Episode #10: All Things Incontinence
Subscribe: Apple Podcasts Spotify Google Podcasts
In this episode, Dayna and Rhonda talk about all things incontinence…
-What is it?
-Types of incontinence
-Is a little bit of leaking ok?
-Ways to treat it
-Habits to be mindful of to help with leaking
-Peezing (peeing when you sneeze)
…Plus so much more!
-
Episode 10 - All Things Incontinence
We're excited to have you join us for this episode of Pelvic Health and Fitness. I'm Dayna Morellato, Mom, Orthopedic and Pelvic Health Physiotherapist. And I'm Rhonda Chamberlain, Mom, Orthopedic Physiotherapist and Pre Postnatal Fitness Coach. On this show, we have open and honest conversations about all phases of motherhood, including fertility, pregnancy, birth, postpartum, menopause, and everything in between.
We also provide helpful education and information on fitness, the pelvic floor, and many aspects of women's health, including physical, mental, and emotional wellness. Please remember as you listen to this podcast that this is not meant to treat or diagnose any medical conditions. Please contact your medical provider if you have specific questions or concerns.
Thanks so much for joining us. Grab a cup of coffee. Or wine. And enjoy!
Welcome everybody to the Pelvic Health and Fitness Podcast for episode 10 and today we're gonna chat about incontinence.
Very common issue and I think both of us have many clients that come to us saying that they're peeing with certain things. Um, so Dayna, why don't you start off with just letting our listeners know what is incontinence? What types are there? What causes it? Start with that. Yes. Absolutely. So incontinence is the leakage of urine or stool.
If we don't want to be super technical of poop, um, and nobody likes to talk about it. Not a lot of people will admit to either of them, I think maybe even with their closest group of friends or on the other side of the coin, I think there's just been for a long time, this understanding of, well, you had a baby.
So, of course, you're going to pee your pants when you do X, Y, or Z. Just suck it up. It's part of being a mom. Suck it up. It's part of being a mom. And it is absolutely not. Just stop. Um, You do not have to experience leaking of any kind as any sort of normal in, in your day to day life. So, the different types of incontinence, as I said, can happen for pee or poop.
Um, I will always I feel like a four year old when I say those words, but any who, here we are. And so they can be different kinds. Stress incontinence is what most people think of when they think of incontinence or leaking and where you have this big increase in pressure in your body. So think sneezes, coughs, laugh, um, even, you know, if you're out running or jumping trampolines, women, postpartum women are living in fear of trampolines.
So that big increase in pressure or load onto the pelvic floor that causes you to lose control. You can have urge incontinence, which is the feeling of once you need to go to the bathroom, again, whether that is for a bowel movement or to go pee, you can't hold it. So once you have that urge, you're, you're feeling like you're leaking and you can be somewhere.
In the middle of the road and have a little bit of both and we call that mixed incontinence. That's good. And so when it comes to the, well, when it comes to incontinence in general, so I have clients come to say, come to see me and they say, well, I only pee a little bit, so that doesn't count. Right. And what do you say to that?
Um, well, if they're asking me point blank like that, I will often say you shouldn't have to leak at all. Right. So any bit of leaking is incontinence. Yes. It doesn't matter the amount, whether it's your full bladder emptying or just a little dribble. Yeah. It's all incontinence. And that doesn't necessarily mean that it's looming trouble.
So let's just, if you get on trampoline for the first time and you're like, Oh shoot, I didn't think I had any troubles and you have a little bit of a leak, um, that doesn't necessarily mean that that's going to continue to worsen for you. You don't have to deal with it either. So anytime you're leaking your inner stool and you are not, you did not intend to, that is incontinence.
Yeah. And there's lots of strategies to help with that. And I think with that conversation too comes, you know, there are a lot of things that can help, but it is also one of those things that's totally up to you. Right. So I think some women come, we get their leaking pretty under control, but there's still, you know, little occasions where it happens, but they feel like their quality of life is great.
And They're okay with little times where it happens. And I think that needs to be said too, right, that you don't need to be 100 percent perfect to be sort of healed from, from leakage. Yeah, for sure. And it really is in the eye of the beholder. If you are okay to wear a panty liner or something, if you're going for a run and you're okay with that because you're okay, the rest of the time, it really is in the eye of the beholder, but you certainly don't have to.
