Category Archives: Bladder Health

Managing a Holiday Flare-Up

happy-thanksgiving-1-1024x768

First, and foremost, a very HAPPY THANKSGIVING! from all of us at Proaxis Pelvic PT! We are so thankful to you–our patients, readers, and friends for all you do to support the work we do, and for allowing us to be a part of your health journey. We are very grateful to be a part of your life.

Now, every year around the holidays, an interesting scenario happens. Many patients come in worried, stressed, and often disappointed as their symptoms tend to go a little “backwards” through the holiday buzz. Often times, they don’t necessarily connect the two together, but instead, come in to their appointment frustrated that things are not going well. And it could be anything– people struggling with bladder control may be leaking more, people with constipation may be having more difficulty, and people experiencing pain may see their pain spike. But, why does this happen? Sometimes, we can’t identify a cause—it just does But during the holidays, there are often a few key things that I find will contribute to a change in symptoms:

  • Stress: Holidays are wonderful, awesome times to be with those we love and celebrate together. However, it is very common for this wonderful season to be accompanied by stress– planning, cooking, eating–spending lots of time with family, etc. Stress is often accompanied by increased muscle activity, increased sympathetic nervous system output, and thus can lead to a spike in pain or changes in bowel and bladder.
  • Diet: I shouldn’t need to explain this (we LOVE eating over the holidays), but many people will change their diets significantly throughout the months of November and December. We eat more rich foods, change our eating routines, and very likely consume slightly different fluids than we typically do. As you may remember from previous posts, the bowels love routine and changing this will likely impact the system.  In addition, both our bowel sand bladder are influenced by the fluids we take in and may become irritated if we are consuming fluids that are acidic, carbonated, caffeinated, artificially sweetened or containing alcohol (Jenna wrote a great post about that last year)
  • Inconsistency in Routine: Even the most compliant and consistent person may have difficulty staying in a healthy routine over the holidays. Often times, people will find it difficult to get in their recommended exercises, and may find themselves slipping from the habits recommended to them by their healthcare team. This can often lead to a worsening of symptoms (bladder, bowel and pain).

So, what to do when this happens?

  • First, do your best to stay calm and stay positive. I know it can be very frustrating when you are hurting/leaking/etc, but realize that this is likely just a small “hiccup” in your progress. Try not to let stress take over (see above), and instead, try to take a proactive approach to calming down the “flare,” whether it be bowel, bladder or pain problems. Check out this great post from Pelvic Health & Rehabilitation Institute for more great info on “How to not freak out during a flare”.
  • Next, evaluate the previous few days and take note of any of the items mentioned above. Did you have a few glasses of wine with dinner last night? Did you skip the fiber for the potatoes and turkey at Thanksgiving? Did that one relative show up at dinner and make you crazy? Have you forgotten to drink your normal water amount with all that Black Friday shopping?
  • Finally, make a plan to get back on track. Fill up that water bottle and start getting fluid. Skip the leftovers for a big salad for lunch. Spend some time doing a guided meditation or breathing routine to calm your body. Take a few minutes to do your exercises. Use an icepack to calm down painful areas.

Most importantly, remember to keep positive. It is easy to go down a negative road when symptoms seem to worsen suddenly, but remember that your journey to better health is in fact a journey. There will be ups and downs, but you are not alone. E-mail your PT if you need to for a little encouragement. Take a deep breath, and enjoy this holiday season.

Have a very Happy Thanksgiving!

Jessica Powley Reale, PT, DPT, WCS

Advertisements

Potty Yoga

As many of you know, I am very nerdy–in a great way, I believe. And this nerdiness especially comes out when you take a look at my leisure reading material. Recently, I began reading a new book that came to me in a package of promotional materials from the awesome website, Potty MD. Potty MD offers excellent products and books–including my reading of choice, Overcoming Bladder & Bowel Problems in Children by Dr. D. Preston Smith. This $8 book is a jewel and is full of great recommendations–including an appendix full of kid-friendly fiber recipes! I have loved reading it, and I especially loved his idea of practicing “Potty Yoga.”

Now, for those of you who have done yoga in the past, I’m sure you are wondering how the two words “Potty” and “Yoga” can possibly be paired together. But actually, I think the ideas work very well and that both children and adults can truly benefit from the idea of “Potty Yoga.”

