Urinary urgency, frequency, and other urinary dysfunction can occur in all genders, and there are usually a few factors involved. As physical therapists, we are always looking at muscle function and how it affects the body. If you see a pelvic floor physical therapist for urinary dysfunction, it is certainly important that they assess how your pelvic floor muscles are functioning and identify any muscle tightness, weakness, or issues with muscle coordination. However, looking at bladder habits and bladder irritants can also be key in optimizing bladder function.

First, let’s discuss some symptoms you may be experiencing if you have urinary dysfunction. These symptoms may include: urinary frequency, urinary urgency (an immediate strong urge to go, and may lead to leaking), hesitancy, slow stream, straining, spraying, incomplete emptying, immediate re-void, and leaking after peeing.

Common bladder habits that can affect bladder health include:

• “Just in case peeing”. This is a common habit that can develop for a few reasons. Sometimes we are told as kids to always use the bathroom before we leave somewhere just in case, or we go before long car trips to try and avoid stopping. This is a habit that can eventually contribute to dysfunction if we are frequently going when we don’t have the urge to go. Instead, only pee when you have an urge to go.

• Hovering above the toilet. This is a habit that is common among vulva owners. Squatting over a public toilet to avoid touching the seat seems like a good idea, but in a squat position our pelvic floor muscles are unable to fully relax to allow the bladder to empty. This can lead to incomplete emptying or dysfunction of muscle coordination. Instead, build a nest and have a seat!

• Pelvic floor muscle exercises (kegels) while peeing. Many patients have been given the advice to practice pelvic floor contractions, or kegels, while peeing. This is often a tip given to new postpartum moms. Frequently stopping the flow of urine can cause further urinary dysfunction, and if you have a hypertonic (tight) pelvic floor, this can cause other pelvic pain symptoms to worsen as well. Instead, relax to pee and allow full emptying without stopping the flow.

• Straining to empty your bladder. Sometimes we are in a hurry - trying to get out the door, the baby is crying, we have a toddler running around, we have a work meeting about to start. The reasons we feel the need to “pee quickly” are endless. However, to fully empty the bladder needs to contract and the pelvic floor muscles need to relax. Straining to pee causes your muscles to contract and may cause incomplete emptying or muscle coordination issues. Instead, take a deep breath and relax to pee.

• Being dehydrated or not drinking enough. It is common to reduce fluids prior to travel in order to reduce the need to stop and pee, however being dehydrated can irritate the bladder and therefore contribute to more urinary urgency and frequency. Plus dehydration can have a lot of other negative health affects. Instead, try to stay hydrated all of the time and consume fluids as you normally would when traveling.

• Habitual holding. Sometimes access to a bathroom is limited with certain jobs and people will have to hold longer than they normally do or should. Some people also have fear or discomfort using public bathrooms and will hold their urine until they get home. Over time, this can cause further urinary dysfunction. Instead, try to work with your schedule to develop a healthy bladder routine.

If you experience urinary dysfunction, these are habits to be aware of and make changes as you can. It doesn’t have to be perfect, but sometimes just becoming aware of these habits can help you make small improvements that make a big difference!

Another factor to look at is bladder irritants. A few foods that may irritate the bladder include: caffeine, alcohol, carbonated drinks, coffee/tea (decaf and regular), citrus fruits/juices, tomatoes, spiced foods, sweets, chocolate, milk/milk products, and artificial sweeteners. These foods have been linked to urinary dysfunction, but they may or may not bother YOU. This is just another factor to explore.

Our best piece of advice if you are experiencing symptoms of urinary dysfunction is to see a pelvic floor physical therapist for an evaluation. Your pelvic floor PT should be discussing bladder habits, nutrition, and assessing your movement and muscle function. To learn more about the pelvic floor conditions we treat, click here.

If you’re interested in setting up an appointment with one of our pelvic floor specialists, reach out to us at info@absolutekineticspt.com.

Blog post written by Dr. Alexis Hutchison, PT, DPT, OCS