Don't have to be dealing with that. And like you said, there's lots of different kinds of strategies and from the other side of the coin as well, you know, clients who have come to see me, or I'm sure you're having these conversations too. And when they are graduating from physio, that's what I call it.
You have to imagine your cap and gown. I always will tell them certain situations where they may feel like they're leaking has come back for, you know, we're hormonal creatures or stress or all of the way life happens and you've gone away from doing some of your exercises and it doesn't necessarily mean that you're right back to square one.
It just means that we maybe need to re up our focus on some of our strategies and hopefully it'll settle back down. Yep. Yeah. And I think you and I are both very similar that way, that I'm all about educating my clients and not having them rely on me. Right. So let's teach our clients as many things as possible in their back pocket.
So when these things do arise, they have strategies to help with it and not panicking. I think that's the thing too, is we don't want to put fear on the symptom, right? With any symptom. These symptoms are just our body's way of talking to us, letting us know, you know, maybe the strategies that we are currently using could be a little better.
So let's change them and start to decrease that leaking if that's a goal for you. Absolutely. Yeah. So what do we expect postpartum? So is this more common postpartum? And is that typically when women are coming to see you with leakage? Yes. I think, um, birth is an Olympic endeavor. It's, it's, it's an athletic endeavor.
So for a vaginal delivery, that pelvic floor, one of its main jobs is of course, to stay contracted in order to keep in urine and stool and then relax. To allow us to go to the bathroom. So if, if that muscle group has undergone the workout of a lifetime and allowing baby to pass through, I think it stands to reason that having some incontinence immediately postpartum for several days or weeks is not out of the ordinary.
I don't want to call it normal, but it's not out of the ordinary. It can be kind of understood. Yeah. And I think that's, that's an important distinction too, is we. We've talked a lot about the pelvic floor on this podcast so far, but we think when it comes to leakage, I only thought about the bladder and the bladders roll.
So the bladder has a reflex action, right? So there's a reflex that when your bladder is at a full uh, phase, then that reflex will in the brain will let urine go. But I think we also have to talk about the importance of how the pelvic floor works with. that action too, right? So the pelvic floor muscles sort of like help to keep urine in until we're able to sit on a toilet and go and then those muscles need to relax to let urine out, right?
So it's not just the bladder. The pelvic floor plays a role too. Public floor plays a role and so does the brain. So yeah, in the, in the, um, urgent continents where we're feeling that urge, that signal is going from brain to bladder telling us that we need to go pee. There is a little bit of a mismatch in timing between the public floor and the brain there as well.
So part of the retraining comes from simple strategies and we'll get into this a little bit. Specifically, but simple strategies and as woo as it can sound repeating. I will not go pee until I'm sitting on a toilet. Yes. And repeat it until you were sitting on a toilet. Which is wild, right? Like the brain component to it.
It's so interesting. And in urgent continence, you'll hear a lot, and I'm sure you hear this from your clients too. We kind of call it key in the door. key in the door where there's a list in your environment that is linked to you having to go pee. So a lot of people will think, Oh gosh, I'm home from the groceries.
I've got my key in the door. I'm close to a toilet. Now I suddenly really have to go pee. So there's something in our external environment that is creating that urge. Or worsening an urge that's already there. Yes, I, I personally deal with that and I can talk about kind of things that have worked for me with that where yeah, so I think it's like an anxiety piece right where it's, I'm home, and all of a sudden like I need to go right now and that feeling of like, Oh my goodness, I don't think I'm going to make it.
It almost ramps itself up right. So yeah, I truly do use that strategy where I like take some deep breaths and I say. You're okay. You can wait. You're almost there. And it's wild how much it works. It's so interesting. It is. I had a client earlier this year, actually. And so one of you just asked me, the question was, can you expect it postpartum?
Is that when you typically see it? Yes, but I would also say kind of in that perimenopause to menopause area as well. I see quite a few clients in that realm, different hormonal shifts, different things happening in the pelvic floor. Um, and she was shocked for her. The biggest help was this idea of her trigger was she lived out in the country and as soon as she turned onto her long lane way back up to her house, she could barely make it to the house.
Right. And so we worked a lot on staying calm. I am safe. I will not pee until I'm on a toilet. And she was shocked. Yeah. So fascinating at how big of a difference that that was. Yeah, for sure. So part of them obviously is kind of where we're seeing this most often in our day to day life, but it doesn't, it's not, um, restricted to women.