Spending time on the toilet is something both children and adults often tend to avoid. We feed into this mindset for ourselves, even referring to bathroom stops as “Pit Stops” comparing our urination to that of a racecar stopping mid-course. The unfortunate side effect of this is that many adults develop poor voiding patterns with bad habits and our children develop frequent urinary tract infections and experience accidents.

Normal emptying of the bladder occurs with a coordinated relaxation of the pelvic floor muscles and a contraction of the detrusor muscle of the bladder to empty urine. This actually involves very little work on our part. Our job is simply to breathe and relax and allow our bladder to empty itself. When we try to speed up this process by pushing or straining, we often negatively impact the bladders function and can develop dysfunctional voiding patterns, difficulty emptying our bladder and pelvic floor muscle incoordination.

For children, dysfunctional voiding patterns often develop from chronically trying to hold urine for longer periods of time. Often times children become involved in playing and do not wish to stop their activities to use the potty. Abnormal habits can often make it more difficult to start a urine stream, which can cause a child to become frustrated and cause unnecessary straining/pushing to empty. Often children are also thinking of other things on the toilet which worsens the difficulty in emptying.

Parents can feed into this process without meaning to by urging the child to “hurry up” or distracting the child by games/playing on the toilet. This unfortunately only makes it more difficult for the child to relax his/her muscles to properly allow the bladder to empty.

Instead, both adults and children should practice, “Potty Yoga.” Yoga focuses on mindfulness, allowing the mind to stay on task, breathing and allowing the body to fully relax. Children and adults should use proper posturing on the toilet as well to allow muscles to fully relax, and should spend 2-3 minutes uninterrupted in order to get positive results. Dr. Smith encourages children to sit in a relaxed position, quiet and comfortable, with eyes closed and slow breathing to avoid being distracted and to allow focus to stay on the bladder.

This same habit should be used for bowel movements to allow muscles to relax and improve ability to empty. So, take a deep breath and get into the habit of practicing potty yoga. The results for your body could be wonderful.

Namaste!

Written by Jessica Powley Reale, PT, DPT, WCS

Is Running Bad for a Woman’s Pelvic Floor?

As some of you may know, I recently completed my second half-marathon. To make it even better, I completed it with my amazing and wonderful husband Andrew:

4 miles in to our first half marathon!

4 miles in, and feeling great!

This was my second half marathon in 1 year, and my third *big* athletic event—the other two being the Disney Princess Half Marathon and the Ramblin’ Rose Sprint Triathlon. I started out 2013 with the goal of being healthier and developing strategies for life-long fitness, and I really am proud to say that as I approach the end of 2014, I am well on my way to better fitness.

Disney princess half

Disney Princess Half Marathon with my awesome sister, Tara and wonderful colleague, Jenna

After completing my last half-marathon, I received the following question from a previous patient of mine,

“Ok, I have to ask, after seeing your race pictures,

isn’t running bad for a woman’s internal organs??”

My initial thought was to respond quickly with a, “Not always, but sometimes…” type of response. But then it got me thinking, and inspired me to really delve into the issue with a little more science to back my thought—although honestly, the gist will stay the same.

So… Is running bad for the pelvic floor? Let’s take a look.

When someone initially looks at the issue, there may be the temptation to respond with a resounding, “YES!” We initially think of running and think of “pounding the pavement,” identifying large increases in intra-abdominal pressure and assuming that this pressure must make a woman more likely to experience urinary incontinence and/or pelvic organ prolapse.

But, what does the research really show?

1. Urinary incontinence during exercise is common and unfortunate.

  • Jacome 2011 identified that in a group of 106 female athletes, 41% experienced urinary incontinence. However, they also found that UI in those athletes seemed to correlate with low body mass index.

2. High impact athletes often may require more pelvic floor strength than non-athletes.

  • Borin 2013 found that female volleyball and basketball players had decreased perineal pressure when activating their pelvic floor muscles compared to nonathletes which they concluded placed these women at an increased risk for pelvic floor disorders and especially UI.

3. Over time, physically active people are not more likely to have urinary incontinence or pelvic organ prolapse that non-active individuals.

  • Bo 2010 found that former elite athletes did not have an increased risk for UI later in life compared to non-athletes (although she did find that women who experienced UI when they were younger were more likely to experience UI later on in life).
  • In another study, Bo (2007) found that elite athletes were no more likely to experience pelvic girdle pain, low back pain or pelvic floor problems during pregnancy or in the postpartum period compared to non-athletes.
  • An additional study by Braekken et. al. 2009 also did not find a link between physical activity level and pelvic organ prolapse. However, they did find that Body mass index, socioeconomic status, heavy occupational work, anal sphincter lacerations and PFM function were independently associated with POP.

