10 Tips for a Healthy Bladder, According to Pelvic Floor Physical Therapists

Truth: You kind of ignore your bladder. You brush and floss your teeth every day to keep them clean and healthy. You take a calcium supplement for your bones and eat veggies for your heart. And your skin — well, that one probably gets your full love and attention. But the organ that stores your urine doesn’t really get much thought — that is, until it gives you trouble. Maybe you start to leak a little when you sneeze or cough. Maybe an urge to pee comes on so strong and suddenly that you can’t quite make it to the bathroom in time. If a day of reckoning with your bladder arrives, you are likely in good company. In a room crowded with women of all ages and in different life stages, more than half are experiencing urinary symptoms. That’s right: Bladder control problems are very common. But there are many simple and effective strategies to help prevent and reduce urinary symptoms. Read on to learn the signs and causes of common bladder problems, and steps you can take to maintain a healthy bladder.

Symptoms of Bladder Control Problems

Bladder control problems are conditions that can affect the way you store or release urine. They can be a small annoyance or disruptive enough to impact your daily routine. Common bladder conditions include urinary urgency and frequency (also known as overactive bladder) and different types of urinary incontinence, including stress incontinence (urine leakage due to stress or pressure on the bladder such as when coughing or laughing), urge incontinence (leaking with sudden and intense urges to urinate), overflow incontinence (leaking due to incomplete bladder emptying), and mixed incontinence (a combination of more than one type). Some signs of these bladder problems may include:

• Having a strong and urgent urge to urinate that’s difficult to control

• Needing to pee more frequently than normal (e.g., more than every two to three hours)

• Urine leakage

• Being unable to reach the toilet in time

• Having trouble emptying your bladder

What Causes Bladder Control Problems?

Bladder control problems are often due to issues with your bladder or your bladder nerves, but they can also be linked to other parts of your urinary system, including your kidneys, ureters, and urethra. Bladder symptoms can also be related to issues with your pelvic floor.

The pelvic floor is a group of muscles and tissues that stretch between your pubic bone in the front and your tailbone in the back. Like the foundation of a house, your pelvic floor supports structures above it, like your abdominal and reproductive organs. Your bladder sits on top of your pelvic floor, and the two are connected by fascia (connective tissue). Pelvic floor muscles need to relax to allow urine to flow out of the bladder. “When pelvic floor muscles are too tight, they can become less flexible and impair normal bladder function,” explains Kandis Daroski, PT, DPT, a Hinge Health pelvic floor physical therapist. Tense pelvic floor muscles may make it hard to start a stream of urine or empty your bladder completely. 

Weak or damaged pelvic floor muscles also affect your bladder and urethra, which may contribute to different types of urinary incontinence. Pelvic organ prolapse (when one or more pelvic organs slip down, press into, or bulge out of the vagina) can put pressure on your bladder and urethra and make it more difficult to empty your bladder. 

Urinary tract infections and interstitial cystitis can be risk factors for bladder control issues, bladder irritation, and sometimes pelvic pain. See your doctor if you have pain, burning or stinging with urination, need to pee often and urgently, have difficulty starting your urine stream, or blood in your urine.

Rarely, bladder cancer can be the cause of bladder control problems. See your healthcare provider if you’re unsure of the cause of your bladder issues.  

10 Tips and Habits to Keep Your Bladder Healthy

While you can’t control everything that affects your bladder, here are everyday tips and exercises to help keep your bladder healthy and improve symptoms:  

1. Practice healthy peeing habits. 

It’s normal to urinate once every two to four hours. Delaying your restroom break for too long can, over time, weaken your bladder muscles and make a urinary tract infection (UTI) more likely. When you do go, try not to push to empty your bladder — that extra oomph to get every last drop can put stress on your pelvic floor, which may contribute to bladder symptoms, like leaking.

Also important: Avoid hovering when you urinate. This prevents your pelvic floor muscles from fully relaxing, which can lead to a disrupted stream or incomplete emptying of your bladder. 

Instead, when you gotta go:

• Sit fully on the toilet with your feet planted on the floor.

• Take a deep breath in and out, relax your pelvic floor, and let your urine stream flow naturally.  

• Try making a “hula-hoop” or circular motion with your hips, if needed, to help fully empty your bladder.

• Wipe from front to back, which helps keep gut bacteria from entering the urethra. (This is especially important after a bowel movement.)

2. Skip the ‘just-in-case’ pit stop. 

Here’s why: Your brain, bladder, and pelvic floor communicate constantly to coordinate urination. As your bladder fills up, it sends a signal to your brain. When you sit on the toilet, your brain tells your pelvic floor muscles to relax and your bladder to contract to release urine. This reflex loop can get disrupted if you, say, make an extra trip to the bathroom before a long car ride just in case. If you don’t really have to pee at that moment, this can confuse your brain because it didn’t send your bladder the usual “it’s time to go” signal. Your brain thinks it missed sending the signal and might start sending more intense signals to compensate, which may not always match up with how full your bladder is. This can lead to bladder dysfunction, including urinary urgency and overactive bladder syndrome (OAB). The good news: You can help reset signals between your brain and bladder to better control urges and frequent urination with behavioral techniques, such as urge suppression and bladder retraining. Check out our urinary urgency and frequency resource for more information.