And it's, you know, we have incontinence in kids. There's incontinence in the elderly or anywhere in between males, females, what, you know, all across the board. So, and hopefully you'll find some strategies depending on who's joining us here that can work for you in your body. Yep. So where, when someone comes to see you with leaking, whether it's stress or urge or mixed, where do you start with them in terms of getting, giving them strategies to help with that symptom?
Lots of, always a good conversation. I think you're the same, always a good conversation. So I'm looking for signs and symptoms in our conversation, uh, to determine is, do I think this is likely a weak pelvic floor issue or is this, a tight pelvic floor issue. Spoiler alert, there's different kinds of incontinence that way as well.
And or is it a little bit of both? And it's more of a timing issue. So always a good conversation. If this individual has chosen to do an internal exam, that can be valuable information. I think it is one of the biggest misconceptions about incontinence or if you're leaking your inner stool that it is coming.
From a weak pelvic floor, right? And I don't have any numbers to support this, but I would say it's. It's very common, if not equally common, to have incontinence, at least what I see clinically, becoming from a tight pelvic floor. Right. And that goes back to our previous episode that hopefully you all have listened to about Kegels, right?
And so women often think, I'm leaking, I just got to keep squeeze, squeeze, squeeze, squeeze, and that's going to make it go away. So hear me out. For true weakness, I think it makes sense. We're going to increase the support system so that we can keep those sphincters, fancy word for squeezing shut where we need to squeeze shut to keep urine in the bladder.
But A tight pelvic floor or tight muscles in general, or muscles that we're holding on, we're holding tension in all the time. And so there is a level of fatigue there. And if we continue to fill a bladder or we have a bladder that we need to empty, that can feel sometimes like too much load now for the pelvic floor it's at its capacity.
And so we start to lose some urine because it can't do its job of closing as well because it's tired. Right. Yeah. And if you think of it, it, it kind of consciously makes sense. If someone that has dealt with leaking for a little while, there's anxiety with that. Right. And it's embarrassing for some people.
So of course you're going to be clenching. Right. And it's seen again, it seems natural that if I'm going to pee my pants, I'm going to squeeze as tight as I can. But I think we're here to tell you that might actually be worsening that symptom for you, which might be mind blowing. Yes, absolutely. You just said it yourself.
You said, I try to, when I have that urge and I feel like I'm not going to make it, I try to take several breaths and just kind of calmly walk to the bathroom, which is hard to do because my natural tendency is to, yeah, clench, cross my legs, squeeze everything tight, but usually, honestly, that makes it worse.
It really does. A hundred percent. I chatted about this already, this idea that we're kind of a canister in the middle of our bodies. So we have our abdominal wall in the front, our back muscles, muscles on the back, uh, our pelvic floor on the bottom and our diaphragm or our breathing muscle up top. And if we pressurize that canister, so think squeezing, like you're saying, holding your breath, kind of really bracing your abdominal wall, which are all natural responses to, Oh shoot.
I'm about to pee my pants. Um, we're pressurizing that canister and putting more pressure like a balloon down onto the pelvic floor. So we're kind of mapping it out before we've even, so this is a hard sell for me, but, um, this is where that internal exam can be very helpful. So if you are somebody listening and you're like, holy, I've been, Kegels for a long time and I just have not been able to figure out why I still leak when I do X, Y, or Z, You might have a tight pelvic floor and it is totally possible to be both weak and tight, right?
Right. So you need a mixture of, of both. Right. And I, I think, you know, I'm not an internal therapist, so I like to work closely with them to make sure I am on the right track, but. Truthfully, with all of my clients, I work on both. I work on pelvic floor relaxation strategies, and we work on pelvic floor strengthening, which also, spoiler alert, pelvic floor strengthening is also whole body strengthening, which again, if we go back to like the Kegel example, like we can't, if we're trying to strengthen our leg.
We can't expect our leg to get stronger by sitting, laying on our back and squeezing that muscle over and over all day and think that that's going to translate to a stronger leg, right? So same with our pelvic floor. I always say to my clients, let's get you moving. Let's get you strengthening in a whole body manner.
And that is going to strengthen your pelvic floor, which again, a lot of people are like, Oh, interesting. I never thought of it that way. Oof. Same. Yeah. Awesome. Yes. So what are the things that you're kind of listening for or assessing with your clients to determine, you know, their trajectory? Do we need to back off on the strengthening?