Is your head spinning yet?? Let’s make some sense of this research…

First, it does seem like UI is a common problem in athletes—the cross-fit video that had all of my colleagues up in arms identified this problem really well—and honestly, runners are no exception to this. Every week, I work with women who experience urinary leakage when they run or may have even stopped running due to leakage, and I can assure you this causes a huge impact to these women’s lives. I also can assure you that there are many women out there dealing with leakage during running or other exercises who suffer in silence, too embarrassed to get help or somehow under the impression that leakage with exercise is normal.

With that being said, I am not ready to throw away running or really any other form of exercise all together (other than sit-ups…let’s never do those again). Running has amazing benefits—weight control, cardiovascular improvements, psychological improvements/stress reduction—and these should not be cast aside due to a fear that running could cause a pelvic floor problem.

As a pelvic floor physical therapist working in a predominantly orthopedic setting, I see many men and women enter our clinics with aches and pains—and injuries—that began while starting or progressing a running program. Often times, our amazing PTs identify running gait abnormalities, areas of weakness, or biomechanical abnormalities which can be contributing to hip/knee/foot/etc. pain with running. Improving those movement patterns and improving those individual’s dynamic stability seems to make a huge difference in allowing the client to participate in running again without difficulty.

To be honest with you, I see pelvic floor problems in runners the exact same way. When a woman comes into my office complaining of urinary leakage during running, I look to identify running gait abnormalities, areas of weakness or biomechanical abnormalities which are impacting her body’s ability to manage intra-abdominal pressure during running. I also make sure I am managing other things—identifying pelvic organ prolapse when it may be occurring and helping the woman with utilizing a supportive device (tampon, pessary—with collaboration with her physician, or supportive garment), managing co-existing bowel dysfunction or sexual dysfunction, and making sure the patient has seen her physician recently to ensure she is not having hormonal difficulties or medication side effects which could worsen her problems.

We know that intra-abdominal pressure is higher when running. A poster presentation at the International Continence Society in 2012 identified that running does in fact increase intra-abdominal pressure compared to walking—but not as much as jumping, coughing or straining (Valsalva). And not as much as sit-ups…which I hate.

Kruger et. al. ICS Poster Presentation, "Intra-abdominal pressure increase in women during exercise: A preliminary study." 2012

Kruger et. al. ICS Poster Presentation, “Intra-abdominal pressure increase in women during exercise: A preliminary study.” 2012

As you know by now if you follow my blog posts, I do not believe that the pelvic floor is the only structure involved in controlling intra-abdominal pressure increases in the body. (This is why I get so annoyed with all of the studies trying to look at the effectiveness of pelvic floor muscle exercises used in isolation in treating pelvic floor dysfunction). The most current anatomical and biomechanical evidence supports the idea that the pelvic floor muscles work in coordination with the diaphragm, abdominals, low back muscles as well as even the posterior hip muscles to create central stability and modulate pressures within the pelvis. In order for a runner to not leak urine or not contribute to prolapse or pelvic floor dysfunction when she runs, she needs the following(well really, more than this…but let’s start here):

  • Properly timing, well-functioning, flexible pelvic floor muscle group.
  • Properly timing diaphragm—that is used appropriately as she runs so she is not participating in breath holding during her exercise
  • Strong and adequately timed abdominals and low back muscles to assist in stabilizing her spine/pelvis and assist in controlling IAP.
  • Flexible and appropriately firing gluteal muscles to support her pelvis during each step as she runs
  • Appropriate shoes to support her foot structure and transfer the loads through her legs
  • A great sports bra to help her use good posturing while running

Now, is there a time when a woman shouldn’t run?

Yes, I do actually think there are times when running does more harm than good and it may be advantageous for a woman to take some time off from running to restore the proper functioning of structures listed above.

