Pelvic Floor Therapy – Bladder Health, Hygiene, and Habits

Bladder function. This may be something we have not thought of since we were potty training as toddlers.  We are born without the awareness that we can use muscles to stop the flow of urine and must be taught through potty training, but sometimes we still have issues maintaining proper bladder function later in life.

As the bladder fills with urine, the walls of the bladder, namely the detrusor muscle, stretch. As soon as the bladder is full, the pelvic floor muscles relax, and the detrusor muscle contract the walls of the bladder, pushing the urine out.

Once we are older and learn how to sense when we need to use the bathroom, we have trained our brain to override information.

  1. As the bladder fills and the walls stretch, a message is sent to your brain. You have a sudden desire to go to the bathroom typically when the bladder is filled around 150-200mL (takes about 3 hours to fill the whole bladder which is about 400-600mL)
    1. Most people can and should delay the voiding after this first signal.
    2. The internal sphincter and pelvic floor muscles are contracted.
  1. Once the bladder is full, your brain receives the signal to void
    1. Voiding is postponed by inhibiting the contraction of the bladder muscle (detrusor) by activating the pelvic floor muscles closing the sphincters.
  2. Once in the bathroom and ready to void:
    1. Pelvic floor muscles relax, and the bladder wall muscle (detrusor) contracts allowing the bladder to empty fully.
    1. “Just-in-case” peeing: not allowing your bladder to fill enough, then you are teaching your brain and body to never fill the bladder fully and the reflex loop can get altered which can lead to incontinence
    2. Semi-squatting over the toilet: this never allows your pelvic floor to fully relax, causing your bladder to not fully empty which can lead to UTIs- ALWAYS SIT!
      1. Wipe off the seat first, or use the barrier, but never squat!
    3. Pelvic floor exercises while voiding: this can cause a disruption in the emptying of your bladder as well which can lead to the bladder not fully emptying.
      1. If you need a check on how you are performing your exercise you are allowed to stop you flow of urine 1x every couple months, but not on a regular basis.
    4. Straining and trying to push out the urine
      1. This also disrupts the relationship between the contraction of the detrusor muscle and the relaxation of the pelvic floor if pushing to void urine which again does not allow to bladder to empty fully
    5. Dehydration
    6. Fear of using public toilets
  2. Healthy bladder habits
    1. Void 5-8 times in a 24 hour period
    2. Interval between each void are about 3-4 or 2-5 hours
    3. Less than 1 void during the night
    4. No just-in-case peeing


If you are having incontinence problems or feel that you need some bladder retraining tips, schedule a free consultation with our pelvic floor therapist, Hillary Jackson, DPT, and she will assist you in returning to optimal bladder health.


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