Do we need to maybe get a little bit more relaxation in the mix? Yeah, so similar to you just get a really thorough history and, um, we've been talking about this with other episodes that if there's a lot of stress in someone's life and we're still in the midst of a global pandemic. So everybody has added stress in their life right now.
So listening to that listening to what is their health history so they. I was, uh, working with a client who had recurring bladder infections and had some procedures done. Um, so she, you know, right from a young age was always clenching because she was nervous to pee her pants after those incidences. So listening for that, um, basically just getting an idea of what does their day to day life look like.
And very often, if that sort of like high stress situation is common for them, they likely are someone that holds. tension in their body, and not necessarily just in their pelvic floor, but in their neck and their shoulders and their jaw and their tummies, all of the above. Um, so with those people, I really do focus first and foremost on how can we Relax your pelvic floor.
How can we relax your nervous system? Because that I think would play a role too, right? If we have a very heightened, hyperactive nervous system, that would make sense to contribute to leaking as well. So I would say honestly, most of my clients, we start with relaxation because Very often that's not talked about with, so she said this, this client said she went to see like multiple urologists with these recurring infections and every single one of them told her to do kegels and that's it.
That's all they, that's all they said. So, it was brand new information for her to hear. Oh, I also need to work on relaxing. Oh, that's interesting. So I'd start with that and then I would say with that too. Still, if that is a case for that person and they really need to focus on relaxation, that doesn't mean we can't also work on strengthening, right?
I think it doesn't need to be one or the other, but when we are working on strengthening, I will have them at the end of the session, do their relaxation again to kind of calm that nervous system down again, relax those muscles, or even throughout the workout schedule in. Breaks to give their pelvic floor arrest.
So they're not constantly clenching the entire time. So yeah, it doesn't need to be either, or we can do both strategies to get that person overall feeling better. Oh goodness. I love that balance balance. Yes. We have to be strong and we want to be strong, especially if we're chatting about being a mom.
And I've been talking a lot about kind of comparing the pelvic floor to a bank account. Okay. And we are continually making withdrawals from our bank account just in our day to day life. You're picking up kids and the car seats and the toys and dog food bags if you have dogs because they're enormous and putting this in the back of the car and carrying like you do your 18 bags of groceries in from the car.
Like all of this is load on our body. And then a lot of women are coming to see us for exercise advice and return to exercise. So all well intentioned, of course, we want to add this beautiful movement for whatever reason into our lives. But that's another withdrawal if we're thinking about it in that way, it's load on the body.
So how do we make deposits? I love that and balance and breathing and good old fashioned zed lying. If you don't have a lot of time, lie on the floor and put your legs up on your couch. Two minutes. It's just the complete weight of the world, literally off of your pelvic floor for a couple minutes a day.
And it can be so great at just allowing everything to rest and relax and kind of balance itself out from the wonderful work of your day to day life. I love that. That's so good. Um, and then the other thing I wanted to touch on too, so we're talking a lot about breathing and kind of retraining that pelvic floor again.
We can do kegels and that can be part of our retraining, but we also need to work on that relaxation. Um, so again, I'm not an internal therapist, but I do suggest my clients go see a therapist just to make sure that we are sort of understanding what it means to lift the pelvic floor versus bear down.
Right. So is that something you assess when it comes to leaking too? Oh, absolutely. There, there's definitely, you know, a lot of people will say to me, I always ask, you know, have you been told to do kegels or have you tried kegels in the past and often I will get the response of, yeah, I think I'm doing them.
That's a great, great reason to perhaps have an internal therapist feel for you. Are you doing it correctly? But. Just as important, can you let that tension go? And what does that feel like in your body? Because the messaging for a lot of us has never been there. It's always been, like you said, with your client, a lot of medical practitioners have always said key goals, and it really, truly is balance.
And I will say this. I don't believe you can overdo the reverse Kegel or the letting go of tension. Yeah. But you can overdo Kegels, right? So if the balance isn't working for you, let's say you're doing, you know, 10 Kegels and 10 reverse Kegels a day. Let's just. Simple math. And you still are finding that like you go to your therapist and they say, Oh, the pelvic floor is still tight.
