Who may need bladder retraining? I'm glad you asked! You may need bladder retraining if you experience symptoms of urinary leaking, incomplete emptying, bladder pain, urinary urgency, or frequent urination. If this sounds like you--keep reading!
Here are some topics we will discuss:
urge suppression techniques
how to complete a bladder diary
bladder irritants
The Knack
water intake
how pelvic PT can help
Urge Suppression Techniques:
If you get the urge to pee more frequently than every 2-4 hours---try this. Ignore the first urge and distract yourself by doing a different task like wiping down the counter, walking to the mailbox, taking out the trash, etc. Another option would be doing 10 calf raises, 3 slow breaths, and a few pelvic floor contractions. Notice if the urge goes away (if so, yay!!). If not, try again next time.
Bladder Diary:
A bladder diary can give your pelvic PT lots of potentially helpful information when figuring out what is causing your bladder symptoms. To complete one, you will keep track of all fluid intake (what is is, how much, what time, etc.), urine output (how long the stream lasted, any pain, color), bladder pain, and urine leakage (what were you doing when it happened and how much. I also like to have patients keep track of food during the bladder diary as well because some bladder irritants are food not fluid. The bladder diary is usually completed for 3-7 days, and then gone over in your next follow-up appointment.
Bladder Irritants:
Sometimes, bladder symptoms like increased urgency and frequency, bladder pain, bladder fullness, increased amounts of leaking, and stinging with urination are caused by bladder irritants. Some common ones are caffeine (coffee and tea), carbonated drinks, fake sugar (aspartame, diet sodas), chocolate, tomatoes and other night shades, citrus, alcohol, and cigarettes (or any nicotine product). We may notice from completing a bladder diary that these things increase your symptoms and have you avoid them to see if they improve.
The Knack:
This is a common cue given to women who experience small amounts of incontinence with coughing and/or sneezing. To perform "The Knack", your pelvic PT will teach you how to correctly perform a pelvic floor contraction in anticipation of a cough or sneeze which can potentially decrease the amount of leakage you are having.
Water Intake:
I know we all know this, but sometimes we need a little reminding (especially moms). Adequate water intake is absolutely essential to your whole body performing optimally---especially your bladder. Well, what is "adequate water intake"? Usually, I recommend about half your body weight in ounces of water a day. It is usually unnecessary to drinks upwards of a gallon of water a day, and can actually flush out those precious minerals and salts in your body. Water intake recommendation may increase or decrease with seasons of life like pregnancy, breastfeeding, or intense exercise. I am also a big fan of adding in trace mineral drops and electrolytes to water to ensure optimal hydration (this is absolutely crucial if you use an RO filter which removes all minerals from your water). P.S. restricting water intake is very unlikely to resolve bladder leakage because dehydration will cause increasing bladder irritation.
How can pelvic PT help?
A pelvic PT is trained to recognize who needs bladder retraining and why. Every patient deserves to receive individualized care because there are often different root causes for bladder issues, and it is the pelvic PT's job to figure it out. They may utilize some of the tools mentioned above combined with things like nervous system down-regulation training, relaxation or strengthening pelvic floor exercises, manual therapy, and internal (vaginal/rectal) treatment to help you meet your goals.