Episode #49: Bathroom habits that may be impacting your pelvic floor health
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In this episode, Rhonda and Dayna chat about some habits in the bathroom that could be impacting your pelvic floor health - and we discuss options for correction!
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PODCAST LINKS & RESOURCES:
🔹 UPDATED Incontinence Resource from Rhonda (and other FREE resources)
🔹 Episode #25: Tips to have great poops with Aliya Dhalla
🔹 Pelvic Health and Fitness Podcast
SHOW NOTES:
(0:52) - What we are talking about, today! (and a helpful guide that Rhonda has updated for you!)
(2:25) - Habit #1: Straining to pee
(8:11) - Habit #2: Straining to poop (and constipation management)
(14:45) - Habit #3: Going pee “just in case”
(21:40) - Habit #4: Having urgency with certain environmental cues
(26:00) - Habit #5: Delaying the urge to have a bowel movement
(29:06) - Habit #6: Hovering over the toilet
(31:27) - Wrap up!
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Episode #49: Bathroom habits that might be impacting your pelvic floor
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!
Hey everyone and welcome back to another episode of the pelvic health and fitness podcast, Rhonda and Dayna here today. And today we are going to be discussing some habits, um, in the bathroom that could be impacting your pelvic floor health.
So Dayna, do you want to start us out with the first one? Yes, I'm going to start with straining in, and most of us think about straining as being with a bowel movements. And yes. With a bowel movements. Oh boy. With a bowel movement. Um, but it can also be pushing pee out. So I'm going to talk about them sort of separately, but both are straining.
A lot of us are, I'm going to start with bladder. A lot of us are going pee. Women, we are distracted peers. We don't have time to be peeing. We're onto the next 47 things on our to do list. So we're sitting down and we are pushing our pee out. Thunder peeing, thunder peeing, power peeing. We've all been beside people in the bathroom stalls in public where you're like, Whoa, that is quite the stream.
Um, when peeing should be relatively passive. So when you go to the bathroom to, to void your bladder, your pelvic floor is going to relax. Your bladder is going to contract. Doesn't really require any conscious effort other than you sort of sitting down on the toilet. Our brain muscle connection between the bladder starts that process.
Yes, there are some idiosyncrasies there, but anyways. You don't want to feel like you are bearing down trying to start that stream. It can actually impact your bladder being able to fully empty because to fully empty again, we need that pelvic floor to completely relax and the bladder to contract. But if we're pushing or bearing down, we're holding a level of contraction in that pelvic floor that can lead to the bladder not fully emptying.
And, or, over time, pressure down onto the bladder, which in, sort of, after doing this for many, many, many years, could lead to some prolapse of that anterior wall or of that bladder. Right. Fair? Yeah. So it should be passive. Sit down, take your time to go pee. I often encourage people, especially in that postpartum period.
Because there's a lot of healing, maybe some swelling in the perineum. If you've had a vaginal delivery in the event of a cesarean delivery, tension in the pelvic floor often is very common postpartum, regardless of what your delivery looked like. So it can take some time for that pelvic floor to completely relax.
So I often will have what people do. What's called a double void. So go pee like you normally would. And then just. Sit there, do one of those nice big reverse heels and inflate your tummy. Maybe gently lean forward and see if any further, um, P comes out. I don't push it out, but don't push it out. No, it really should just be that nice big inhale, gently leaning forward.
You're not bearing down. I think a lot of us could benefit from doing this. Honestly, it takes probably an extra four seconds just to make sure. But especially if you are someone who is finding that you have a lot of frequency, a lot of urgency, if you are having any dribbling when you stand up from the toilet, um, if you feel like you can't completely empty your bladder, because that can be a feeling, uh, which can look like just feeling like there's still pee sitting there, or maybe you leave the bathroom five minutes later, like, what the heck, I just went pee.
Can happen a lot during pregnancy. Um, if you're someone who gets chronic UTIs or bladder infections, it's something to think about as well. Yeah. And part of that too, um, do you teach people to go to the bathroom, stand up, like stand up, hold their hands up, stand up a bit, maybe like move their hips around a bit as, as like a double avoiding strategy too.
