Your bladder is meant to be a reservoir, and it should be able to hold enough that you would need to pee every 2-3 hours you’re awake.
If you’re usually going more often than that, or are always needing to know where the toilet is wherever you go, it is possible to train your bladder to be a better reservoir by using your pelvic floor muscles.
How Can You Train Your Bladder?
What is Normal?
It would be typical to urinate 5-8 times each day, and not at all through night unless you’re over 65. Each time you use the toilet you should have a good stream that lasts at least 8 seconds, which would be more than 200ml of urine.
What is “Overactive” Bladder?
The bladder can become irritable or “overactive”, making you pee more often. This could be due to habit, if you often empty the bladder before it is full. If your bladder never fills up, it doesn’t ever expand and can become smaller over time. But this can be reversed! You can use your pelvic floor muscles to train your bladder to hold more urine before you need to pee.
It is important that you first get checked by your family doctor, as there can be medical reasons for experiencing urinary frequency or urgency. If there is no underlying medical issue, you can get some help from a pelvic health physiotherapist who has advanced training in working with pelvic floor muscles and other structures in that area.
What to Do?
If you feel you need to urinate more than every 2 hours, try not to go with the first urge you feel.
When You Do Feel the Urge to Pee
- be still (standing or sitting) and tighten up through your pelvic floor muscles
- try to distract your brain at the same time with something else
Doing this can help settle down the urge to urinate. If after a minute or two you still need to go, try to walk to the toilet slowly. If the urge to pee has settled down, try to delay going until you feel an urge again. Over time you are trying to lengthen the time between visits to the toilet.
When you first sit down on the toilet, your brain recognizes that you are in the appropriate place to pee, and it will signal your pelvic floor muscles to relax. This automatic release through your pelvic floor makes your bladder contract, and that is what starts the flow of urine. Your job is to keep those muscles relaxed and take a few deep breaths. Once the stream of urine is done, keep your muscles relaxed and take another breath or two, just giving it 5-10 more seconds before you get up and move. Do this every single time you go to urinate, and over time your brain should learn that you are going to keep your pelvic floor muscles relaxed enough to empty more completely.
It is important to drink enough through the day so that your urine does not become too concentrated. Your goal would be to drink about 2L of fluid each day. Try to limit any fluid intake after dinner so that you don’t have to get up through the night to pee.
Caffeine can irritate the bladder in some people. It is found in coffee, tea, colas and chocolate. If you feel that caffeine makes you urinate more often, see how things change if you replace these drinks with decaffeinated versions. If you notice a significant reduction in how often you are having to pee, it would be beneficial to reduce caffeine over the long term.
Drinks that do not irritate the bladder are:
- decaffeinated tea and coffee
- diluted cranberry juice
Your Partner in Pelvic Health
Elevation Physiotherapy & Wellness is an excellent place to start addressing your problem. Many people have heard of Kegel exercises, but they are not appropriate for everyone and many people perform them incorrectly. It is very important to seek care from an experienced clinician trained in this area, who can do an internal exam to assess your muscle strength and look at other tight or weak tissues that contribute to your problem. Internal palpation is the gold standard of care, and we are sensitive to the fact that it can be difficult for some people to be comfortable with this. We will discuss our plan of action with you before initiating treatment.
At Your First Appointment
We will send you a form for you to describe your issue and return prior to being seen for your first appointment. This completed form allows the physiotherapist to effectively prepare further questions and plan what to focus on first.
Your physiotherapist will need a very detailed history of your issue, and will then start a physical examination of the joints, muscles and connective tissue of your pelvis, lower back and hips. Most of the time, this assessment will include an internal exam to evaluate the pelvic floor muscles and other tissues in that area, since these muscles are only accessible internally. If an internal exam can’t be tolerated initially, we can start treatment by focusing more externally and progress to internal work as you can.
On the initial visit, you’ll spend about one hour with your physiotherapist, and together you will discuss your goals of treatment and devise a plan to get there!
Your Pelvic Health Treatment
Your treatment will include education about your problem, and may also include manual therapy (hands-on work by your Physiotherapist), and performance of specialized exercises designed to help with pelvic floor problems. Some people may benefit from a muscle stimulation machine to help you get your pelvic floor muscles functioning properly, or a biofeedback machine to ensure proper contraction and relaxation of the pelvic floor muscle group.
You Will Have Homework!
At Elevation Physiotherapy & Wellness, we will devise a personal home program for you to work on daily between appointments to efficiently address your concerns. It will not take you more than 10 minutes at a time, and practicing these focused exercises regularly will allow for progressions to be made each time you see your Physiotherapist.
Contact Us to Book an Appointment
If you’re suffering from urinary frequency and urgency or another type of pelvic health issue, we’d love to provide the treatment you need! Please contact our office to book your first appointment, or simply fill in our form and we’ll get in touch with you.