  • If a woman has pelvic organ prolapse, for example, she may need to take some time off from running and participate in other exercises emphasizing functional stability with less of an increase in IAP prior to resuming an exercise program. Some women can return to running in the meantime using a supportive device like a pessary or tampon to help support her organs; however, this may not ultimately mitigate the harm if a person is not stabilizing properly as she runs.
  • I also recommending taking a break from running if a woman is leaking significantly during running or experiencing pain with running. I generally believe that once these structures are appropriately restored to function, women can return to running with less difficulty.
  • The other time I will often recommend waiting is when a woman is further along in her pregnancy or early post-partum. At this time, the increased weight on the pelvis as well as the loss of stability occurring due to hormonal changes places a woman at a higher risk for pelvic floor dysfunction. This, of course, varies based on the individual, but in many cases it may be helpful for these women to choose alternative exercises until after they deliver their children.
  • And lastly, I do recommend a woman holds off on running immediately after gynecological surgery (no-brainer here folks). The research does not indicate that said woman should never return to running—but again, I do think she should allow her body to heal and build up the appropriate strength and coordination needed to support her organs and her pelvis when running.

This post got a little longer than I originally anticipated… so to sum it up… is running bad for your female organs? Not always… but sometimes.

Many of my colleagues have some fantastic blog posts regarding exercise and pelvic floor dysfunction. Check out a few of them below:

Vlog by Julie Wiebe providing an alternative to running:

https://www.juliewiebept.com/video/integrative-programming-for-female-runners-with-incontinence/

Safe exercise for those with pelvic pain:

http://www.pelvicpainrehab.com/pelvic-floor-physical-therapy/2058/pelvic-pain-and-exercise-general-fitness-tips/

Tracy Sher, “Pelvic Guru” on Leaking during exercise:

http://pelvicguru.com/2013/06/22/dear-crossfit-and-crossfit-gynecologist-im-appalled-theres-help-for-peeing-during-workouts/

Seth Oberst’s 4-post series on the Diaphragm:

http://www.sethoberst.com/blog/category/breathing

What do you think? Let me know in the comments below!

Written by: Jessica Reale, PT, DPT, WCS

References:

Bo K, Backe-Hansen KL. Do elite athletes experience low back, pelvic girdle and pelvic floor complaints during and after pregnancy? Scand J Med Sci Sports. 2007 Oct;17(5):480-7. Epub 2006 Dec 20.

Bo K, Sundgot-Borgen J. Are former female elite athletes more likely to experience urinary incontinence later in life that non-athletes?

Borin L, Nunes F, Guirro, E. Assessment of pelvic floor muscle pressure in female athletes. PM R. 2013 Mar;5(3):189-93. Scand J Med Sci Sports. 2010 Feb;20(1):100-4

Jácome C, Oliveira D, Marques A, Sá-Couto P. Prevalence and impact of urinary incontinence among female athletes. Int J Gynaecol Obstet. 2011 Jul;114(1):60-3.

Yes, you have incontinence. No, I do not necessarily want you to do Kegel Exercises.

This past week, I was fortunate to evaluate a nice middle-aged woman referred to me by her urogynecologist for urinary incontinence. When we first sat down, she looked at me and said, “I’m not sure why I am here. My doctor specifically told me that I have a strong pelvic floor. I really don’t think you can help me.” I smiled. I hear this same thought process on a weekly basis (See my previous article on common misconceptions of pelvic physical therapy) You see, at some point the world became convinced that from a musculoskeletal perspective, urinary leakage is always due to a weak muscle. And the best way to fix a failed muscle is to strengthen, strengthen, strengthen. But, if that’s the case, then why do I have so many patients walking into my office telling me that they have done “Kegel” exercises and still leak? Why would a patient like the one above have a “strong” pelvic floor that cannot hold back urine? Why is urinary leakage associated with low back pain and pelvic pain- disorders that we know can often include tight and irritated pelvic floor muscles?

Now, as a caveat to this article, let me say now that it is sometimes totally appropriate for a person to start a pelvic floor strengthening program. In fact, the person with a truly weak, overstretched, poorly-timing pelvic floor will likely be prescribed a strengthening program. With that being said, the truth is that the majority of patients referred to my clinic for evaluation of urinary incontinence are not issued a traditional kegel exercise program. Jenna and I actually tend to be surprised when we evaluate a new patient who truly needs to start a strengthening program for their pelvic floor at the first visit. The reason behind this is that Incontinence is not simply a failed muscle, but a failed system.