I've heard of that one too. Yeah, for sure. Sometimes you're just moving your hips around on the toilet. Sometimes the, the breath, the breath or the breathing doesn't work as well, but yeah, you can sort of swivel your hips around on the toilet. Um, you can stand up and sit back down, especially, um, I use that one for people who, if the double void or that, that using your breath and leaning forward is, Hasn't addressed the dribbling for people.
Cause most often that dribbling is happening. We stand up and you're wiping and then more dribbles out or you get your pants up and then it dribbles into your underwear. Um, if that strategy isn't working, then I'll have them stand up and sit back down. Cause sometimes just that's enough of that relaxation on the way back down to get that last little bit that's trapped.
Is it true too, that our bladder doesn't necessarily need to fully empty each time? Like doesn't a little bit of urine stay in the bladder? Yeah, I don't, my understanding of the bladder is that there's always some residual volume. So I get into this a lot with people who, and it happens so much during pregnancy, because especially in that like third trimester, um, people can get in the habit of getting in and out of bed like four or five times before they go to sleep at night because they're already not Sleeping well, they know they're going to have to get up probably at least twice to pee in that third trimester.
They don't want their bladder waking them up even more. And so they start to get into this habit where they're going and they get in and out and they're, they're like, well, every time I go, there's still pee there. There's always going to be always, always going to be a little bit there. And certainly some of that could be coming from you.
Not. Now again, fully emptying, the urine that is available to empty, if you are sort of in this tension, not taking your time situation, but there's always going to be urine there. Yeah. You're never bone dry in that bladder. Yeah. Yeah. Good tips. So don't strain to pee, but also don't strain to poop. And I, a lot of people hear this, they hear it, maybe they've got hemorrhoids or constipation, or maybe someone again, well intentioned has said don't strain, but then nobody ever tells you what don't strain means while you're pooping.
So I'm here to tell you don't strain, don't, again, don't strain means to, Try to avoid that sort of typical, hold your breath and bear down until you're red in the face. Use a squatty potty or some sort of stool. We should all be using these just from, it can really help straighten out our rectum. So we've got more complete emptying.
That's one way to avoid straining. The second way is to, if you are someone, especially if you have this feeling of incomplete emptying, chronic constipation, fissures, hemorrhoids, pain with bowel movements, blow into your fist. Instead of using that bear down breath, hold tactic as you're pooping. Yes, exactly.
That blow into your fist. You're pressurizing that canister to relieve yourself, but in a more gentle way that can actually maintain the relaxation of the pelvic floor that's needed so that your rectum then isn't contracting against resistance in your pelvic floor. Yeah. Um, can you talk about, do you talk about like splinting with that too?
I know I've, I've heard people talk about that have prolapse issues too, cause your, your organs can kind of almost get in the way of being able to let poop slide out. Yes. Especially with erectile seal, which is a fancy word for a rectal prolapse. So, um, the, Uh, posterior wall of your vagina, the rectum can sort of push in there, so then you've got this extra little, uh, bump, for lack of a better curve, for lack of a better description that the poop sort of has to go by.
So a squatty potty can sometimes help this. Um, and sort of straightening out that rectum a little bit more. But yes, depending on the severity or if you're really just needing a little bit of trouble, some people can splint in the vagina. So you could insert your finger or your thumb or whatever you have.
I shouldn't say whatever you have. Obviously, make it sanitized. Sanitary people, um, into the vagina to splint that back wall. So I just push it like a little bit pressure or literally like just sort of, um, to give it some support from inside so that the poop isn't going into that little bit of a dip. I'm using a lot of hand motions here and I realize if you're listening to this in your car, you cannot see me.
Um, but it's just going to sort of pop that back wall and. So the stool goes straight down rather than that little pocket right into the vagina. In the event of a, um, like a cervical or uterine prolapse or a bladder prolapse, splinting, like inserting anything to the vagina is just going to sort of. Maybe support those other organs.