You can never overdo the reverse Kegel. So you can always take time to do, let go of tension a little bit more. It's not the same as stretching. I think that's important to know. You can overstretch a muscle like your hand. But if you're just letting go of tension and letting something relax, you can't really overdo that.
Yeah, and I actually had an interesting question about that the other day. A postpartum mom, newly postpartum, asked, she was working on these strategies for a hypertonic pelvic floor, and she said, when When can I stop doing these things? And I said, this might not be the answer you want to hear, but I'm two years postpartum and I'm still doing these things.
And truthfully, it'll be a lifelong practice, right? So I always encourage, let's just see if there is a strategy that works for you, whether that's meditation, whether that's just laying on that deadline position once a day. Find something that you can incorporate similar to incorporating exercise. It's, it's never something that you're done doing, right?
Um, relaxation is the exact same thing. Absolutely. Yeah. So let's talk about, so there might be some interesting things that are Worsening your leaking that you might not realize are are causing that to be worse. Um, so do you want to talk about first some irritants of the bladder that might be worsening people's symptoms?
Yes, for sure. So we have thus far really talked about the pelvic floor as being um, The main driver of incontinence and whether or not that's kind of urge or stress or mixed and I think it's important to just reiterate here that we're focusing mainly on bladder incontinence here but this is absolutely can happen with bowels.
And I think it's important to have that conversation too and put that out there to just decrease a lot of people who are experiencing bowel incontinence think they're the only ones you are not. You are not very, very common. Um, but yes, the bladder itself, we can also help the bladder. The bladder is a muscle.
As you were saying, Rhonda, it has its own little, little, it has its own reflex loop with the brain that allows us to go pee, but the bladder itself can be irritated by certain things. And a lot of people are pretty, um, surprised to hear that one of my first recommendations is for leaking is to make sure you're drinking enough water, which usually causes some large eyes.
Yeah, because people are terrified to drink too much water because, oh my goodness, I'm going to have to pee so much more. Right. And I, I, I hear a lot in my histories or conversations with clients that they have started to restrict water in some way, shape, or form. Maybe it's total volume or they don't drink before a workout or things like that.
Um, but water can really help dilute urine. What can and concentrated urine or urine that's really yellow in color, like, you know, that dark pee look. can be irritating to the bladder, which can make us feel like we have to go pee more. It can increase that urge, which is so fascinating. Yes. Yeah. Other common irritants for the bladder are things like carbonated beverages.
So they, they, it's not for everybody. These are things that could be irritating your bladder. Carbonation can be an irritant. I did have a client not too, too long ago that loved her sparkling water. Um, and. I love it too. And it is not an irritant, but I lightly suggested that she swap out kind of one or two of her sparkling waters a day for flat water.
And that was a game changer for her saying she was pretty surprised to find that that was an irritant for her. Or, you know, if you like pop and you're drinking.
A lot of pop, this is not judgy at all. Uh, that can also be irritating. Caffeine can be irritating to the bladder. So if you're someone who finds you have to pee a lot, and this is me after coffee in the morning. Mm-hmm. it, some of your leaking could be contributed to just a sensitivity to the caffeine and that's irritating your bladder, which is increasing your urge, which can increase your incontinence.
And in that case, you have a couple options, I would say. One is to decrease the coffee. I say that lightly, please don't stop listening. Um, maybe space it out a little bit more for balance with water. Yeah. Yeah. I think, yeah. The interesting thing with coffee too is It is a known diuretic too. So this is my case where first of all, I just love coffee.
We're both coffee lovers. So I love, I love the taste of coffee. I love that habit of having a coffee first thing in the morning. I find it helps. I've typically dealt with constipation and I find it helps keep me regular the caffeine. And so then it becomes a trade off, right? So I, I'm not willing to give up my coffee because I love it.
And also it helps with my bowels. Yes, it can irritate my bladder. And I find in the mornings, I also drink a lot of fluids in the mornings. So whether it's fully the coffee's fault, I'm not sure, but I have water before my coffee. I have my coffee and then I have a smoothie. So I think just the total volume of liquid is also what's making me go pee multiple times in the mornings.
Um, so yeah, listeners, you don't need to give up your coffee. It's okay. Um, I did have a chat with one of my clients recently who had like five or six, uh, cups of tea in a day. And we talked about again, no judgment, but let's see if we can alternate that. Maybe do cup of tea, cup of water. Take that down, divide it in half and just see how your bladder does.