3. Do pelvic floor exercises.

Your pelvic floor muscles support your bladder. Exercises to lengthen and strengthen these muscles can help improve bladder control and reduce bladder leaks. 

“Exercise therapy can also help ease bladder irritation and improve the strength and flexibility of muscles that connect to or support the pelvic floor muscles,” adds Dr. Daroski. Check out our resources on how to strengthen and relax pelvic floor muscles. 

4. Keep Kegels out of the bathroom. 

If you’ve heard of Kegel exercises, you know they can help strengthen pelvic floor muscles, which helps treat bladder problems. But if you heard you should practice Kegels when you pee — that piece of advice is actually incorrect. Doing so can disrupt your natural bladder reflex and can even make it more difficult to empty your bladder. To learn how and when to do Kegel exercises and when to avoid them, check out our Kegel exercises resource.

5. Stay hydrated. 

If you frequently feel the urge to pee or leak a little when you laugh, simply drinking less water would seem like a smart solution. Except it’s not. Limiting your fluid intake can actually make bladder problems worse. When you’re dehydrated, your urine becomes more concentrated with waste products, which can irritate the lining of your bladder and increase that gotta-go feeling. Plus, dehydration can play a role in bladder infections and contributes to constipation. Stool in your colon can put extra pressure on the bladder. To get the enough water, follow these tips:

• Aim to drink half your body weight in ounces of water. That means a person who weighs 150 pounds should shoot for 75 ounces a day. You may need more or less depending on the weather, your activity level, medications, or medical conditions.

• Space out your water intake. Drinking too much too quickly can put stress on your kidneys and bladder. Instead, try to drink one glass of water or healthy liquid every two to three hours, and only drink more after you empty your bladder (also every two to three hours).

• Consider the color of your urine. It should be pale yellow (kind of like lemonade). If yours is more golden or dark yellow, that’s a clue you need more water.

6. Stop drinking two hours before bed.

If you need a gulp to swallow a nighttime medication, that’s fine. But try not to drink any more than that. Limiting fluid intake before bed can help manage a condition called nocturia, which is when you wake up more than once during the night to pee.

7. Be conscious of your diet. 

For some people, coffee and alcohol can irritate your bladder and trigger symptoms. For others, it can be tomato sauce, citrus fruits, or chocolate. Certain foods and beverages have diuretic properties, which means they stimulate your kidneys and make you urinate more. Others are acidic, which can irritate the lining of your bladder and increase your urge to pee. If you suspect something in your diet is irritating your bladder, reducing your intake may help. You can also try having a small glass of water along with the food or beverage culprit to help dilute the irritant before it reaches your bladder.  

8. Urinate after sex.

Sexual activity can move bacteria from the bowel or vaginal cavity to the urethral opening. Urinating shortly after sex can help flush bacteria out of your urinary tract and prevent UTIs. UTIs can lead to a number of bladder symptoms, including urinary frequency and urgency, and burning or stinging with urination.

9. Maintain a healthy weight. 

If you are overweight or obese, you may be at higher risk for urinary incontinence. Following a healthy diet and regular physical activity can help you maintain a healthy weight.

10. Ask a pelvic floor physical therapist about your bladder health. 

Muscles are designed to contract and relax. For a healthy pelvic floor, you need to be able to tighten (contract) the muscles and fully release (relax) them so they function properly. When pelvic floor muscles are constantly contracted, it can irritate your bladder. Pelvic floor physical therapists (PTs) can provide relaxation exercises to help stretch and relax tense muscles to relieve symptoms.  For example, diaphragmatic breathing (also known as belly breathing) lengthens pelvic floor muscles so they remain strong and flexible. It also helps relax the entire nervous system. 

“The bladder has many nerves that travel to it and can be affected by emotions, such as stress and anxiety. Slow, deep breathing can help calm those nerves, which may help reduce bladder irritation and urgency,” Dr. Daroski explains. 

Talk to a pelvic floor physical therapist for help with your bladder symptoms. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

PT Tip: There Are Lots of Ways to Love Your Bladder

“Whether it’s staying hydrated, ditching those ‘just-in-case’ pees, or performing routine pelvic floor exercises, each time you practice one of these habits, your bladder will thank you,” says Dr. Daroski. “You’re accustomed to care routines for your skin, hair, and teeth. Why not give your bladder the same attention,” she adds.  

Learn More About Hinge Health for Pelvic Symptom Relief

If you have pelvic pain or symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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