But I think that using the breathing into your fist and a squatty potty, decreasing the overall strain down on the pelvic floor is sufficient. Yeah, that's good. Yeah. And, uh, make sure you refer back to our episode with Aaliyah Box Wellness Co, who talks all about constipation and having good poops.
Because that is a big part of this too, right? Is, yeah, if you're always, you know, if you hear saying it, say, hear Dayna say that and you think, well, how do I not strain? Like my poops are so hard. They, you know, take forever to come out. Um, working on your constipation is going to be your pelvic floor will thank you to work on that constipation piece.
Um, so just a couple of little quick tips is, you know, making sure that you're drinking enough water. Uh, fiber intake is a big one. Squatty potty, like Dayna said. So there's a lot of things that you can do to improve that constipation piece that will take a lot of that strain, that downward strain. And it can actually, if you're someone and you're like, Oh, I am constipated, but my main, my main symptoms are bladder.
Like I'm leaking. Constipation can be a game changer for leaking. Yeah. Game changer. So they're all sitting in the same house. So we got to make sure that we're treating them all well. If you've got some stool that's sort of stuck in that rectum, sitting on that pelvic floor, it pushes pressure, not only forward onto that ladder, but down onto the floor.
Yeah. And the floor gets a little bit tired and then it can't do its other jobs as effectively if I'm breaking it down just into the most simple of terms. So yes, constipation managing constipation is a game changer and not to go make this into a poop, just strictly poop talk. People's understanding of constipation is very skewed.
Often people think that they're constipated if they're not going poop every day. Some people don't poop every day. If that's sort of always been your way, that's not necessarily constipation. Constipation is, um, Like it can be in the quality of the stool. So, you know, our, our goal for everybody is like one solid, smooth log.
If you can Google it, the Bristol stool chart, um, if you're interested, um, if it tends to be more knobbly or think rabbit pellets, like lots of little pieces. That's one, the quality of your stool can indicate constipation. Certainly if you are someone who goes a length of time, and then it's hard for you to have a bowel movement that can be, so you're finding that you do have to strain and, or you feel like you never fully get it out, even if you're going every day.
Yeah, like when you're wiping, wiping, wiping, wiping, wiping, wiping, wiping, fecal smearing is what we call that. That can be a sign of constipation. A lot of people will say, Oh, I'm not constipated because, you know, I'll have a day or so where I don't go, but then I almost have diarrhea. That can be a sign of constipation.
There's like a rebound effect of your gut that will clear it out. If you have had a period of time where you couldn't go, so let's fix the poops and it helps the pelvic floor. Yeah. So check out box wellness coach. Check out that episode that we did with Aaliyah. It was super helpful. She gave lots of great tips.
All right. So next one. So this is, I think many of us struggle with this one is the going key just in case. Um, so yeah, many of you might feel triggered when you hear this one, um, which is interesting now having kids because we like train that in kids right from day one. Oh, I think about that all the time.
All right, kids, we're, you know, we're going to the mall. Let's everybody go pee. I don't have to pee. Nope. Let's just try just in case. So I know. Put some, yeah. Squeeze them out. Go squeeze them out. Yeah. I'm trying my best to be mindful of that because I know, again, it's a habit, right? It's a habit that if we learn it from young age, it's, it can be hard to break.
So the reason why we don't want to go pee just in case, and this is, um, if I'm explaining this incorrectly, Dayna, you can, um, stop me, but. So basically our bladder, it is a muscle, but there is like a neurological brain body connection that happens there. So when we have the urge to pee, there's a signal from our brain to let us know.
And for many of us, if we have good you know, bowel and bladder habits. It's when the bladder is like almost full, um, of pee. And that is when we get that cue to go to the bathroom. If we're always going pee just in case and we're peeing, you know, like you said, Dayna, that example during pregnancy, Oh, I'm up anyways in the night.
I might as well go pee. If we're always doing that. that cue for that bladder fullness gets more and more sensitive. So when, even if our bladder is just partially full, that brain signal is coming to us that we have to pee. And so that just becomes a habit where even if there's just a minor amount of pee, we feel like we have to go and we feel like it's an urgent matter.
And so, yes, if we can try to break free of that habit, Um, is it like two? How many times an hour should we be paying on average for like the average adult? So this is obviously there's lots of variation here. Don't come at me. But in general, every two to three, four at the absolute most. Yeah. We want to go be going pee.
So if you're someone who's going pee every 45 minutes, we're definitely going to be working on some strategies, maybe some pelvic floor strength or letting go of tension. Um, it could go either way, um, or maybe just retraining that brain muscle connection to the bladder. And. your environment. If you're someone who's comfortably going longer than three or four hours, we probably need to up your fluid.
So, um, but yeah, no, you explained that perfectly. Right. We want, we want to avoid the just in case P because it's not a true urge to go pee. And it can, over time, lead to, sort of into one of our next points, environmental cues dictating when you have to go pee, which can get tricky. Yeah. Right? So, um, yes, we want to avoid the just in case pees.
Coming back to your point with kids, listen, I'm not here to tell you what to do with your own children. If you're someone who's on the 401 all the time, I still make my kids go pee. Yeah. Okay. But I do, and you have to know your kid too. I do try very hard when they tell me they don't have to go pee to honor that.
Right. Yeah. Cause we want them to learn to trust their own bodies too. Right. That's a big, that's like goes into other layers. Just learn to trust what their body's telling them for sure. And like, you know, in the first several months of potty Maybe this isn't something that you do. Um, but I do think These habits are ingrained in us from an early age.
I am a big fan of just having the potty in the trunk in case you need to go pee. Um, yeah. So, I mean, take that information and do with it what you will when it comes to children. Um, but certainly as adults, try not to go just in case. Like if you're, I always use the example of, um, coming into the clinic to see me.
If you've gone 10 minutes before and then you're about to leave the house so you go again, but you're coming to a place where you know where the toilet is, it's a safe space, try to start challenging there. You can drive for 20 minutes, you just went pee 10 minutes ago, try to get rid of that one. Use it in your safe spaces where you're going to a place that's relatively close, that you know you can use the toilet when you get there if you needed to.
Yeah. Don't challenge us going to Windsor for the first time. Windsor has like the, that stretch of 401 has the least amount of enroutes, I think, um, but yeah, so it's just start challenging your body and thinking more about it and do I really have to go pee or am I going pee because I'm leaving the house?
Right. And it is something you can retrain just that body connection. You can retrain it. It just takes a little bit of time and effort. Um, I was just going to add to, I think I've heard this before that there is two times where intentionally you might want to try to go pee before bed, because then ideally you're not getting up in the night and after having sex, like, I think that is proven, right.
That we should try to empty our bowels or our bladder after, uh, having sex. I think that helps. Does it help minimize UTI risk? Is that? Yeah, it definitely does. Yeah, it definitely does for I think a number of reasons. And I always will have people do the double void after intercourse to fully empty their bladder because the tissues are engorged from arousal.
And so that Feel like you can't go pee sometimes. So sitting there and sort of not bearing down, but using that breath can help fully empty the bladder after. So then you're getting, um, making sure that you're fully emptying, um, as well as sort of you, yeah, going pee after sex. I think it has, it's like a bacterial thing and it can, um, that, and yeah, certainly like.
Going pee before bed when you're about to hopefully, I mean, ideally sleep for eight hours without getting up. Wouldn't, that's the dream. Um, so yeah, I mean, you're about to go that length of time without going pee. So certainly, and when we're talking about habits, it's exactly that it's our habits. So like if you're doing it every now and then, are you really setting yourself up for challenges?
Probably not, but it's, it's every time you leave the house and you leave the house five times a day. Now we're in a bit of a more of a situation that could lead to some challenges, right? Um, so as I was saying, this sort of leads into one of my other points to chat about is sort of going P or having urgency.
Urgency is a big one with certain environmental cues, and that's how the just in case can start to become a little bit of challenge or be problematic for some people. Uh, key in the door is a very common one. Meaning you get home, you pull into the driveway, maybe it didn't even register that you had to pee, but suddenly you're hopping on the spot, can't quite get the key in the door and get your stuff down your coat off fast enough to get to the bathroom.