The urethra is supported within the continence system by fascia, ligaments, as well as muscular structures. When a downward force is applied to this system as occurs with coughing, sneezing, lifting, bending, etc, these structures function in a coordinated way to compress the urethra and prevent urine from leaking. In fact, Hodges et. al. in 2007 examined musculoskeletal activation occurring when a person performed an arm movement and found that the pelvic floor muscles pre-activated to prepare the body for movement. But, from a muscular standpoint, stability of the lumbopelvic structures (organs included!) requires optimal function of the diaphragm, the deep abdominal muscles, the deep low back muscles as well as the pelvic floor muscles.

When any of these structures are not functioning well, leakage can occur. Now, the tricky part here is that optimal functioning requires both strength, flexibility and proper timing. A tight irritated muscle then becomes equally as dysfunctional as a weak over-stretched muscle. And, a strong, flexible muscle that doesn’t have the right timing contributes to a very dysfunctional system.

So, treatment for incontinence then must include retraining and reconditioning the system to ensure its proper functioning—which for me includes a bit of detective work to truly identify the faulty structures. And, when it comes down to it, typically does not include doing 100 kegel exercises a day. More often, it includes learning to relax the pelvic floor, learning to coordinate the pelvic floor with the diaphragm, eliminating trigger points and restrictions, and then retraining the motor control of the lumbopelvic girdle as a system.

So, for now, take a deep breath and relax. We’ll save Kegels for another day.

For more information, check out the following:

Written by: Jessica Powley Reale, PT, DPT, WCS

STOP trying to “stop the flow of urine” !

At Proaxis we treat a large majority of patients who are struggling with urinary leaking. Most of them are embarrassed and seek Dr.Google’s help with their issues. A common misconception when trying to retrain the pelvic floor muscle group to gain control of leakage is to try and “stop the flow” or “stop the stream of urine” while peeing. Sure, this seems like a good idea since that is one of the pelvic floor’s jobs; however there is a normal bladder reflex at work that you are interrupting when consistently trying to stop the flow.

continence

When the bladder is contracting, or emptying, the pelvic floor muscles should be fully relaxed. This allows for complete bladder emptying. When you try to stop the flow each time you urinate, you are actually interrupting this reflex which can contribute to incomplete bladder emptying, continued urinary leakage, and put you at risk for a UTI (urinary tract infection). This technique is also not functional. Most people leak urine when they perform a functional activity (cough, sneeze, stand, lift) or with strong urinary urgency, therefore, the muscles should be re-trained during these activities.

If you do have urinary leakage and have been trying to “stop your stream”, STOP! Proper pelvic floor muscle coordination or strength training can be facilitated by a pelvic floor therapist. We would love to help you in any way necessary, so leave a comment or call with additional concerns.

Written by: Jenna Sires PT, DPT

“Do you need to go potty?” 5 Tips to Improve Your Kiddo’s Bathroom Health

Image

“You don’t understand! I’ve been constipated since I was a kid–it runs in my family!” 

I can’t tell you how many times I have heard that statement! We constantly reiterate on this blog that bowel dysfunction is never normal–common, yes–but not normal! And this is true for any situation, whether a person is 5 years old or 85 years old. Recently, I’ve been thinking about that same above statement and a light bulb went off,

“What if we were to change poor bathroom habits into good bathroom habits from an early age?” 

Would that help reduce the number of people who need my help when they’re older? I can’t help but think it would! So, today’s post is for you Moms and Dads! Strive to build healthy, good bathroom habits for your kids to decrease problems both now and later on!

Here are your 5 tips to do just that!

1. Encourage adequate fluid intake (mostly water!) and fiber intake

The average person should consume 5-8 8-oz cups of fluid per day–and your child is no different! Fluid is SO important for both the bladder and the bowels! For the bladder, having adequate fluid decreases the risk of urinary tract infections, encourages normal bladder urges, and allows for a normal light colored urine instead of a dark concentrated urine. As an aside, taking in too many sweet sugary drinks, caffeinated drinks, and carbonated drinks will actually irritate the bladder and could make your child go to the restroom more frequently as well as put your child at risk for problems with the bladder later on in life! (Note: Remember this if your child has difficulty with bed wetting!). For the bowels, adequate fluid allows for a soft stool that is easy to pass! If your child is not getting enough water, he or she will likely have a  more firm stool as the intestines have worked to absorb the fluid your child needs for normal bodily functions. Many a patient has been “cured” of constipation simply by drinking more fluid!

Fiber is also very important to encourage a good bowel consistency. Aim for 20-30 grams of fiber per day! Good fiber sources include fresh fruits and vegetables, whole grains, oatmeal, granola, seeds and nuts! For good recipes for your kids, check out Gina’s recipes from Skinnytaste.com that are “Kid Friendly” here.

