Urinary Incontinence, Frequent Urination, Overactive Bladder, Incomplete Emptying and Nocturia
Urinary incontinence (leaking urine) is extremely common, occurring most often in women, and can happen anywhere throughout their lifespan. It affects adolescents and young adults (25%) – and is often seen during this age in athletes. It is also common during pregnancy and postpartum time periods, and again around perimenopause and post menopause (44-57%).
On average 30-47% of all women leak during fitness or recreational activities, this includes walking, hiking, running, jumping, HIIT and yoga!
What Causes Urinary Incontinence
There can be several causes behind urinary incontinence, including:
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Urethra hypermobility
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Pelvic organ prolapse
Types of Urinary Incontinence
Stress Incontinence
The most common type of incontinence and occurs during laughing, coughing or
sneezing. Stress incontinence includes leaking during running, jumping or HIIT workouts.
Urge Incontinence
When you are unable to make it to the bathroom in time, or leaking with the sense of an urge to urinate. This can happen when you pull in the driveway, at the door of the bathroom, or as you walk into your house (otherwise known as the “key in the door syndrome.)
The pelvic floor muscles and their coordination with breathing also play a role. The pelvic floor muscles contract, or lift up on the exhale to help push air out of the lungs.
Weakness in the pelvic floor muscles (and deep core), and/or poor coordination with the exhale of a breath, can cause that downward force of the air (cough, sneeze, laugh) to push urine out.
Understanding Normal Bladder Function
The bladder can hold up to 2 cups of urine. Normal voiding is 6-8 times a day, or about once every 2-3 hours. Nocturia is getting up at night to use the bathroom, and is not OK. After the age of 65 it is considered to be “normal”, but should definitely not happen before then.
The urge to urinate is your bladder sending a signal to you that it is stretching, and filling. You should be able to put this urge off once or twice, depending on your activity and where you are. Giving into the urge consistently can lead to decreased bladder filling and too many trips to the bathroom. On the flip side, putting it off too much can lead to tension in the pelvic floor and poor emptying habits.
Helpful Tips for Managing Bladder Symptoms
Bladder Diaries
Bladder diaries can be helpful to get an idea of how often and how much you are voiding. Track how often you urinate, approximately how much, your fluid intake and whne your symptoms occur.
Increase Time Between Bathroom Tips
Using techniques such as urge suppression techniques, can help you start to lengthen the time between voiding. Start with small increments (5 minutes) and build to larger ones.
Awareness of Bladder Irritants
The bladder is sensitive to the contents inside it, and can be irritated with different foods or
beverages. The simplest thing to do is to drink plenty of water, to dilute the contents of the bladder. Bookending caffeine and carbonation with water before and after can help you to better tolerate bladder irritants.
How Pelvic Floor Muscle Tightness Affects Bladder Function
Tightness in pelvic floor muscles also play a role in bladder function, causing many common symptoms such as:
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Overactive bladder
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Incomplete emptying
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Post void dribbling
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Urge incontinence
This is because of the pelvic floor and bladders close-knit relationship to each other. Pelvic floor muscles become tight for many reasons, including:
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Previous UTIs
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Constantly putting off voiding
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Hormonal changes
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Constipation
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Trauma
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And more
This tension can be released with soft tissue techniques, internally to the pelvic floor muscles and to surrounding hips and abdominals. Pelvic floor muscles typically respond well, improving symptoms and tolerance to foods and activities.