That is an environmental cue that's dictating how badly you have to go pee and not necessarily the volume of urine in. Not always, maybe you just really have to be. Um, but it is helpful if it is sort of come out of nowhere and you know, you just went pee 45 minutes ago, you can do a Kegel in those moments.
A Kegel will relax the bladder. I will not pee until I'm sitting on a toilet. I will not pee. Repeating that sort of reinforces to your central nervous system that no, I can control this urge. And then calmly walk to the bathroom so that that link of pulling in the driveway, getting the key and doesn't have to be this dance of like, I'm almost going to pee my pants every single time.
Right? Yeah. I've heard someone say like your bladder starts to act like a toddler where it's like, I have to go pee now. It's like. Yeah. No bladder. Like I, I have to practice as I will admit, I deal with urgency. Sometimes it's just again, that mind body connection. Um, when I pull into the driveway, even if I don't have to go pee super bad, I feel like that sudden urgency and yeah, things that work for me.
Um, like Dayna said, just a bit of a Kegel, you know, self talk, like I closed my eyes. I'm like, I'm okay. I don't have to go pee yet. I'm fine. I'm fine. Um, another one, if I'm standing up, if I do some like heel raises, like go up and down on my tippy toes, because I've heard that's the same like nerve connection in your calf muscle as your pelvic floor to kind of cue it to settle down a little bit.
Um, that tends to work. I know, I think Aaliyah talks about this, distracting your brain. So counting backwards. by threes or by sevens. Um, something to just get your brain off of the fact that you have to pee. All of those things might help. Yeah. Interesting with the heel raises, because that's another thing with going, if you are someone like me, who is shorter, a lot of toilets are too tall for you.
If you are constantly sitting on the toilet with your toes down and your feet sort of in that planner flexed or pointed toe position that can actually increase your pelvic floor tension. Yeah. That's connected. Yeah. I actually talked to someone about that this week. Cause I told her, I said, Oh, um, she deals with constipation.
I said, do you use a squatty potty? No, I probably should, but I just go on my tippy toes. So that brings my knees up. I'm like, it does. You're right. But you're not actually relaxing. So if you picture, yeah, I'm like holding myself up on my tippy toes, I'm contracting things. So I'm not letting those pelvic floor muscles relax to let the poo come out.
Yeah. Yeah, so interesting. I think this stuff is cool. I, this is like light bulb stuff for me when I learned it. So I love teaching this stuff. Um, so yes, being more in control of your environment. I, I hope when you listen to this, you can start to understand how sort of these things. Get away from us a little bit.
It's very easy for it to get away from us. Um, I had a client just this week who she realized as we were talking through some urgency, she came to me for this key in the door type phenomenon. She was finding that she was actually leaking a lot of the time when she would feel these urge, even if she didn't have to pee four minutes before that.
Um, she's come to find that like running water, if she hears running water, she suddenly has to pee, which is a very common one. And so she's working on retraining that now, but she's got the tools that she can say, no, I just peed 20 minutes ago. Like I don't have to do it again, but you can imagine if she's gone pee her whole life.
She said, I think it's been going on since I was a child. You know, your whole life you've been like running water. Oh, I've got to go to pee. And you listen to that urge, how that pathway becomes. So strong for sure. Yeah. It's a hard, hard habit to break. That's for sure. It's hard, but it can be like a quality of life game changer too.
Now we're talking about delaying the urge with bladder. One of the factors or one of the habits that we have that can impact in a negative way, our pelvic floor for bowels is delaying the urge to have a bowel movement, which is another big one with kids, right? Like I will say, um, my, my toddler Tegan is three and we've been dealing off and on with.
constipation with her because typical toddlers, what, you know, they become potty trained. They need to go to the bathroom to poop instead of just pooping in their diaper. But they're having so much fun being a toddler. Why would I leave, you know, playing with my sister to go poop if I can keep playing and yeah, that, you know, I actually talked to a dietician about this to help with her constipation.