And that's the interesting thing with our body too. It's all experimental, right? So we don't know, we can't say with 100 percent certainty, Oh, it has to be the caffeine that's causing it. These are just possible irritants. So play around with it and just see how your body responds. Yes. I think that comes back to the idea of it's all in the eye of the beholder.
I'm exactly the same way as you Rhonda. Like I kind of giggled to myself when I get to work because I pee like 14 times. It feels like sometimes in my first couple hours of work. And I think, man, my coworkers are probably like some public physio, but for me, I'm the same way. I'm getting my water a lot. A good start of my water in the morning.
I have a coffee. Or two. And then I usually have, um, kind of a tea, a decaf tea, but more fluid when I get to work. So my fluid is high in the morning and I'm okay with that. Yeah, me too. Again, it's all in the eye of the beholder and suggestions that can help decrease the irritation. Yes. Let's talk about, um, some habits that people might have.
So, um, I definitely was someone that did this, call it thunder peeing or power peers. And a lot of this comes back to the type A individuals. A lot of us are very busy and. Heaven forbid, we have to stop what we're doing to go pee. It's such an inconvenience, right? And that's, that was me. So I'd get to the bathroom, push it out as hard as I could.
It's like a race to finish peeing as fast as I can to get back to day to day life. And honestly, it wasn't until I got into this world that I even knew that might be an issue, right? So I've dealt with urge incontinence and that could be a contributor. So when you're going to the bathroom. you know, some of us are moms and we might not have any peace and quiet, but still try as best you can to relax your muscles.
Again, the pelvic floor needs to relax to let urine out. So do some deep breaths. You can even kind of wiggle your hips back and forth, kind of just let the pee flow. It's supposed to just do its thing. You don't have to force it out. Absolutely. I. Literally think I have had 100 percent agreement anytime I've had this conversation with clients being like moms are power peers on to the ticker of a to do list before we have even sat her bum down on the toilet to go pee.
Um, you're right. It should be passive. We need that, uh, inhale, you know, take, I always kind of encourage taking a nice big inhale. If you think you're empty, take another nice big inhale and see if any more empties out and it's passive. You're not pushing down. Yeah. We call this double voiding, which can be a strategy if you're about to go do something that typically causes leaking for you.
So whether that's running, or the dreaded trampoline, or your workout, or maybe you're somebody who is not necessarily leaking, but you find that you're, I hear this all the time, I have a small bladder, I pee all the time. I use my, my suspicion in those cases is often that they're not fully emptying. So I think it's super important that we take our time in the bathroom, wiggle around.
I love that. Wiggle it around, take a deep breath, make sure that you're fully emptying. Another common thing that can happen if you're not fully emptying is you get a little bit of a dribble of urine once you stand up. So that is incontinence as well. So just this idea of. Just taking your time. Take baby into the bathroom.
Moms, I know it can be super stressful if you've left your toddler in the other room. Just thank you. Whatever is going to help you just take your time to go pee. Yes. And then a couple other ones to leave you with. So I know clients that I speak with that have incontinence issues are always doing the just in case pee, right?
I'm going to go out, do some errands. So I'm going to go pee, even though I don't feel the urge to pee. I'm going to pee just in case. I don't know if there's going to be a bathroom. And the other one with that is if you are out and about and you're in a public bathroom and you are someone that hovers over the toilet.
So those are both things that we want to maybe do less of. Do you want to sort of tell us why for both of those, Dayna? Yeah. So the hovering comes down to what we were just talking about. When you're hovering. You can't fully relax your pelvic floor. So you, therefore you can't fully empty. Um, I don't think, and I'm open to discussion on this, but I don't think you're going to get any sort of terrible illness from sitting your butt on a public toilet.
Yeah. I've heard there's more germs from touching the doorknob than there would be. And we don't even really touch the seat. It's just our bum touching the seat. Right. So the seat, um, you need to You need to be sitting down, fully relaxed, try to take your time. Um, and that will serve you well. And, but that is why you're not getting that full relaxation.
The just in case pee is such an interesting thing. And I think about this a lot. Um, having young kids that are potty training slash still in the early stages is trying to let them appreciate their true urge to go pee. Yeah. Frustrating endeavor as a mom. However, um. What, what truly happens, and this I think probably simplifies it too much, but I, it's a good visual.
