 days to bring awareness to your habits. You might be surprised by what you learn! Try to gradually extend the time between bladder emptying to help your bladder relearn how to stretch more fully. Many of my patients see progress in 1-3 weeks with this alone.

💪 Build strength in and around your pelvic floor. Your pelvic floor is part of your core team which includes your back muscles, hip muscles and diaphragm. Lack of strength and/or tightness in one of these areas can also contribute to urinary symptoms. Not sure how to safely start strengthening these areas? Check out my follow-along Kegels in Motion series on YouTube. And if you're a new mom, my Cleared to Confident course is designed to strengthen your pelvic floor and help you ease back into exercise with confidence.

❌  Don't Kegel or try to stop your stream while you pee. Keep your pelvic floor exercises OUT of the bathroom (see this 30s video). These practices, when done while peeing, confuse your brain-bladder-pelvic floor connection and often increase urinary symptoms as a result. Peeing should be a relaxing activity, don't try to force it out or bear down either.

Get help from a pelvic pro!

It's always a good idea to connect with a pelvic floor physical therapist, especially one with experience treating urinary symptoms. We help get to the root cause of your symptoms and offer solutions without surgery or medication. Not sure how to find one in your area? Try the Pelvic Guru search tool and use my free Interview Guide to find out if they're the right fit for you.

Thank you so much for wanting to get pelvic savvy with me and for reading my first ever newsletter! I'd love to hear from you and want your feedback (send an email to info@pelvicsavvy.com). And if you want to help spread the word about pelvichealth, please forward this to a friend.

Your pelvic health matters,

Dr. Chris

Find me on Instagram & YouTube​​

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    Leaking While Running Is NOT OK - Part 1