Cause she was somebody interestingly, um, That's, this is the interesting thing with constipation too, because she would have phases of being fine and then phases of constipation. So we kind of chalked it up to she's a toddler. It'll work itself out. But she was starting to have, um, accidents. So she was fully potty trained doing, she did really, really well with it.
And in daycare was starting to like have pee accidents. And so we're like, that's interesting. And it was becoming like daily. And so, and then she started to say like her tummy or no, she kept saying her bum was hurting. Like, okay, something's up. And so, yeah, we figured out the constipation was getting away from itself a little bit.
And so, yeah, we got some help, but, um, that is what this dietician was saying is that it is very, very common in toddlers because yes, they get so distracted with their environments. They forget to poop and then. Remind me why. I think it's because then it gets kind of withdrawn back up into the system, loses some water, right?
And then it makes it harder to pass out. Is that what it is? And fairly quickly, like, yeah, we know this, we know this as adults, if you have to poop, like you wait five minutes and you don't really have to go anymore. It happens pretty quickly. The yeah, the poop moves back up, water gets drawn out and then it's harder to pass.
So now we're into a bit of a straining scenario. Right. And maybe incomplete emptying happens all the time. And kids, even you get a little bit more like school age and they suddenly are aware of like the social implications of going poop at school, or maybe they're not confident in cleaning themselves.
And so they start to hold it longer. Right. That can lead to constipation for kids there too. Yeah. And with adults, you know, same as what you were saying with the pee thing. It's like, sometimes we're too busy to go to the bathroom. It's like, you know, I need to keep doing what I'm doing. Yeah. I have to poop, but I can hold it a little bit longer.
But yeah, try as best you can to, when you feel that urge to poop, go poop. Yeah. Literally just go as best you can. Yeah, like, um, it can just be a massive for one prevents constipation to can prevent needing to strain which decreases the risk for fishers hemorrhoids pain. It can decrease your leaking if you're fully emptying your bow like I can't stress it enough.
Go like you have to go poop. Yeah. Yeah. And then the last one, and you might add me for this one, people, um, try your best to not hover over the toilet. So this is a big one for people in public bathrooms and yes, you know, if we're afraid of germs, I get it, but use the toilet, toilet seat cover, put some toilet paper down, do what you need to do to sit down on the toilet.
And why do we say that? So. We were just saying previously, in order for pee and poop to pass easily, we need to allow those pelvic floor muscles to fully relax. And if we're hovering, basically we're doing a static squat, which also is just very hard. So relax in that moment. Um, yeah, so we're contracting.
We're contracting everything to hold ourselves up. So yes, then our pelvic floor and our bum muscles are not able to relax to let things pass through. And over time, so then we might need to strain a little bit to get the pee or the poop out. Um, which yeah, could contribute to pelvic floor symptoms down the road if we're always, always doing that.
Yeah. If we're doing it once in a blue moon, it's not probably dangerous or going to do anything, but yeah, if we're have a habit of that. When we're in a public bathroom. Yeah, try to not do that. Yeah, no hovering and I'm just going to go out on a limb and say that nobody has ever had any sort of like, uh, back.
Not anybody. Okay. I got to be careful with my language, but I don't think many people are getting any sort of like severe bacteria on their bum cheeks from sitting on a public toilet. Yeah, I think I've heard that. Like it's, yeah, it has bacteria on it, but there's things like our phone that have more bacteria on it.
Yeah. If you're freaked out about public bathrooms, like look into what's on your phone and then it maybe will make you feel better about putting your bum on something rather than what you put to your face. Yeah. Cause that you're, and you're washing your hands right after too. Right. So. Wash your hands right after.
Use the seat covers. Um, generally you're not, you know, flushing the toilet while sitting on it, which I think then we could maybe be a little bit worried about, you know, some sort of bacterial transfer. Um, but you're good. Just sit, pee, sit, poop, don't hover. Yes. All right. I think that's everything right, Dayna?
Yes. Happy, happy bathroom. Yes, your bladder, your pelvic floor will thank you with all of these trying to minimize all of these habits.
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.