Image

2. Encourage your child to listen to his or her normal body urges

This goes for both the bladder and the bowels as well! Quick lesson on anatomy and physiology–We have a normal reflex in our colon that helps us hold our stool to empty at an appropriate time (Yay!). Unfortunately, if a person holds stool for too long, the normal colon response to help us poop is dampened–meaning it won’t work as well! For the bladder, over suppressing bladder urges can cause a similar issue; however, your child could also develop some problems from going too often without an urge–Yes, I’m talking to you, “Just-in-case Mom.” A bladder that empties often without an appropriate urge can begin to give urges at inappropriate times. So, go when you need to go. Don’t go when you don’t!

3. Get your kids moving! 

I’m sure you’ve heard it in the news these days that kids need to get moving more! But, to take a new spin on it, encouraging your kids to move more will actually help keep their bowels more regular! Yes, it’s true, exercise is a stimulant to the bowels. So, encourage your kids to get outside and play, ride their bikes, do family walks and games– the more your kids move the better!

4. Help your child develop a bowel routine 

This one ties in perfectly with our last point. Here’s the scenario:

“8 year old Mary is not a morning person. Mom has a hard enough time getting Mary out the door in the morning, and this often means eating a bagel on the way to school. After Mary gets to school, she often needs to go #2, but is too embarrassed to go and holds it the whole day.”

Unfortunately, kids like Mary usually develop constipation from over suppressing those urges! This can be helped by building a routine for your kids in the morning (or evening) to help encourage a normal bowel movement.  We know that the colon LOVES consistency, so try to encourage your kids to spend some time on the toilet at the same time each day. We also know that the colon loves fluid (hot especially), hot food, and exercise! So, a good bowel routine would look like this:

“To help Mary’s bathroom habits, Mom started waking Mary up 30 minutes earlier. Mary starts her day with a warm bowl of oatmeal, then plays with her pet dog.  After they play, Mary heads straight to the bathroom to have a BM.”

Yes, building a routine takes some extra time–but it is well worth it to prevent constipation in your kiddos!

5. Encourage proper toilet positioning

Yes, there is a right way to sit on the toilet. For children, most toilets are too tall and this makes it difficult for them to relax the muscles around the anal canal to help them poop without pushing hard. Kids will compensate by straining, but over time this can be very detrimental to their pelvic health. To help them out, get a small stool to go in front of your toilet seat which will help encourage them to fully relax their muscles. Encourage them to lean forward and relax on their knees. This will help straighten out the rectum to encourage easy emptying.

Image

Then, and most importantly, make sure they have time. Encourage them to read a book or magazine and give their colon 5 uninterrupted minutes to “do its thing.” If they feel like they need to push, encourage them to breathe while they push to avoid the typical valsalva maneuver we often see. Learning this will help them so much both now and in the future! For more information, read this excellent post from my colleague, Jenna Sires, called “Are you Pooping Properly?

What have you tried to help encourage good bathroom habits for your kids? Feel free to comment below! Here’s to a healthy upcoming generation!

Written by: Jessica Powley, PT, DPT, WCS

Does Your Bladder Have the Thanksgiving Day Blues?

thanks 1

This time of year is known for delicious food, fabulous drinks, and quality time with family and friends. But with the yummy treats can come adverse effects. Some patients who struggle with urgency, frequency, and leaking of urine may notice worsening bladder habits. This may be due to the change in diet and fluid intake. So this holiday season, here are a few tips to help improve your bladder health:

  • Drink plenty of water!
  • Remember that there are certain drinks and food items that may irritate the bladder. These include alcoholic beverages (triple whammy- diuretic, irritant, and muscle relaxer), caffeine, carbonated beverages, artificial sweeteners (Splenda, Equal, etc.), tea, spicy foods, and some citrus fruits.
  • Avoid constipation by utilizing proper toilet positioning (www.squattypotty.com), staying hydrated, and eating ample fiber.
  • Try to avoid those “just in case” voids. It’s easy to get into the bad habit of going pee before you leave the house or whenever you see a vacant commode, but this is just reinforcing poor bladder behavior and decreases the storage capacity of bladder.

Hope these tips are helpful and feel free to leave a comment with some other bladder or bowel health tips!

Written by: Jenna Sires PT, DPT

%d bloggers like this: