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How to fix tiny bladder syndrome

Here are some strategies that I share with my clients who struggle with urinary frequency or what I like to call “tiny bladder syndrome”. It’s exactly what you’d imagine - they need to pee all the time, sometimes even multiple times an hour. A normally functioning urinary system only requires the bladder to be emptied every 2-4 hours depending on fluid intake and how well the pelvic floor muscles are working. Anything more frequent than every 2 hours would warrant some investigation.

So when caffeine and fluid intake are stabilized or ruled out as an issue, the next step is to train the bladder to not need to be emptied as frequently, because when you start peeing more frequently your bladder gets used to not being completely full. We do this by gradually extending the time between trips to the washroom in 10-15 minute increments. For example - you feel an urge but you know you peed less than 2h ago, so you wait 10-15 minutes before heading to the washroom. This is where I get the incredulous looks. You want me to wait?? Yes. But I’ll also give you some things to do while you wait to try to minimize that urge. These are called urge suppression techniques. 

#1 - The Sustained Kegel - If my client is able to find their pelvic floor muscles, I have them first contract and hold for as long they can (the longer the better). When we feel an urge to pee, what we are feeling is the bladder contracting as it is filling. This sends a message to the brain which we register as needing to head to the washroom. Contracting the pelvic floor muscles closes off the urethra (the opening that urines comes out of) and sends a message to the brain that it is not time to empty the bladder, which makes the bladder stop contracting, and thus stopping the urge. While it is a reflex, it does take some time for this communication to happen, so a nice long, strong pelvic floor contraction is needed for this technique to be effective.

#2 - Deep Breathing - Sometimes frequent urination is a sign of a tight pelvic floor so in order to be able to generate a strong enough contraction to suppress the urge, we first need to get those muscles to relax. Stress and anxiety can also be a sign of or a cause of frequent urination. Either way, deep breathing can help with both. Taking the time to focus on 5-10 deep breaths can help decrease stress, relax the pelvic floor muscles or distract you from your urge.

#3 - Ankle Pumps - You know how it’s recommended to perform ankle pumps if you are on a long flight to help with circulation and prevent blood clots? Well, the same little movement can also help calm down an urge to pee! Kids actually do this naturally - have you ever watched how a kid moves around when they need to pee? It often involves a lot of wiggling but it also often involves going up on their tippy-toes and back down repeatedly. You can leave out the wiggling and crazy dance moves (unless that’s your thing, then by all means, have at it!) and just lift your heels up and down! You can do this sitting or standing.

#4 - Distraction - If you were thinking that strategies #2 and #3 are essentially distraction techniques, you would be correct, but they also work on their own without necessarily distracting you from the urge. What I mean by distraction are things that completely take your mind off the urge or trying to suppress it. For some this might look like trying to recite the alphabet backwards or counting by 3’s starting from 11. It could also be finding a new mindless task to distract you like filing paperwork or folding laundry. It could also be lightly snapping an elastic or hair tie that’s around your wrist. Anything that will make your brain focus on something else.

For some people, one or more of these techniques makes the urge pass and they can wait 10+ minutes before heading to the washroom. For others, it’s a real struggle at first to make the 10 minutes. Others still can’t make the 10 minutes, but any length of time they are able to wait is a win and we go from there.

If you struggle with “tiny bladder syndrome” and want to learn more about getting leaks and urges under control, I’m having a free virtual Pelvic Floor 101 workshop on Tuesday, January 19th at 7:30pm. It will be run on Zoom, so you get to listen in from the comfort of your own home!

This workshop is open to anyone (not Modern Sports clients), so feel free to invite anyone you think would benefit!

Register here: Pelvic Floor 101 Workshop

by Natasha Tétreault - Physiotherapist


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