I kind of like to think about the bladder as having three fill lines on it. Mm-hmm. or a bladder will get to that first line, gets a little bit of a stretch in it, and first line of pee, I mean the bladder will send that signal to the brain. The brain will usually say, ah, You're sitting in line, you know, trying to pay for your groceries or you've got your 84 million things in your to do list.
You don't have time to go pee right now. We've all had that experience where we had to go pee in an hour later. We kind of forgot we had to go pee. That's that low level. So then our bladder will continue to fill with urine. We get to that middle fill line, more stretch. Our bladder will say, okay, this is a good amount of urine.
If a toilet is available to you, your brain will happily say, yep, go find a. Go, I was going to say, go find a potty, go find a potty and go if that's not available to you. So you're stuck in the 401 or, you know, in a meeting or something, you will continue to fill. And now you're at your bells and whistles.
So we're squirming around. We've got a lot of discomfort. If we continually lower or empty our bladder, pardon me at low volumes, or just in case before we ever even fill an urge over time, these fill lines can lower. So that now our bells and whistles are more of our average fill line and that low level feels like a full bladder.
Yes. But the good news is our bladder is a muscle. Our central nervous system is very, uh, teachable and can relearn. And then our pelvic floor will learn to hold more urine as we kind of retrain that system. That's so cool. And then that goes back to some of the urge strategies we were talking about earlier, right?
It is. Um, and maybe I always say to clients to maybe don't practice this when you're pregnant because pregnancy adds even more pressure onto the bladder. So, uh, maybe wait till postpartum to retrain your bladder, but, um, just working on when you get that initial urge. Focusing on those deep breathing strategies, focusing on reminding yourself, you don't have to go pee yet, you're okay.
And then gradually just increasing that window. And then do you give strategies in terms of like, how much time to give it or kind of just, just see how the person feels? Um, if we're really struggling, if I have a client who's really struggling with urge, then I might map it out a little bit more specifically.
I really like to have the client learn to listen to their body and just use whatever strategy works well for them in general. The average non pregnant person, we want them to aim for that kind of every two to four hours to be going pee. So we don't want somebody to be going pee every hour. Certainly that we want to work on maybe some pelvic floor retraining.
We want to work on some delay tactics. Um, and if you're going kind of closer to that four hour mark, uh, teachers and nurses. Guys are like camels. I'm, I'm painting a word picture here and no disrespect. They're wonderful, but, um, we maybe want to increase your water a little bit. Okay. We just always kind of, it's a balance.
Everything's a balance here. Yep. Yeah, for sure. I love it that I wanted to circle back to, um, just is because cold and flu season will be upon us and peezing. Ooh, yes. Using will be a thing. So peeing when you sneeze, if you have clients, do you have any specific strategies that you give for? Yeah. So do you call it the knack?
I call it the knack. Is that what you call it? So basically, yeah, so a a pelvic floor contraction right before you're about to cough or sneeze. So, we've, we've talked about how we don't want to do that, like, you know, strong squeeze with people, and it doesn't need to be a strong squeeze, but just thinking about that deep breath, a little bit of a lift, and then coughing.
That's usually what I teach. Yeah. It's perfect. And it comes back to this canister idea, right? We all, we feel that sneeze coming or that cough coming and we're like, Oh shoot. So we bend forward, we pinch our legs tight, close together. And what we've inadvertently done is pressurize that canister. So that pelvic floor now has more load down on it before you've even added that big extra load of a sneeze or a cough.
So doing that knack or a little bit of picking up the blueberry or whatever you want to think can really help just prime that system. Yeah, a little more effectively. And I think one thing too is when you're sneezing or coughing instead of like crunching in because again that's like pressurizing is you can't see me right now but starting almost leaning back and then cough or sneeze into an upright position instead of crunching down sometimes that subtle change helps too.
Absolutely. Absolutely. Awesome. Well, hopefully this was helpful, everyone. We would always appreciate any comments or questions you have on this topic. I know it's a super common occurrence for a lot of us. So just a reminder, it's very a normal process and there is a lot of things that can be done to help you all.
Yes. You don't have to deal with this just because you had a baby. There's lots we can help coach you through. Awesome. Thanks for listening to today's podcast. We hope you enjoyed the conversation. If you liked what you heard, we would love if you could share this with a friend, leave us a review, or subscribe to anywhere that you listen to your podcasts.
Thanks for being here.
