A key part of pelvic health physical therapy is learning about your body. We spend a lot of time talking about bladder and digestive health because small changes can make a big difference. Let’s go over a few simple tips you can start using right away to keep your bladder healthy!
A good estimate is to take your body weight and divide it by 2. This equals the ounces of water you should aim to drink per day. Alcohol doesn’t count! Ideally, 2/3 of the liquid you drink is plain water. Your urine should be a light yellow (like lemonade) when you’re properly hydrated.
When you’re dehydrated, the concentrated urine irritates the bladder lining. This can make you more likely to leak urine and increase the need to urinate. If you’re worried about bladder control, it is natural to drink less but dehydration will only irritate and stress the bladder, worsening the problem.
Not only does downing a lot of water increase the risk of leaking and overloading the bladder, it also dilutes your body of electrolytes. There should be some color to your urine. Sipping water regularly throughout the day (rather than chugging all at once) is an excellent strategy to stay hydrated!
4-7 times per day is normal for the average person. Generally, if you’re under 65 years old, you should not have to wake up to urinate during the night. 1-2 times per night is normal for those over the age of 65. Stopping liquid consumption 2 hours before you go to bed helps to reduce night time bathroom trips.
Going to the bathroom when you don’t have an urge can disrupt the normal reflexes around your bladder. When the first urge to pee hits, your bladder is about half full— containing around 1 cup of urine. The stretch of the bladder being half full triggers the urge. When you consistently go before any urge occurs, your body can become oversensitive to the feeling of urine in the bladder, making urges more frequent and urgent.
You should be going to the bathroom by your second urge. The bladder is usually 2/3 of the way full at this point. Ignoring the urge to empty the bladder for hours can overextend the bladder. This can lead to incomplete emptying of the bladder over time.
When you hover over the toilet, the pelvic floor is unable to completely relax. This increases the challenge on the bladder and pelvic floor. When you urinate, your pelvic floor is meant to relax, moving out of the way to allow the flow of urine out. Sitting down on the toilet or deep squatting (like over a hole in the ground) allows the pelvic floor to relax. Using a seat cover or toilet paper to sit on is much preferred to hovering.
If it feels like you’re actively pushing the urine out of your body when you go, you might be power peeing. Try taking some deep breaths and relaxing as you pee. Pushing down and straining can stretch your pelvic floor muscles and increase pressure on the ligaments supporting your pelvic organs. This can lead to weakness, leaking, and even prolapse.
Leaking or urinary incontinence is common, but it is not normal. Urinating more than 8 times per day, or fewer than 3 times, is also outside the expected range. Likewise, feeling sudden urgency or needing to rush to the bathroom every time is not typical. These are all signs of possible pelvic floor dysfunction.
The good news is that these pelvic health issues are treatable with physical therapy. At Aware Health, every treatment session is led by a licensed Doctor of Physical Therapy to ensure you receive expert, personalized care.
Pain before, during, or after urination, blood in the urine, strong smelling urine, and cloudy urine should not be ignored—please see a physician.
References:
1. Karhu E, Gurland B, Barten J, Miller L, Yi G, Shen S, Neshatian L. Telehealth is effective for pelvic health physical therapy. Neurogastroenterol Motil. 2024 Aug;36(8):e14844. doi: 10.1111/nmo.14844. Epub 2024 Jun 14. PMID: 38873829.
2. Coad B, Ramani S, Michel L, Peled A, Morgan J, Hartnett J, Chudnoff S, Andikyan V. Effectiveness of telehealth physical therapy for patients with pelvic floor disorders in a community hospital setting. Arch Gynecol Obstet. 2023 Aug;308(2):661-665. doi: 10.1007/s00404-023-07078-6. Epub 2023 Jun 3. PMID: 37268794
3. https://www.nia.nih.gov/health/bladder-health-and-incontinence/15-tips-keep-your-bladder-healthy
4. https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/in-depth/bladder-control-problem/art-20046597